Treating excessive underarm sweating: RF microneedling for hyperhidrosis
Anyone who constantly has wet patches under the arms, even though it is neither hot nor time for exercise, may be suffering from hyperhidrosis. Excessive sweating is common and can be treated. Alongside antiperspirants, injections and surgery, RF microneedling is used for this, a procedure that reaches the sweat glands with heat directly at depth.
Here you will find out when a doctor should investigate the cause, how radiofrequency acts on the glands, how many sessions are usual, how long the effect lasts and where the limits lie, for example on the hands and feet. The matching SIACSKIN device is the EUPHEUS M8, which lists hyperhidrosis of the underarms as an application.
What is hyperhidrosis, and when is underarm sweating considered excessive?
Hyperhidrosis means that the body sweats markedly more than it needs for cooling, regardless of heat or exertion. Typical of the underarms: wet patches even at rest and in the cold, on both sides, onset usually in youth, but dryness during sleep. The sweat glands themselves are structurally normal; they are simply overstimulated by the nervous system. Sweating is considered excessive when it restricts daily life, for example in the choice of clothing, at work or in contact with others. More people are affected than you might think; many simply do not talk about it.
The diagnosis is made by a doctor. Once it is established that the underarms are the problem, RF microneedling is an option: the EUPHEUS M8 explicitly lists underarm hyperhidrosis as an application.
When should a doctor investigate the cause of excessive sweating?
Excessive sweating should always be assessed by a doctor when it is new, affects the whole body or occurs at night. The common form in the underarms, hands and feet begins early in life and has no identifiable cause. Sweating that only starts in adulthood, affects only one side or is accompanied by weight loss, palpitations or fever, on the other hand, may be the consequence of another illness or a medication. In that case the cause is treated first, not the gland. It is also worth consulting a doctor in the case of diabetes, during the menopause and in pregnancy.
Only once this has been clarified does local treatment of the underarms make sense. The EUPHEUS M8, whose RF microneedling targets the sweat glands in the underarm, is intended for this.
What treatments are there for excessive underarm sweating, and where does RF microneedling stand?
Treatment usually follows a stepped approach: first antiperspirants, then injections or energy-based procedures, finally surgery. Antiperspirants with aluminium salts close the outlets of the glands and are enough for mild cases. Botulinum toxin injections block the nerve signal for a few months. Surgically, the glands are suctioned out or excised, which is effective but means scars and downtime. RF microneedling sits in between: it damages the glands with heat, manages without an incision and usually works for longer than an injection, but has a shorter track record. Tablets that reduce sweating across the whole body are prescribed only by a doctor.
The EUPHEUS M8 lists underarm hyperhidrosis as an application. With bipolar radiofrequency of 4 MHz and needle depths up to 7 mm, it reaches the layer where the glands sit.
How does the heat in RF microneedling act on the sweat glands?
The radiofrequency heats the tissue around the needle tips so strongly that some of the sweat glands are damaged or destroyed. The gland coils lie at the junction between the dermis and the subcutaneous fat. There the needles deliver the current, the tissue warms through its electrical resistance, and small coagulation zones form. Glands in these zones stop working. According to current knowledge, destroyed glands do not grow back, whereas glands that are only partially damaged can recover. Because the heat is placed in a pinpoint fashion, the tissue in between is largely preserved. With every pass and every session, further glands are reached.
The EUPHEUS M8 operates in bipolar mode at 4 MHz and regulates the power from 10 to 400 W. Its needle depth can be set in 0.1 mm steps up to 7 mm.
RF microneedling or botulinum injections for hyperhidrosis: what is the difference?
Botulinum toxin switches the sweat glands off temporarily, whereas RF microneedling reduces their number. The injection blocks the chemical messenger that activates the gland. This works quickly and reliably, but wears off after a few months, often after about half a year, and then has to be repeated. The radiofrequency damages the glands themselves, the effect builds up over 2 to 3 sessions and usually lasts longer, but there is less long-term data than for the injection. On the other hand, the treatment is more involved, the underarm is tender for a few days, and it rarely becomes completely dry. Some practices combine both.
Injections belong in the hands of a doctor. For radiofrequency, SIACSKIN offers the EUPHEUS M8, which lists underarm hyperhidrosis as an application and, with needle depths up to 7 mm, reaches the gland layer.
How many RF microneedling sessions do you need for underarm sweating, and when do you notice a difference?
The usual course is 2 to 3 sessions at intervals of 4 to 6 weeks, and many people notice an initial improvement after just the first appointment. In the days afterwards, the underarm can briefly seem drier or wetter than usual because of the swelling, which does not yet mean anything. What is meaningful is the situation after about 4 weeks. Each further session reaches glands that lay between the needle points in the previous pass. If the result is not sufficient after 3 appointments, a fourth session is possible. Treating both underarms takes about 30 minutes, excluding numbing time.
With the EUPHEUS M8, needle depth and power can be adjusted from session to session, depending on how the underarm reacted to the first appointment.
How much does sweating decrease after RF microneedling, and how long does the effect last?
A marked reduction is realistic, not a completely dry underarm, and the effect can last many months to over a year. Many people treated report that stains on clothing become less frequent and an ordinary deodorant is enough again. How strong the effect is depends on the starting point, the number of sessions and the depth reached, and some respond only a little. Because not all glands are reached and the remaining ones keep working, sweating may increase again over time. A top-up is then possible.
For practices and studios, this means: advise openly, promise no particular result and schedule a follow-up appointment after about 3 months. With the EUPHEUS M8, the top-up is a single appointment using the settings that proved effective during the course.
Does RF microneedling in the underarm hurt, and how is the area numbed?
Without anaesthesia the treatment in the underarm would be very unpleasant, but with good anaesthesia it is tolerable. The skin there is thin and sensitive, and treatment is deeper and uses more energy than on the face. A numbing cream usually takes 45 to 60 minutes to work under occlusive film here, longer than on the face. In medical practices, the underarm is often also infiltrated with a local anaesthetic, in which case hardly anything is felt. With cream alone, pressure and a brief sensation of heat remain with each pulse. Cooling between passes takes the heat away.
For this, the EUPHEUS M8 comes with a Cold Hammer. The KYROMASTER cools the skin with cold air before, during and after the session and is suitable for RF microneedling.
How does underarm treatment with RF microneedling work, step by step?
An appointment takes around 90 minutes including anaesthesia, with the actual treatment of both underarms about 30 minutes. You arrive shaved and without deodorant. Often an iodine-starch test is first used to show where the underarm sweats most: these areas turn dark and are marked. After anaesthesia and disinfection, the handpiece is placed field by field, usually in 2 passes at different depths. Afterwards the skin is cooled and a soothing care product is applied. You can move your arm normally straight away, but you refrain from exercise for a few days.
The EUPHEUS M8 has gold-plated needle heads with 12, 24 and 40 pins, and the depth is set in 0.1 mm steps. Photos of the iodine-starch test before and after the course document the result.
What downtime and side effects does RF microneedling in the underarm have?
The downtime is short: redness usually fades within 1 to 3 days, and swelling and tenderness in the underarm often last 3 to 7 days. You can usually work the next day. Small bruises, pinpoint crusts and a feeling like sore muscles are also common. Occasionally, palpable nodules or slight numbness remain for a few weeks, and both generally resolve. Inflammation or darker patches occur rarely. If pain, redness or swelling increase again after a few days, it should be seen by a doctor. Avoid exercise, sauna and swimming pools for 3 to 5 days, and deodorant and shaving for 2 to 3 days.
The EUPHEUS M8 cools the skin directly after the session with the Cold Hammer. Which skincare is suitable afterwards is set out in the aftercare guide.
Does RF microneedling also help with underarm body odour?
Yes, often the odour also decreases along with the amount of sweat, because the heat reaches both types of gland in the underarm. Odour does not arise from the watery sweat but from the secretion of the apocrine (scent) glands, which bacteria on the skin break down. These apocrine glands lie at a similar depth to the sweat glands, in part somewhat deeper in the upper subcutaneous fat. If they are reached as well, less secretion is produced. In addition, bacteria find poorer conditions in a drier underarm. Strong body odour without much sweat can have other causes and should be investigated by a doctor.
With the EUPHEUS M8, the needle depth can be selected up to 7 mm in 0.1 mm steps, so that the more deeply seated glands can also be reached.
Can excessive sweating on the hands, feet or face be treated with RF microneedling?
No, RF microneedling is not an established treatment for sweating on the hands, feet and face. In the underarm, the glands lie in a soft cushion beneath which enough distance from nerves and vessels remains. On the palms and soles, the skin is thick and firm, and directly beneath it run tendons, nerves and vessels that are important for sensation and grip. Deep heat would be risky there. For these areas there are other routes: tap water iontophoresis, antiperspirants, injections or medication, in each case after medical advice.
The EUPHEUS M8, too, lists only underarm hyperhidrosis as an application. On the face and body, it is used for tightening, scars and pores, not against sweating.
How deep do the needles have to penetrate the underarm for hyperhidrosis?
In the underarm, treatment is usually carried out at a needle depth of 2 to 4 mm, often in 2 passes at different depths. The sweat glands sit at the junction between the dermis and the subcutaneous fat, and how deep that is depends on skin thickness: in slim people the layer lies shallower, in people with a heavier build deeper. A shallow pass reaches the upper glands, a deeper one those lying in the fat. Energy placed too shallow puts strain on the epidermis and misses the target, while energy placed too deep is lost in the fat.
The EUPHEUS M8 sets the depth in 0.1 mm steps up to 7 mm and regulates the power from 10 to 400 W. This gives enough room to adjust the setting to each underarm.
Do you sweat more on other parts of the body after the underarms are treated?
As a rule, no: increased sweating in other places is known mainly after surgical severing of the nerve trunk, not after local treatment of the underarm. In that operation, the nerve that controls sweating is switched off, and the body often compensates on the back, abdomen or legs. RF microneedling does not intervene in the nerve control; it only reduces the number of glands in the treated area. The underarms also make up only a small part of the body surface, and heat regulation is preserved. In isolated cases, studies have described slight, temporary increased sweating in other places, and some people simply notice it more consciously afterwards.
The EUPHEUS M8 treats the marked area of the underarm specifically, with the needle depth set in 0.1 mm steps.
For which practice or studio is hyperhidrosis treatment with RF microneedling worthwhile?
It is worthwhile above all for practices and studios that already offer RF microneedling for tightening and scars, because the device is the same. Hyperhidrosis brings clients who are actively seeking treatment, are under considerable distress and would otherwise need an injection every few months. Demand exists all year round, with a peak before summer. What is needed are a prior medical assessment, effective anaesthesia and realistic advice. Who is allowed to perform which treatment is regulated differently depending on the country.
The EUPHEUS M8 covers tightening, acne scars, stretch marks, pores and underarm hyperhidrosis with one device. Replacement needles are available in the SIACSKIN shop. The price calculator shows how the treatment pays off.
