Maybe you’ve seen the miraDry videos in your social media feed and wondered if it could help your Hidradenitis Suppurativa (HS).  According to the company website, the miraDry System uses thermal energy that targets and eliminates the sweat and odor glands in your underarm. Once those glands are eliminated, they do not grow back.

In theory, it certainly seems like it would help; many patients report that sweating is a trigger for HS, so if miraDry can reduce sweating, can it in turn reduce flare-ups?

Unfortunately, the answer seems to be no – and in fact, it may actually make HS symptoms worse.

In a small study conducted in the Netherlands and published in the Journal of American Academy of Dermatology in 2018, eight HS patients were treated in only one of their underarms, and treatment results were compared both to the other side of the body and the severity score of the treated underarm before treatment began.   Of the eight patients that participated, 5 had a worsening of their symptoms.  Two patients saw improvement, and the last patient dropped out of the study because her symptoms had worsened so much that she couldn’t continue.

Why didn’t this work?  The study authors provided this possible explanation:

Because the miraDry device targets the dermal zone rather than a particular structure, its nonselectivity might have resulted in the poor study outcomes. Accordingly, we argue that the microwave energy is able to rupture pre-existing and subclinical or microscopic HS precursor lesions (cysts), subsequently resulting in an intense inflammatory response beyond the initially visible lesions.

Although the trial was completed in only 8 patients, our findings indicate that microwave ablation using the miraDry device has no apparent clinical benefit and could even be harmful in patients with mild HS. Commercial miraDry clinics in the Netherlands also observed a few cases of flaring of the disease in HS patients (A. Roopram and W. Venema, personal communication, May 2018). Taken together, we question the utility of microwave ablative therapy in patients with HS in clinical practice.

This means that the miraDRY system doesn’t target specific structures in our skin (in the way that laser hair removal specifically targets a hair follicle) and could potentially be creating an inflammatory response through the rupture or damage of HS affected skin.

The full text of the study is available here.