High-Intensity Radiofrequency Microneedling Device Effective for Hyperhidrosis

The HIFRF device offers versatility to patients who have been seeking a treatment option for PAH.

The use of high-intensity focused fractional radiofrequency (HIFRF) microneedling in the treatment of patients with primary axillary hyperhidrosis (PAH) is effective and well tolerated, according to study data published in the Journal of Drugs in Dermatology.

Several treatment options are available for PAH, all providing varying efficacy. HIFRF microneedling has been approved by the US Food and Drug Administration (FDA) for the treatment of facial wrinkles. The system is designed with an insulating technology that is considered safe for use in patients with all skin types and controls the location of the energy delivery within the skin.

In this analysis, the HIFRF device was offered to patients who presented with hyperhidrosis and severity scores of 3 or 4 on the Hyperhidrosis Disease Severity Scale (HDSS), as well as to patients in whom sweating was a concern. Approximately 45 patients from 3 dermatology clinics (mean age, 29; range, 18 to 68) have been treated with the HIFRF device. Most of the patients had failed antiperspirant, anticholinergic, and neuromodulator treatments; none had undergone any prior invasive therapies. Participants discontinued the use of antiperspirants 1 to 2 weeks prior to treatment and had cleanly shaved axillae.

Starch iodine testing was performed on each axilla in order to outline the areas of excessive sweating and pretreatment anesthesia was administered. The

HIFRF treatment protocol included a multi-treatment series, with between 2 and 4 treatments recommended. The first and second treatments were usually provided 1 month apart, then patients waited 3 to 6 months before receiving additional treatments.

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The HIFRF treatments were well tolerated. A marked reduction in patients’ pre- to post-treatment HDSS scores was reported, decreasing from an average baseline score of 3.2 to an average of 1.6 following the use of HIFRF treatments. Patients reported a difference in symptoms of hyperhidrosis at 1 day to 1 week following treatment. Overall, patients reported a 75% to 80% improvement in sweating in the treatment areas, with a high level of treatment satisfaction. Quality-of-life improvements were reported by the participants as well.

The investigators concluded that the HIFRF device offers versatility to patients who have been seeking a treatment option for PAH. HIFRF microneedling is well tolerated, with only mild or minimal anticipated treatment effects reported, which are of short duration.


Chilukuri S, Robb CW, Weiner SF, Grossman J. Primary axillary hyperhidrosis treatment using high intensity focused fractional radiofrequency microneedling. J Drugs Dermatol. 2018;17(7):745-748.