3 The procedure
3.1 Transcutaneous microwave ablation for primary severe axillary hyperhidrosis is done under local anaesthesia using a machine with a hand-piece that emits microwaves. After numbing the underarm with several injections of local anaesthesia, the hand-piece is placed on the area where the sweat glands are and microwaves are applied, with the intention of ablating the sweat glands. The machine has a cooling system that prevents damage to the superficial skin layers and a vacuum system that lifts the underlying skin to help isolate the target tissue from underlying structures. The procedure takes about 1 hour; patients typically have a second treatment session about 3 months later to get the greatest benefit. Patients may need to take oral analgesics and apply ice packs to reduce swelling of the treated area for a few days after the procedure.