Botox is approved for the treatment of hyperhidrosis in the United States. It is injected intradermally to treat hyperhidrosis and inhibits the release of acetylcholine at the neuromuscular junction and from the sympathetic nerves that innervate eccrine sweat glands. When performed correctly, patients have little pain or discomfort. Proudly at MSI, a newer bipolar RF device are effective in reducing the amount of sweating. The new bipolar microneedles radiofrequency device can destroy the eccrine glands by thermolysis at the interface of the deep dermis and subcutis while minimizing damage to the surrounding tissue. Fractional radiofrequency treatment appears to be a new safe and effective treatment alternative for mild to moderate primary axillary hyperhidrosis. Prof Moawad suggests repeated sessions of fractional radiofrequency to achieve a complete response. When medical treatment fails, he will offer ultrasound and power-assisted liposuction of armpits to gently and thoroughly remove sweat glands.