Center for

Center for Excessive Sweating
5225 Sheridan Drive
Williamsville, NY 14221
(716) 839-3638

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The Center for Excessive Sweating and the Buffalo Sabres

National Center of Excellence for Hyperhidrosis Treatment

The Center for Excessive Sweating
    A National Center of Excellence for Hyperhidrosis Treatment



News Flash - Dr. Hratch Karamanoukian and Dr. Raffy Karamanoukian have published a new book about the miraDry procedure. It is called the miraDry Procedure for Underarm Sweating. This is their 5th book about hyperhidrosis (see below).


Located in Williamsville, just outside Buffalo, NY, The Center for Excessive Sweating specializes in the treatment of hyperhidrosis (excessive sweating) and bromhidrosis (excessive odor related to sweating). We also have offices in East Amherst , NY and Clarence, NY as well offices in Santa Monica, CA and Beverly Hills, CA in conjunction with Dr. Raffy Karamanoukian, Dr. Karamanoukian's brother and partner. 

The Center for Excessive Sweating was established in 1999 and is the one and only comprehensive hyperhidrosis centers in the region and also one of the most comprehensive hyperhidrosis treatment centers in the U.S. We offer EVERY treatment option for hyperhidrosis including medical therapy (natural and prescription), topical (OTC and prescription), Botox, retrodermal suction curettage for underarm sweating, the NEW miraDry procedure for underarm sweating and the STITCH procedure (aka micro ETS or ETS), among others. Whereas there are doctors that provide one of these procedures (medical or topical), Dr. Karamanoukian provides EVERY treatment described for hyperhidrosis and will find one that suits your particular needs - whether it is hperhidrosis that only affects the underarms, or palms and feet, or craniofacial type involving the head and neck. A consultation will determine which is the best treatment option for your particular hyperhidrosis type.

We have evaluated and treated patients from every state in the U.S. except Alaska and over a dozen countries outside of the American Continent!

Not only do we offer medical therapies, we have also developed and clinically tested natural treatments for hyperhidrosis including the Hyperhidrosis Fighter.

Dr. Karamanoukian is one of the first half dozen physicians in the U.S. that is offering and performing the miraDry procedure, an FDA approved procedure that uses a novel microwave energy source to treat excessive underam sweating. A very mild vacuum draws underarm tissue into the miraDry handpiece where concurrent microwave energy and tissue cooling occur. It is an office procedure that has 'no downtime', minimal discomfort with most patients returning to their normal routine within 24 hours of the procedure. We are the only center withing a several hundered mile radius to provide the miraDry procedure to our patients. Primary care physicians, dermatologists and other specialists recognize our expertise and refer the vast majority of patients with hyperhidrosis to the Center for Excessive Sweating.

Dr. Karamanoukian has used his extensive clinical expertise in hyperhidrosis to write 4 books about hyperhidrosis and makes it available to his existing patients.

Dr. Karamanoukian's existing patients can request free copies of his books:

1. Craniofacial Hyperhidrosis - Treating Excessive Sweating of the Head and Neck - by Hratch L Karamanoukian and Raffy L Karamanoukian

2. Hyperhidrosis of the Underarms - by Hratch L Karamanoukian and Raffy L Karamanoukian

3. The Healthy Legs and Healthy Feet Guide to Hyperhidrosis - by Hratch L Karamanoukian and Raffy L Karamanoukian

4. Excessive Sweating of the Palms - by Hratch L Karamanoukian and Raffy L Karamanoukian

5. The miraDry Procedure for Underarm Sweating - by Hratch L Karamanoukian and Raffy L Karamanoukian

Hyperhidrosis is a condition that causes abnormal sweating of the head, face, scalp, underarms, palms and feet - in any combination. It may be associated with facial blushing that is beyond the normal emotional and physiological need.

Hyperhidrosis is a medical condition with untoward psychological consequences. The areas of the body affected may occur in any combination. It may start with the beginning of the day and be constant or intermittent. It may be due to emotional stress, and/or a  physiologic trigger. It is caused by a hyperactive sympathetic nervous system. Typically patients with hyperhidrosis sweat throughout the year, in cold and warm temeratures, indoors and outdoors.

It is not uncommon, in areas of the country such as the Northeast for patients to say that they go to an outdoor event such as a football game in December or January and still experience dripping sweat from their hands or underarms! Although the severity of sweating may be worse in the warmer months of the year, the presence or absence of sweating has nothing to do with the ambient temperature, as patients have been known to sweat during a blizzard or indoors in air conditioned settings. It is also not uncommon for patients to say that they drive with their windows open in winter months to help stop the excessive sweating! This is rarely effective.

Hyperhidrosis causes daily embarrassments and affects the quality of one's life. It also has an influence upon relationships and career choices. Friends, colleagues and relatives of affected individuals with hyperhidrosis usually fail to appreciate the impact that this condition can have on one's social life and work. Treatments can help eliminate excessive sweating and get you on your way to having dry hands, dry feet, dry underarms and stop the dreadful dripping sweat from your face and scalp !

A recent study done and published by a dermatology group looked at the quality of life (QOL) indicators for patients with hyperhidrosis compared to other skin conditions such as acne and psoriasis. They found that patients with hyperhidrosis had lower QOL indicators than patients with severe acne, rosacea or psoriasis. This means that hyperhidrosis can have a significant impact on one's social life or perception of quality of life.

  • Hyperhidrosis affects 1 to 3 % of the U.S. population 
  • Hyperhidrosis reduces Quality of Life (QOL) indicators in most patients
  • Bromhidrosis is an embarrasing condition

Dr. Karamanoukian, Director of The Center for Excessive Sweating, has treated several thousand patients since 1999 with all types of hyperhidrosis - from medical therapies, Botox, iontophoresis, suction curettage (retrodermal suction curettage) and micro ETS (sympathectomy, STITCH procedure). We have recenty added the miraDry procedure for underarm sweating (axillary hyperhidrosis).

Treatments at the Center for Excessive Sweating are multidisciplinary, as this is one of few centers in the U.S. where ALL treatments for hyperhidrosis are available as an option to patients with disabling hyperhidrosis of the head and neck, underarms, palms and feet - as well as atypical areas of hyerhidrosis, such as the back and groins. 

Dr. Hratch Karamanoukian has been performing the STITCH procedure (a less invasive approach to ETS) since 1999 and has performed ever 2,000 such procedures.  

Learn more about hyperhidrosis and how the Center for Excessive Sweating provides hyperhidrosis treatment through a combination of medical therapy, surgical intervention (STITCH procedure, micro ETS, retrodermal suction curettage), as well as alternative therapies such as Iontopheresis and Botox injections.

Watch a clip of Botox injections for hyperhidrosis of the palms by Dr. Karamanoukian: 

Read Dr. Karamanoukian's book about hyperhidrosis of the palms - contact Dr. Karamanoukian for a free copy


image of the STITCH procedure with the sympathetic nerve trunk shown


Retrodermal Suction Curettage (RSC) procedure for Axillary Hyperhidrosis

To schedule an appointment, contact Dr. Karamanoukian at The Center for Excessive Sweating, a National Center of Excellence for Hyperhidrosis Treatment by email or by phone at (716) 839-3638. A full evaluation and consultation will be done, which in the vast majority of cases is covered by medical insurance. Once treatments are recommended, authorization will be requested from your insurance company to see if the recommended treatment(s) are covered.

To schedule retrograde suction curettage (RSC procedure) in our Califormia offices, call Dr. Raffy Karamanoukian @ 310-998-5533 or go to

For the miraDry procedure for axillary hyperhidrosis in the Buffalo Niagara area, contact Dr Karamanoukian @ 716-839-3638. Other pioneering physicians who have incorporated the miraDry procedure in their practices include doctors in California and Texas. According to Dr. Ava Shamban of Beverly Hills, CA who demonstrated the miraDry procedure on The Doctors TV SHow, "the miraDry procedure is absolutely "game changing for patients with excessive underarm sweating and excessive underarm odor from sweaintg". Dr. Michael Maris of Dallas, Texas sums it up best when he stated that "it is not often that we get a procedure [miraDry] which appeas to a large segment of the population. This type of thing does not happen very often". Dr. Raffy Karamanoukian has also appeared on The Doctors TV Show to highlight other cosmetic procedures.

image showing Dr. Karamanoukian's latest book (in print) - the miraDry Procedure for Underarm Sweating - (Publication date 6-1-2012)

Watch a clip of the miraDry procedure on The Doctors TV Show with Dr. Ava Shamban:

The miraDry procedure at the Center for Excessive Sweating and is lso offered to Canadian patients. Patients have come from Toronto, Fort Erie, Mississauga, Saint Catherines and as far away as Montreal and Vancouver.


image of the miraDry procedure - the device, located at the top of the cartoon image, has a suction apparatus which allows axillary tissue to be drawn into the device for delivery of microwave energy and subsequent cooling.

The miraDry procedure - Williamsville, Clarence, East Amherst, Buffalo, Niagara, Canada, Toronto patients are welcome to our facilities.

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