Treatment begins with a cold cycle where skin temperature is gradually lowered to between +5° C and -5° C, the point at which tissue freezes. This low temperature destroys the eccrine glands through ischemia and crystallization of extracellular fluid, leading to cell leakage and wall rupture. During the heat cycle, the reperfusion of previously ischemic tissues causes free radical formation which further damages cells and ultimately reduces the glands’ rapid rate of sweat production.