A systematic review of microwave-based therapy for axillary hyperhidrosis

Hsu, Tzu-Herng; Chen, Yu‐Tsung; Tu, Yu–Kang; Li, Chien-Nien

doi:10.1080/14764172.2017.1303168

Cited by 22 publications

(24 citation statements)

References 20 publications

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“…In both this and another study, four of 81 subjects (4.9%) and one of 31 (3.2%) achieved full sweat reduction with one session using low energy level 1 or 3, respectively [10,11]. Two sessions are usually scheduled 3 months apart with severe PAH using a low energy level [10,11,[13][14][15][16][17][18]. In these previous studies, the percentage of responders with a 2-point drop in HDSS score were stable from 1 month (67%) to 12 months (38-55%) [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…Microwave treatment for PAH was approved by the United States Food and Drug Administration (FDA) in 2011. It is noninvasive and effective with less scarring and longer acting than other treatments [9][10][11][12][13][14][15][16][17][18]. Microwave devices focus heat at the interface between skin and subcutaneous tissue and have been shown to cause thermolysis of sweat glands in an experiment using apocrine glands of a porcine skin model [9].…”

Section: Introductionmentioning

confidence: 99%

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Clinical and histological evaluation of a single high energy microwave treatment for primary axillary hyperhidrosis in Asians: A prospective, randomized, controlled, split‐area comparative trial

et al. 2019

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Background and Objectives Microwave treatment is an effective non‐invasive treatment option for primary axillary hyperhidrosis (PAH), but the treatment parameters vary and no histopathological studies have been performed to validate clinical outcomes. This study investigated its efficacy and safety and histopathological changes after a single microwave treatment at the maximum energy level for PAH in Asians. Materials and Methods A prospective, clinical, and histological split‐area randomized controlled trial (RCT) was performed in Japan. Twenty‐six subjects underwent a single microwave treatment at the maximum energy level 5 (5.8 GHz/axilla) on the randomized side of axillae. The primary outcome was the mean difference between both sides in the improvement of modified single‐underarm Hyperhidrosis Disease Severity Scale (msHDSS) scores over the course of the 12‐month study period from baseline. The secondary outcomes were; the percentage of responders with at least a 2‐point drop in the msHDSS score of 3 or 4 group or with a 1‐point drop in the msHDSS score of 2 group; the percentage of responders with at least a 75% reduction in sweat weight over 12 months; recurrence rate; and adverse effects. We also performed a histological assessment for 13 selected subjects. Results Twenty‐four subjects completed the study. There were statistically significant differences in improvement of msHDSS scores between the microwave‐treated and control sides (P < 0.05) from baseline at 0.5, 1, 3, 6, and 12 months. In the msHDSS score of 3 or 4 group, the percentage of responders with at least a 2‐point drop on the microwave‐treated side versus control side was 72.2 versus 11.1% (P < 0.05) at 1 month, 83.3 versus 5.6% (P < 0.05) at 3 months, 61.1 versus 38.9% (P = 0.317) at 6 months and 38.9 versus 16.7% (P = 0.264) at 12 months. The percentage of responders with at least a 75% reduction in sweat weight on the microwave‐treated side versus control side was 75.0 versus 37.5% at 1 month, 75.0 versus 29.2% at 3 months, 83.3 versus 50.0% at 6 months and 70.8 versus 33.3% at 12 months (all P < 0.05). Recurrence on the microwave‐treated side was observed in 4.2% and 12.5% of 24 subjects at 3 and 12 months, respectively. No serious side‐effects were noted. Histology showed the diameter and density of secretory eccrine glands and nerve fiber lengths around eccrine glands were significantly decreased after treatment compared to baseline (P = 0.002, 0.027, 0.003, respectively). Conclusions A single‐session microwave treatment at the maximum energy level significantly improved the PAH of Japanese patients and had minimal side effects. This technique demonstrates that diminished size of secretory eccrine glands and nerve fiber degeneration could be useful markers for predicting the efficacy of the treatment. Lasers Surg. Med. 9999:1–8, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical and histological evaluation of a single high energy microwave treatment for primary axillary hyperhidrosis in Asians: A prospective, randomized, controlled, split‐area comparative trial

et al. 2019

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“…Sympathectomy is not the preferred treatment for mild axillary hyperhidrosis because of side effects [23]. The treatment of mild axillary hyperhidrosis includes topical aluminium chloride, iontophoresis, injection of botulinum toxin A, oral medication, surgical methods, laser treatment, and microwave thermolysis, with the latter two treatments particularly being accepted by more patients because of their positive effects, less pain, and less trauma [24]. However, for patients with PH and axillary hyperhidrosis, TS may be the best treatment choice.…”

Section: Discussionmentioning

confidence: 99%

A retrospective cohort study of T3 versus T4 thoracoscopic sympathectomy for primary palmar hyperhidrosis and primary palmar hyperhidrosis with axillary and plantar sweating.

Xie¹,

Lu²,

Zhu³

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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Introduction: Thoracoscopic sympathectomy (TS) has been proven to be a safe and effective treatment for primary palmar hyperhidrosis (PH). However, the complications include compensatory hyperhidrosis (CH), and over-dry hands may occur in some patients after TS. Aim: To compare the therapeutic effect of T3 and T4 TS on primary PH and primary PH with axillary and plantar sweating. Material and methods: We retrospectively analyzed 100 patients with PH who had undergone T3 (group A, n = 49) or T4 (group B, n = 51) TS in our department, with at least 1 year of postoperative follow-up. Results: At discharge, no major complications or deaths occurred in either group. The condition of sweaty hands was fully improved in 44 of 49 patients in group A and all patients in group B, with a significant difference (p = 0.031). After 12 months of follow-up, 18 (36.7%) patients in group A and 4 (7.8%) patients in group B developed CH, 16 (48.5%) patients in group A and 24 (77.4%) patients in group B had improved axillary sweating, with a significant difference (p < 0.05). The satisfaction rate of group B was significantly higher than that of group A (p < 0.01). Conclusions: Both T3 and T4 TS were safe and effective treatments for PH patients, but the incidence of CH in T4 TS was lower than that in T3 TS. T3 TS may be more suitable for patients with severe PH, while T4 TS had a better therapeutic effect on PH patients with axillary sweating.

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“…Primary treatment options for this condition involve lifestyle changes (eg, losing weight, avoiding stimulant‐containing foods, and restricting provocative clothing) and applying topical antiperspirants, including aluminum chloride, glycopyrrolate, and formaldehyde solution . Secondary non‐surgical treatment options include tap‐water iontophoresis, systemic anticholinergics, energy‐delivering modalities, including neodymium‐doped yttrium aluminum garnet (Nd:YAG) lasers, long‐pulsed diode lasers, and radiofrequency, microwave, and ultrasound devices, and botulinum neurotoxin (BoNT) injections . Otherwise, surgical treatment options can provide promising therapeutic effects on axillary or palmar PH and encompass the curettage removal of axillary subcutaneous tissue containing sweat gland components and open or endoscopic sympathectomy …”

Section: Introductionmentioning

confidence: 99%

Pressure‐and dose‐controlled, needle‐free, transcutaneous pneumatic injection of botulinum neurotoxin‐A for the treatment of primary axillary and palmoplantar hyperhidrosis

Kim¹,

Lee²,

Lee³

et al. 2020

Skin Research and Technology

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Primary hyperhidrosis (PH) is a common, uncontrollable, excessive sweating disorder along the axillary area or palms, without associated systemic disorders. 1 Primary treatment options for this condition involve lifestyle changes (eg, losing weight, avoiding stimulant-containing foods, and restricting provocative clothing) and applying topical antiperspirants, including aluminum chloride, glycopyrrolate, and formaldehyde solution. 2,3 Secondary non-surgical treatment options include tap-water iontophoresis, systemic anticholinergics, energy-delivering modalities, including neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers, long-pulsed diode lasers, and radiofrequency, microwave, and ultrasound devices, and botulinum neurotoxin (BoNT) injections. 2-5 Otherwise, surgical treatment options can provide promising therapeutic effects on axillary or palmar PH and encompass the curettage removal of axillary subcutaneous

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A systematic review of microwave-based therapy for axillary hyperhidrosis

Abstract: Microwave-based device treatment may be an effective alternative treatment for axillary hyperhidrosis. However, further investigation is necessary to determine its long-term efficacy and safety.

Cited by 22 publications

References 20 publications

Clinical and histological evaluation of a single high energy microwave treatment for primary axillary hyperhidrosis in Asians: A prospective, randomized, controlled, split‐area comparative trial

Clinical and histological evaluation of a single high energy microwave treatment for primary axillary hyperhidrosis in Asians: A prospective, randomized, controlled, split‐area comparative trial

A retrospective cohort study of T3 versus T4 thoracoscopic sympathectomy for primary palmar hyperhidrosis and primary palmar hyperhidrosis with axillary and plantar sweating.

Pressure‐and dose‐controlled, needle‐free, transcutaneous pneumatic injection of botulinum neurotoxin‐A for the treatment of primary axillary and palmoplantar hyperhidrosis

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