The efficacy of a microwave device for treating axillary hyperhidrosis and osmidrosis in Asians: a preliminary study

Lee, Sang Jun; Chang, Ka Yeun; Suh, Dong Hye; Song, Kye Yong; Ryu, Hwa Jung

doi:10.3109/14764172.2013.807114

Cited by 49 publications

(64 citation statements)

References 20 publications

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“…There is only one preliminary report evaluating the efficacy of microwave-based devices for axillary osmidrosis in Asians, which showed good efficacy (93.8%). 5 Our study further demonstrates good efficacy for axillary hyperhidrosis and osmidrosis. At the visits 30 days and 90 days after treatment series, 100% and 85.7%, respectively, of patients had achieved the primary end point of odor reduction.…”

Section: Discussionmentioning

confidence: 60%

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A prospective clinical and histologic study of axillary osmidrosis treated with the microwave-based device

Chang

Chen

Hui

et al. 2015

Dermatologica Sinica

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a b s t r a c tBackground: Microwave-based devices target sweat glands through energy delivery at the dermal esubcutaneous interface. These devices have been approved by the Food and Drug Administration as a noninvasive treatment for axillary hyperhidrosis. Treatment for osmidrosis has only been reported in one preliminary study. Objectives: To investigate the efficacy, safety, and histological changes of the microwave-based devices in treating axillary osmidrosis. Methods: We conducted a prospective study in a tertiary referral center in Taiwan. Patients with axillary osmidrosis were recruited and received two consecutive treatment sessions with a 3-month interval. Skin biopsy was obtained to evaluate histological changes. The efficacy was determined by odor reduction using a patient reported 10-point odor scale. Responders were defined as participants with a reduction of at least 3 points of the Odor-10 score at their 90-day follow-up visit. Results: Seven patients were enrolled. Mean reduction of odor was 61.8%. Six patients met the primary endpoint of odor reduction. Skin biopsy specimens reveled 93% reduction of apocrine glands. Histopathological changes include dermal fibrosis, necrosis of sweat glands, and subcutaneous fat necrosis. Transient swelling, bruise, numbness, lumps, and hypotrichosis were possible side effects. No patient reported disabling side effects. Conclusion: Microwave-based devices are noninvasive and a potential alternative therapeutic modality for axillary osmidrosis treatment.

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Section: Discussionmentioning

confidence: 60%

“…4 However, treatment of axillary osmidrosis using this technique has only been reported in one preliminary study. 5 The objectives of this study were to investigate the efficacy, safety, and histological changes of microwave-based devices in treating axillary osmidrosis.…”

Section: Introductionmentioning

confidence: 99%

A prospective clinical and histologic study of axillary osmidrosis treated with the microwave-based device

Chang

Chen

Hui

et al. 2015

Dermatologica Sinica

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“…16 Improvement of axillary odor has been noted by patients. 18 Lee and colleagues reported using the microwave device on 11 Asian patients: 3 with HH only, 3 with HH and osmidrosis, and 5 with osmidrosis alone. The HDSS scores improved in all patients with HH (1-point to 3-point decrease in the HDSS) and axillary odor improved in all patient with osmidrosis.…”

Section: Curettagementioning

confidence: 98%

“…From the baseline HDSS assessment, 94% of patients experienced a 1-point decrease in their HDSS score, 16 and 55% to 83.3% experienced a 2-point or greater decrease in their HDSS score at 12 months after treatment. 16,18 Based on gravimetric assessments, 90% of patients experienced a 50% or greater reduction in axillary sweating, with an average reduction of 81.7%. 16 At 12 months after treatment, 85.5% of patients were satisfied with their treatment outcome.…”

Section: Curettagementioning

confidence: 99%

Local Procedural Approaches for Axillary Hyperhidrosis

Glaser

Galperin

2014

Dermatologic Clinics

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“…Studies that were found to use the HDSS tool were conducted globally, including the USA and Canada (n = 21 21,27,29,52,77,107,108,139,159,160,164,175,176,179,180,208,209,218,225,226,229 ), Spain (n = 6 167,207,210,224,230,231 ), the UK (n = 5 91,97,125,222,232 ), Germany (n = 5 2,131,145,161,227 ), Italy (n = 5 102,106, 136,214,223 ), France (n = 3 59,61,211 ), South Korea (n = 3 51,171,174 ), Australia (n = 2 53,221 ), Egypt (n = 2 213,219 ), Iran (n = 2 28,220 ), the Netherlands (n = 2 ...…”

Section: Hyperhidrosis Disease Severity Scalementioning

confidence: 99%

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

Wade

Rice

Llewellyn

et al. 2017

Health Technol Assess

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BackgroundHyperhidrosis is uncontrollable excessive sweating that occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life. The management of hyperhidrosis is uncertain and variable.ObjectiveTo establish the expected value of undertaking additional research to determine the most effective interventions for the management of refractory primary hyperhidrosis in secondary care.MethodsA systematic review and economic model, including a value-of-information (VOI) analysis. Treatments to be prescribed by dermatologists and minor surgical treatments for hyperhidrosis of the hands, feet and axillae were reviewed; as endoscopic thoracic sympathectomy (ETS) is incontestably an end-of-line treatment, it was not reviewed further. Fifteen databases (e.g. CENTRAL, PubMed and PsycINFO), conference proceedings and trial registers were searched from inception to July 2016. Systematic review methods were followed. Pairwise meta-analyses were conducted for comparisons between botulinum toxin (BTX) injections and placebo for axillary hyperhidrosis, but otherwise, owing to evidence limitations, data were synthesised narratively. A decision-analytic model assessed the cost-effectiveness and VOI of five treatments (iontophoresis, medication, BTX, curettage, ETS) in 64 different sequences for axillary hyperhidrosis only.Results and conclusionsFifty studies were included in the effectiveness review: 32 randomised controlled trials (RCTs), 17 non-RCTs and one large prospective case series. Most studies were small, rated as having a high risk of bias and poorly reported. The interventions assessed in the review were iontophoresis, BTX, anticholinergic medications, curettage and newer energy-based technologies that damage the sweat gland (e.g. laser, microwave). There is moderate-quality evidence of a large statistically significant effect of BTX on axillary hyperhidrosis symptoms, compared with placebo. There was weak but consistent evidence for iontophoresis for palmar hyperhidrosis. Evidence for other interventions was of low or very low quality. For axillary hyperhidrosis cost-effectiveness results indicated that iontophoresis, BTX, medication, curettage and ETS was the most cost-effective sequence (probability 0.8), with an incremental cost-effectiveness ratio of £9304 per quality-adjusted life-year. Uncertainty associated with study bias was not reflected in the economic results. Patients and clinicians attending an end-of-project workshop were satisfied with the sequence of treatments for axillary hyperhidrosis identified as being cost-effective. All patient advisors considered that the Hyperhidrosis Quality of Life Index was superior to other tools commonly used in hyperhidrosis research for assessing quality of life.LimitationsThe evidence for the clinical effectiveness and safety of second-line treatments for primary hyperhidrosis is limited. This meant that there was insufficient evidence to draw conclusions for most interventions assessed and the cost-effectiveness analysis was restricted to hyperhidrosis of the axilla.Future workBased on anecdotal evidence and inference from evidence for the axillae, participants agreed that a trial of BTX (with anaesthesia) compared with iontophoresis for palmar hyperhidrosis would be most useful. The VOI analysis indicates that further research into the effectiveness of existing medications might be worthwhile, but it is unclear that such trials are of clinical importance. Research that established a robust estimate of the annual incidence of axillary hyperhidrosis in the UK population would reduce the uncertainty in future VOI analyses.Study registrationThis study is registered as PROSPERO CRD42015027803.FundingThe National Institute for Health Research Health Technology Assessment programme.

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The efficacy of a microwave device for treating axillary hyperhidrosis and osmidrosis in Asians: a preliminary study

Cited by 49 publications

References 20 publications

A prospective clinical and histologic study of axillary osmidrosis treated with the microwave-based device

A prospective clinical and histologic study of axillary osmidrosis treated with the microwave-based device

Local Procedural Approaches for Axillary Hyperhidrosis

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

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