Department of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21287.
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland, 21287.
Lasers Surg Med. 2020 Nov;52(9):842-847. doi: 10.1002/lsm.23229. Epub 2020 Mar 16.
Hyperhidrosis (HH) is associated with impairments in quality of life (QOL) and elevated anxiety. Microwave thermolysis is a newer treatment that reduces sweating, yet effects on QOL and emotional symptoms have not been examined. Two treatment sessions are recommended to achieve 80% amelioration of clinical HH. We hypothesized that microwave thermolysis would reduce sweat severity, improve QOL, and reduce anxiety in young adults suffering from axillary HH in a prospective clinical trial.
STUDY DESIGN/MATERIALS AND METHODS: We enrolled 24 young adults (mean age = 23.57 years, 54% female) with elevated scores on the Hyperhidrosis Disease Severity Scale. All participants received one session of microwave thermolysis, and 83% received two sessions. Participants completed measures of sweat severity, QOL, generalized anxiety, social anxiety, social avoidance, and anxious/depressive mood symptoms at baseline; post-first treatment; and following second treatment.
At baseline, all participants had severe sweating; 87.5% had impaired QOL, 75% had elevated social anxiety, 50% with generalized anxiety, 48% with social avoidance, and 38% with anxious/depressed mood. Paired samples t tests indicated significant improvements from baseline to first procedure, including decreased sweating (t(21) = 5.68, P < 0.001), improved QOL (t(23) = 4.97, P < 0.001), and decreased generalized anxiety (t(23) = 8.11, P < 0.001), social anxiety (t(22) = 4.55, P < 0.001), mood symptoms (t(21) = 3.81, P = 0.001), and social avoidance (t(22) = 3.12, P = 0.005). After second treatment, further improvements were noted in sweating (t(18) = 3.28, P = 0.004) and QOL (t(18) = 3.83, P = 0.003), and a marginal trend for generalized anxiety (t(19) = 1.96, P = 0.064).
There were significant improvements in sweat severity, skin-specific QOL, generalized anxiety, social anxiety, anxious/depressive symptoms, and social avoidance. The majority of the psychosocial benefit appears to emerge after one treatment of microwave thermolysis, whereas the level of sweat severity and QOL continued to show further improvements after a second treatment. Results would suggest that although two microwave thermolysis sessions are needed for maximal treatment optimization of axillary HH, patients may experience significant benefits in improving psychosocial functioning after just one session. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
多汗症（HH）与生活质量（QOL）受损和焦虑增加有关。微波热疗是一种较新的治疗方法，可减少出汗，但对 QOL 和情绪症状的影响尚未得到研究。建议进行两次治疗以实现 80%的临床 HH 改善。我们假设微波热疗会减少出汗严重程度，改善年轻人腋下 HH 的 QOL，并减轻焦虑，这是在一项前瞻性临床试验中。
研究设计/材料和方法：我们招募了 24 名年轻成年人（平均年龄 23.57 岁，54%为女性），他们的多汗症严重程度量表评分升高。所有参与者均接受一次微波热疗，83%接受两次治疗。参与者在基线时完成了出汗严重程度、QOL、广泛性焦虑、社交焦虑、社交回避和焦虑/抑郁情绪症状的测量；第一次治疗后；以及第二次治疗后。
在基线时，所有参与者均有严重出汗；87.5%的人 QOL 受损，75%的人社交焦虑，50%的人有广泛性焦虑，48%的人有社交回避，38%的人有焦虑/抑郁情绪。配对样本 t 检验表明，从基线到第一次治疗有显著改善，包括出汗减少（t（21）=5.68，P<0.001）、QOL 改善（t（23）=4.97，P<0.001）和广泛性焦虑（t（23）=8.11，P<0.001）、社交焦虑（t（22）=4.55，P<0.001）、情绪症状（t（21）=3.81，P=0.001）和社交回避（t（22）=3.12，P=0.005）。第二次治疗后，出汗（t（18）=3.28，P=0.004）和 QOL（t（18）=3.83，P=0.003）进一步改善，广泛性焦虑（t（19）=1.96，P=0.064）呈边缘趋势。
出汗严重程度、皮肤特异性 QOL、广泛性焦虑、社交焦虑、焦虑/抑郁症状和社交回避均有显著改善。大部分的心理社会获益似乎在微波热疗一次后就出现了，而汗液严重程度和 QOL 的水平在第二次治疗后仍继续进一步改善。结果表明，尽管腋下 HH 治疗的最佳方案需要两次微波热疗，但单次治疗后患者的心理社会功能可能会有明显改善。
