Department of Dermatology, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark.
Department of Dermatology, Copenhagen University Hospital - Gentofte, Copenhagen, Denmark.
Lasers Surg Med. 2023 Jan;55(1):105-115. doi: 10.1002/lsm.23610. Epub 2022 Oct 13.
Microwave thermolysis (MWT) is an emerging treatment for axillary hyperhidrosis reducing both sweat and odor. No prior studies have investigated and compared the different available energy settings of the MWT device. This study evaluated patient-reported outcome measures (PROMs) for axillary hyperhidrosis and osmidrosis following MWT treatment with two different energy levels.
Twenty adults with axillary hyperhidrosis and osmidrosis reported sweat on Hyperhidrosis Disease Severity scale (HDSS: 1-4) and odor on Odor scale (OS: 1-10), respectively, supplemented by overall Dermatology Life Quality Index (DLQI: 0-30). This was a prospective, randomized, patient-blinded and intraindividually controlled study with 3 months follow-up (FU). Randomization comprised MWT treatment of one axilla with a standard medium energy setting (energy level 3) and the contralateral axilla with a standard high energy setting (energy level 5).
At baseline, patients reported substantial sweat and odor, negatively affecting their quality of life. At 3 months FU, PROMs showed improved quality of life with significantly reduced odor and sweat. Overall DLQI was reduced from a median of 10 to 4, with a median 6.5-point reduction (p = 0.0002). HDSS was reduced from a median of 4 to 2 on both sides, with a median reduction of 1 for medium energy level and 2 points for high energy level (p = 0.014). OS was reduced from a median of 8 to 3 for both energy levels, with a median reduction of 3.5 and 4.5 points for the medium and high energy level, respectively (p = 0.017). Local skin reactions were mild and transient, but slightly more pronounced following treatment with the high energy level.
MWT effectively improved patients' quality of life, axillary sweat, and odor 3 months after on baseline treatment. Treatment with the high energy level presented a subtle but significant increase of efficacy based on PROMs for both sweat and odor. Patients were willing to accept a higher amount of temporary local skin reactions from a higher energy setting when experiencing greater odor and sweat reduction.
微波热疗（MWT）是一种新兴的治疗腋窝多汗症的方法，可同时减少汗液分泌和气味。目前尚无研究探讨和比较 MWT 设备的不同可用能量设置。本研究评估了两种不同能量水平的 MWT 治疗后腋窝多汗症和腋臭患者的报告的患者报告结局测量（PROMs）。
20 名腋窝多汗症和腋臭患者分别报告多汗症的严重程度（HDSS：1-4 分）和腋臭的严重程度（OS：1-10 分），并补充总体皮肤病生活质量指数（DLQI：0-30 分）。这是一项前瞻性、随机、患者盲法和个体内对照研究，随访 3 个月。随机分组包括用标准中能设置（能量水平 3）治疗一侧腋窝和用标准高能设置（能量水平 5）治疗对侧腋窝。
基线时，患者报告大量出汗和臭味，严重影响其生活质量。3 个月随访时，PROMs 显示生活质量得到改善，臭味和出汗明显减少。总体 DLQI 从中位数 10 分降至 4 分，中位数降低 6.5 分（p=0.0002）。双侧 HDSS 从中位数 4 分降至 2 分，中能水平降低 1 分，高能水平降低 2 分（p=0.014）。双侧 OS 从中位数 8 分降至 3 分，中能和高能水平分别降低 3.5 和 4.5 分（p=0.017）。皮肤局部反应轻微且短暂，但高能水平治疗后略明显。
MWT 可有效改善患者生活质量、腋窝出汗和腋臭，治疗后 3 个月时基线治疗。基于 PROMs，高能水平治疗在汗液和气味方面表现出轻微但显著的疗效增加。当患者经历更多的气味和出汗减少时，他们愿意接受更高的能量水平带来的暂时的局部皮肤反应。
