Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Department of Dermatology, Chang Gung Memorial Hospital, Linkou and Taipei, Taiwan.
Lasers Surg Med. 2023 Apr;55(4):372-377. doi: 10.1002/lsm.23656. Epub 2023 Mar 23.
Microwave therapy is used to treat axillary hyperhidrosis and osmidrosis. Even while a "danger zone" has been identified and reports of potential complications from nerve injury have been made, there has been little real-world discussion regarding whether there is any pretreatment evaluation key factor that may lower the risk. Furthermore, the efficacy of a single treatment and the safety of high-energy therapies have not been well investigated.
The aim of this study is to demonstrate the key aspects of pre-therapeutic assessment, efficacy, and suitability of a single treatment, as well as the safety of high-energy treatments.
Fifteen patients with axillary hyperhidrosis (AH) and axillary osmidrosis (AO) between ages of 20 and 50 had pretherapeutic ultrasonography and clinical assessments performed followed by a single-pass microwave treatment using the miraDry system at energy level 5. The severity of AH and AO was evaluated using the Hyperhidrosis Disease Severity Scale and Odor-10 scale, respectively, at baseline, 1 month, 3 months, and 1 year after treatment. Adverse reactions were recorded at each point of evaluation.
Out of 30 treatment areas, 14 have a danger zone. Female gender, a small mid-upper arm circumference, and a low body mass index (BMI) are all associated risk factors. The average Hyperhidrosis Disease Severity Scale score decreased from 3.1 ± 0.7 to 1.3 ± 0.5 (p < 0.001), while the odor-10 score declined from 7.1 ± 1.6 to 3.0 ± 1.6 (p < 0.001), indicating a significant improvement in AH and AO. Most of the unfavorable treatment effects disappeared within the first month.
This study has no objective quantitative measurement of axillary odor severity and sweat assessment.
Female patients, those with a smaller mid-upper arm circumference, and those with a low BMI should be treated with extra caution, and the tumescent anesthetic dose may be increased based on safety. A high-energy microwave treatment procedure performed in a single session is a safe and effective therapeutic option with good recovery.
微波疗法用于治疗腋窝多汗症和腋臭。尽管已经确定了“危险区域”，并报告了神经损伤的潜在并发症，但很少有关于是否存在任何可能降低风险的预处理评估关键因素的实际讨论。此外，单次治疗的疗效和高能治疗的安全性尚未得到充分研究。
本研究旨在展示治疗前评估、疗效和单次治疗适用性的关键方面，以及高能治疗的安全性。
对 20 至 50 岁的 15 例腋窝多汗症（AH）和腋窝腋臭（AO）患者进行了治疗前超声检查和临床评估，然后使用 miraDry 系统进行单次微波治疗，能量水平为 5。使用多汗症疾病严重程度量表和 Odor-10 量表分别在治疗前、治疗后 1 个月、3 个月和 1 年评估 AH 和 AO 的严重程度。在每次评估时记录不良反应。
在 30 个治疗区域中，有 14 个区域存在危险区域。女性、较小的中上臂围和较低的体重指数（BMI）都是危险因素。平均多汗症疾病严重程度量表评分从 3.1±0.7 降至 1.3±0.5（p<0.001），而气味-10 评分从 7.1±1.6 降至 3.0±1.6（p<0.001），表明 AH 和 AO 显著改善。大多数不利的治疗效果在第一个月内消失。
本研究没有对腋窝气味严重程度和汗液评估进行客观的定量测量。
女性患者、臂围较小的患者和 BMI 较低的患者应谨慎治疗，并根据安全性增加肿胀麻醉剂量。单次治疗的高能微波治疗程序是一种安全有效的治疗选择，恢复良好。
