Carbon Dioxide Laser Treatment vs Subcutaneous Resection of Axillary Osmidrosis

Abstract

CO2 laser vaporization in osmidrosis produces significant patient-benefit during the postoperative course. We believe that this laser-assisted combined surgical procedure can be a viable option for the treatment of axillary hyperhidrosis and osmidrosis.

Subcutaneous curettage vs. injection of botulinum toxin A for treatment of axillary hyperhidrosis

“…Therefore, local surgical methods are preferable in axillary hyperhidrosis. Various local surgical methods described for axillary hyperhidrosis can be divided into three major approaches: (i) removing only subcutaneous tissue without removing skin; 11–18 (ii) removing skin and subcutaneous tissue by wide excision; 19–24 and (iii) partial excision of the skin and subcutaneous tissue as well as open curettage of the adjacent area 25–29 . We prefer the technique first described by Jemec in 1975 involving removal of subcutaneous tissue of the axilla by means of curettage 13,30 …”

Upper thoracic sympathectomy for axillary osmidrosis or bromidrosis

“…9;10;12;16 Park et al compared the effect of carbon dioxide laser with that of subcutaneous resection for the treatment of AO. 9 They found that the complication rate associated with wound problems (unhealing, necrosis or seroma formation) was much lower in patients treated with laser than those treated with surgical resection (15% vs. 55%). However, reoperation was sometimes necessary for malodor or the ugly scars, although the final result was very good.…”

“…Different modalities that have been applied to patients include topical or systemic medication, and surgical techniques. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Upper thoracic sympathectomy has been widely used to treat PH and can block the axillary sweating as well. [19][20][21] In comparison with other cutaneous or subcutaneous procedures, upper thoracic sympathectomy may cause less infection of the axillary sweat glands or ducts and may not produce unpleasant scarring after the procedure.…”

Axillary hyperhidrosis: A review of the extent of the problem and treatment modalities

“…Goldman et al also, encouraged by results from Kim and Park on treating osmidrosis using CO 2 lasers, decided to investigate laser therapy for hyperhidrosis. 30,31 Seventeen patients with axillary hyperhidrosis were treated with subdermal Nd-Yag laser. 32 By passing a flexible fibre optic through an epidural needle in the underarm area they were able to get in direct contact with the target tissue, eccrine sweat glands.…”