Impact of microwave thermolysis energy levels on patient‐reported outcomes for axillary hyperhidrosis and osmidrosis

Abstract

Objective 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. Methods 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). Results 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. Conclusion 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.

Clinical analysis of tumescent anesthesia technique combined with superficial fascia rotational atherectomy in axillary bromhidrosis

“…The mean DLQI score for preoperative patients was 16.10, whereas for postoperative patients it decreased to 3.30. In the present study, the DLQI scores for postoperative patients in the two groups were significantly decreased compared with the scores for preoperative patients in the two groups and these results were consistent with the results reported by a previous study (31), and the removal of sweat gland and hair follicle tissue is more complete in the experimental group. However, the present results showed recurrence in some patients who still had a grade 2/3 odor degree 6 months after surgery and indicated some protective effect for patients.…”

A single session of high‐energy microwave axillary hyperhidrosis and osmidrosis therapy: Key pretherapeutic assessment and outcome analysis

“…A single-session one-pass protocol is adequate, as evidenced by a recent published article's claim that patients were willing to endure a greater degree of transitory local skin reactions from a higher energy setting in exchange for more odor and perspiration reduction. 18 By ensuring the depth of the deep fascia was at least 5 mm in all cases, high-energy treatment with a level 5 setting is safe, and the effect of the treatment is long-lasting. After 1 year, participants still had a significant improvement in AO compared with their pretherapeutic status.…”

“…Our study revealed that microwave treatment is an efficient method for treating AO and AH in Asians. A single‐session one‐pass protocol is adequate, as evidenced by a recent published article's claim that patients were willing to endure a greater degree of transitory local skin reactions from a higher energy setting in exchange for more odor and perspiration reduction 18 . By ensuring the depth of the deep fascia was at least 5 mm in all cases, high‐energy treatment with a level 5 setting is safe, and the effect of the treatment is long‐lasting.…”