Laser treatment of primary axillary hyperhidrosis: a review of the literature

Abstract

Hyperhidrosis o`ccurs when the body produces sweat beyond what is essential to maintain thermal homeostasis. The condition tends to occur in areas marked by high-eccrine density such as the axillae, palms, and soles and less commonly in the craniofacial area. The current standard of care is topical aluminum chloride hexahydrate antiperspirant (10-20%), but other treatments such as anticholinergics, clonidine, propranolol, antiadrenergics, injections with attenuated botulinum toxin, microwave technology, and surgery have been therapeutically implicated as well. Yet, many of these treatments have limited efficacy, systemic side effects, and may be linked with significant surgical morbidity, creating need for the development of new and effective therapies for controlling excessive sweating. In this literature review, we examined the use of lasers, particularly the Neodynium:Yttrium-Aluminum-Garnet (Nd:YAG) and diode lasers, in treating hyperhidrosis. Due to its demonstrated effectiveness and limited side effect profile, our review suggests that Nd:YAG laser may be a promising treatment modality for hyperhidrosis. Nevertheless, additional large, randomized controlled trials are necessary to confirm the safety and efficacy of this treatment option.

Hyperhidrosis treatments in hidradenitis suppurativa: A systematic review

“…Two RCTs studied its use in hyperhidrosis, and results were equivocal but promising: one study on 19 patients noted improvement in hyperhidrosis on both the treated and untreated axilla, while another study on 100 patients noted it to be comparable to curettage. 26 There is a paucity of literature on utilization of diode laser in HS. Non-ablative light-based therapies in general have been shown to improve HS lesions.…”

“…The role of the diode laser in treatment of hyperhidrosis is not well studied. Two RCTs studied its use in hyperhidrosis, and results were equivocal but promising: one study on 19 patients noted improvement in hyperhidrosis on both the treated and untreated axilla, while another study on 100 patients noted it to be comparable to curettage 26 . There is a paucity of literature on utilization of diode laser in HS.…”

Propranolol versus Other Selected Drugs in the Treatment of Various Types of Anxiety or Stress, with Particular Reference to Stage Fright and Post-Traumatic Stress Disorder

“…Propranolol has been also used in the treatment of various rare vascular diseases, including hereditary haemorrhagic telangiectasia, von Hippel–Lindau disease, paraganglioma syndrome, cerebral cavernous malformations, angiosarcoma, and tuberous sclerosis [ 132 ]. Oral propranolol administration seems to be an effective method to minimise the development of sight-threatening choroidal effusion after glaucoma surgery [ 133 ] as well as an effective and safe medication in the treatment of primary hyperhidrosis [ 134 ].…”

Axillary hyperhidrosis: An update

“…[36] Lasers Nd:YAG 1064 nm and other lasers show significant reduction in hyperhidrosis when associated with surgical excision of the glands. [37][38][39][40][41][42]…”