Minimal Subdermal Shaving by Means of Sclerotherapy Using Absolute Ethanol: A New Method for the Treatment of Axillary Osmidrosis

Abstract

BackgroundAxillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol.MethodsA total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group) and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group). Postoperative outcomes were compared between the study and control groups.ResultsThe length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes.ConclusionsSclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.

Treatment of Axillary hyperhidrosis

“…In a series of 12 cases of axillary osmidrosis ablation of axillary apocrine glands by minimal subdermal shaving using sclerotherapy with absorbable ethanol was performed. The results of this simple technique showed good objective improvement with no complications of hematoma or seroma formation 71 …”

“…The results of this simple technique showed good objective improvement with no complications of hematoma or seroma formation. 71 Thoracoscopic sympathetic surgery has been evaluated to determine the optimal level of sympathetic trunk interruption by clipping and to assess postoperative compensatory sweating, patients satisfaction, and QoL, showing that thoracoscopic R3 to R4 clipping appears to be a safe and effective treatment for primary palmar and/or AH. 72 Surgical options could be offered based on each patients' condition even in younger age groups as an analysis of 639 adults and adolescences patients who underwent Video Assisted Thoracoscopic Sympathectomy (VATS) manifested that adolescent patients could benefit from VATS performed as the same level of adult patients.…”

Combination of topical agents and oxybutynin as a therapeutic modality for patients with both osmidrosis and hyperhidrosis

“…Surgical excision of the subcutaneous tissue and/or the overlying skin, which entails a complete excision of the apocrine and eccrine glands, 16 can be performed to reduce malodor and sweating. Minimally invasive procedures [17][18][19][20] such as liposuction, laser therapy, subdermal shaving, microwave-based device and ultrasonic surgical aspiration are also used to reduce malodor and sweating caused by the excessive secretion of these glands. However, recurrence of malodor is more frequent with minimally invasive procedures.…”

Axillary hyperhidrosis: An update

“…Endoscopic thoracic sympathectomy may be done in recalcitrant cases. [45][46][47][48][49][50][51][52][53][54][55][56][57]…”