Combination laser energy tackles primary axillary hyperhidrosis

Kissimmee, Fla. - A procedure known as Axilase that involves use of a fixed combination of 924 nm and 975 nm continuous wave laser energy can treat primary axillary hyperhidrosis, according to study data presented at the 2012 annual meeting of the American Society for Laser Medicine and Surgery.

The procedure appears to effectively destroy eccrine and apocrine sweat gland units, says Mitchell Chasin, M.D., the study’s principal investigator and medical director, Reflections Center for Skin and Body, Livingston, N.J.

Study details
The study consisted of 22 patients (16 women and six men) with a mean age of 34, and it excluded patients who had undergone Botox (onabotulinumtoxinA, Allergan) injections within the past year, previous axillary surgery or diabetes. All patients indicated a grade 4 rating on the Hyperhidrosis Disease Severity Scale (HDSS), meaning underarm sweating constantly interfered with their daily activities, Dr. Chasin says.

Investigators performed baseline VapoMeter (Delfin) readings and starch iodine sweat tests. Complete anesthesia was achieved using a modified Klein tumescent formula. Investigators divided the axillae into sections and administered laser energy to each section, with total energy delivering seven to 11 joules per side. Cannulas were used for aspiration of the region.

Histology results
Histological examination pre- and postprocedure showed destruction of eccrine and apocrine sweat gland units. In addition, patients took part in follow-up interviews at six to nine months postprocedure, and some beyond one year. The HDSS rating was reduced to l in all patients postprocedure, meaning sweating is not at all noticeable and doesn’t interfere with daily activities.

In terms of toxicities, some patients reported self-limited induration and lumpiness in the axillae, Dr. Chasin says.

“The goal was to try and bring them down at least two levels on the scale (HDSS),” Dr. Chasin says. “The selectivity of the wavelength appears to be the key (in reaching the sweat glands). We are bringing the sweating down to a level that is not bothersome to patients anymore. Patients are looking for a permanent solution to their sweating.”

Patients did not experience compensatory hyperhidrosis at other sites, Dr. Chasin says.

Disclosures: Dr. Chasin reports no relevant financial interests.

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