title: Treatment of axillary hyperhidrosis/bromidrosis using VASER ultrasound.
abstract: BACKGROUND
  Current methods of treatment for axillary hyperhidrosis and/or bromidrosis are palliative (use of topical aluminum chloride or injections of botulinum toxin type A) or surgically based for more permanence (excisional surgery, endoscopic transthoracic sympathectomy, liposuction/curettage). The surgical approaches have mixed effectiveness and incur the risk of significant side effects and complications.
  
  
  METHODS
  Thirteen patients (3 males, 10 females) with significant axillary hyperhidrosis and/or bromidrosis were recruited, treated with the VASER ultrasound, and followed for 6 months. Preoperative assessment of the impact of hyperhidrosis and/or bromidrosis on lifestyle and the degree of sweat/odor were completed. Postoperative assessment of changes relative to lifestyle and degree of sweat/odor reduction and patient and surgeon satisfaction were completed.
  
  
  RESULTS
  Eleven of 13 patients had significant reduction in sweat/odor and had no recurrence of significant symptoms at 6 months. Two patients had a reduction in sweat/odor but not to the degree desired by the patients. No significant complications were noted. A simple amplitude and time protocol was established that provides consistent and predictable therapy. The complete procedure takes less than 1 h to treat two axillae using local anesthetic.
  
  
  CONCLUSIONS
  The VASER is safe and effective for treatment of axillary hyperhidrosis/bromidrosis. The method is minimally invasive with immediate return to basic activities and only temporary minor restriction of arm movement. At 6 months the treatment appears to be long-lasting, but further follow-up is required for verification of permanence. This method has become the standard of care for the treatment of axillary hyperhidrosis/bromidrosis in the authors' practice.
authors.affiliation: Stanford University School of Medicine, 1515 El Camino Real, Suite C, Palo Alto, CA 94306, USA. GCommonsMD@aol.com
authors.forename: George W
authors.initials: GW
authors.lastname: Commons
authors.forename: Angeline F
authors.initials: AF
authors.lastname: Lim
mesh_terms: D000328:Adult; D001050:Apocrine Glands / Q000601:surgery; D001365:Axilla; D003475:Curettage / Q000379:methods; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D014464:Ultrasonic Therapy / Q000379:methods*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine