title: Treatment of Primary Axillary Hyperhidrosis by Fractional Microneedle Radiofrequency: Is it Still Effective after Long-term Follow-up?
abstract: BACKGROUND
  Primary axillary hyperhidrosis (PAH) is a chronic idiopathic disorder causing major stress in patients. Among the common therapies for PAH, only surgical interventions have proven feasible as a permanent solution.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the efficacy and safety of fractional microneedle radiofrequency (FMR) as an alternative permanent treatment for PAH with long-term follow-up.
  
  
  METHODS
  This was a single-blind, sham-controlled comparative study. Twenty-five patients with severe PAH were provided three treatments of FMR at 3-week intervals (the treatment group), and a control group was provided the sham treatment. Clinical efficacy was evaluated using the hyperhidrosis disease severity scale (HDSS) at baseline and the end of the study, as well as during the 1 year follow-up phase.
  
  
  RESULTS
  HDSS demonstrated significant improvement after treatment in the treatment group compared to the sham control. The mean (±standard deviation) of HDSS in the group being treated with radiofrequency was 2.50 (±0.88) after 1 year follow-up, and that of the control group was 3.38 (±0.49; P < 0.001). Follow-up results show that there were 10 patients (41.6%) with no relapse and 11 patients (45.9%) with relapse after 1 year. There was a significant correlation between HDSS changes in relapse and body mass index (BMI) (P = 0.03).
  
  
  CONCLUSIONS
  Treatment of PAH with FMR is a safe and noninvasive procedure with a positive therapeutic effect on HDSS. It is recommended, however, that sessions of FMR be repeated after 1 year, particularly in overweight patients with high BMIs.
  
  
  BACKGROUND
  IRCT2013111915455N1.
  
  
  METHODS
  Level II-1.
authors.affiliation: Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical sciences, Isfahan, Iran.
authors.forename: Bahareh
authors.initials: B
authors.lastname: Abtahi-Naeini
authors.affiliation: Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical sciences, Isfahan, Iran.
authors.forename: Farahnaz Fatemi
authors.initials: FF
authors.lastname: Naeini
authors.affiliation: Pharmacy Students' Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Isfahan University of Medical sciences, Isfahan, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Saffaei
authors.affiliation: Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, Isfahan University of Medical sciences, Isfahan, Iran.
authors.forename: Shadi
authors.initials: S
authors.lastname: Behfar
authors.affiliation: Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Pourazizi
authors.affiliation: Social Determinants of Health Research Center, Department of Community Medicine, Semnan University of Medical Sciences, Semnan, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Mirmohammadkhani
authors.affiliation: Students' Research Center, Department of Dermatology, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Najmeh-Sadat
authors.initials: NS
authors.lastname: Bolandnazar
keywords: Fractionated microneedle radiofrequency; hyperhidrosis disease severity scale; primary axillary hyperhidrosis