Treatment of axillary hyperhidrosis/bromidrosis using VASER ultrasound

Aesthetic Plast Surg. 2009 May;33(3):312-23. doi: 10.1007/s00266-008-9283-y. Epub 2009 Jan 3.


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.

Conclusion: 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.

MeSH terms

  • Adult
  • Apocrine Glands / surgery
  • Axilla
  • Curettage / methods
  • Epinephrine / administration & dosage
  • Female
  • Humans
  • Hyperhidrosis / therapy*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prospective Studies
  • Ultrasonic Therapy / methods*
  • Vasoconstrictor Agents / administration & dosage
  • Young Adult


  • Vasoconstrictor Agents
  • Epinephrine