Clinical evaluation and quantitative analysis of axillary hyperhidrosis treated with a unique targeted laser energy delivery method with 1-year follow up

J Drugs Dermatol. 2014 Apr;13(4):449-56.


Background: Primary Focal Axillary Hyperhidrosis (PHH) is a chronic disorder of excessive underarm sweat that causes significant impairment of an individual's daily activities. Multiple studies have established the psychosocial burden of PHH and its negative impact on quality of life. Current first-line therapies include the use of topical aluminum chloride with limited efficacy. Second line therapy includes the use of Botulinum toxin, which is effective, but duration is limited to 6-7 months.

Objective: The purpose was to evaluate the long term efficacy and safety of the Nd:YAG 1440 nm wavelength with a unique delivery fiber (SideLaze) and the Smartlipo TriPlex device (Cynosure Inc).

Methods: Fifteen subjects were recruited to an approved Institutional Review Board study. Outcome measures were comprised of clinical and quantitative evaluation of functional impairment. This included HDSS scale, physician and subject evaluation, and digital photography of before and after starch iodine tests utilizing image processing and analysis software. Subjects received a single treatment and were evaluated at 1 week and at 3, 6, and 12 months post treatment. Responders were defined as those that scored an HDSS score of 1 or 2 post-treatment. Those that were non-responsive at 6 months received a second treatment.

Results: All patients responded to treatment with 72% reporting a two-point HDSS score improvement and 28% reporting a 1-point improvement at 1-year follow-up. The average HDSS score improvement was 1.9/3.0. Three of the 15 patients at 6 months received a second treatment. The HDSS average score for all patients remained statistically stable at 1-year follow-up.

Conclusions: Treatment of axillary hyperhidrosis with the 1440 nm Nd:YAG-pulsed laser combined with a targeted fiber and temperature-sensing device provides a safe and minimally invasive approach to the treatment of axillary hyperhidrosis with minimal side effects and long-term efficacy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Axilla
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperhidrosis / surgery*
  • Laser Therapy / adverse effects
  • Laser Therapy / instrumentation
  • Laser Therapy / methods*
  • Lasers, Solid-State / adverse effects
  • Lasers, Solid-State / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Young Adult