Short- and long-term efficacy and mechanism of action of tumescent suction curettage for axillary hyperhidrosis.
Feldmeyer L, Bogdan I, Moser A, Specker R, Kamarashev J, French LE, Läuchli S.
J Eur Acad Dermatol Venereol. 2015 Oct;29(10):1933-7. doi: 10.1111/jdv.13078. Epub 2015 Mar 12.
Excessive Sweating under the armpits (Axillary Hyperhidrosis, AH) is a chronic psychologically devastating condition.
Treatment options include crystal salts, botulinum toxin injections and in extreme cases surgical excision of the sweat glands or suction curettage. The first two treatments are conservative and the effects are temporary.
In this Swiss study 30 patients (17male, 13 female) were enrolled and the affected area was anesthesized (tumescent anesthesia) and after rods were inserted in small incisions, subcutaneous tissue was sucked out (suction curettage).
Results show that the quantity of sweat was decreased by 85% after 1 month, 71% after 6 months, 77% after 12 months and 61% after 24 months (when compared with before the treatment). Patient satisfaction scores were high but reduced progressively.
–Complications observed were mild to moderate erosions (n=19), pain (n=12), axillary ecchymosis
(n=12 patients, 41%). No long term side effects were observed (One patient complained about dysaesthesias at the operation site, still present 6 months after the operation).
Recurrence may occur due to reinnervation as on histology and increase in nerves correlated with a decrease in sweat glands is observed
The full surgical method can be found in the article but here are a few facts:
-tumescent anesthesia was performed by injecting 100–200 mL of lidocaine 0.25% (concentration:
0.25 g/100 mL) with epinephrine
-patients were given cefuroxime 250 mg bid for 5 days to prevent infectious complications