Wednesday, August 12, 2009

Internal US Technique Treats Hyperhidrosis—an Article Review

Updated 3/2017-- all links (except to my own posts) removed as many no longer active. and it was easier than checking each one. 

This was suppose to simply be an article review. I was intrigued by the potential of using ultrasound (US) to damage the sweat glands when I read this article in the August issue of Cosmetic Surgery Times. I even went back and read the Aesthetic Plastic Surgery Journal article referenced, but I have gotten sidetracked by this photo. It troubles me.
See how it is labeled an intra-operative photo? Notice the surgeon is wearing what appears to be a large jeweled ring under her sterile glove. Who wears jewelry in the OR??? That’s not proper sterile technique!

Intra-operative photo shows application of internal ultrasound therapy to damage the sweat glands. (Photo credit: Sharon Giese, M.D., F.A.C.S.)
In the article Dr. Giese states the procedure uses the heat energy of the ultrasound liposuction to “presumably kills the sebaceous glands. Permanently." No biopsies done to know for sure. No starch– iodine testing to quantify the decrease in sweat.
Dr Giese reports good results with her patients, but doesn’t quantify the number of patients. She reports that all the women no longer need deodorant. She reports that one male has had 65% reduction in sweating which can now be controlled by deodorant.
In looking further into the technique I found two more recent articles (the 3rd and 4th below).
In the 4th article, the researchers had 13 patients (3 males, 10 females) with significant axillary hyperhidrosis which they treated with the VASER ultrasound and followed for 6 months. Eleven of 13 patients had significant reduction in sweat/odor with no recurrence of significant symptoms at 6 months. Two patients had a reduction in sweat/odor but not to the degree they desired. No significant complications were noted. They report the complete procedure takes less than 1 h to treat two axillae using local anesthetic.   Once again, no objective measures of sweating.
I remain intrigued with this procedure, but would love more scientific measures and studies.  Still, I suppose the patients only care about the subjective measures when it comes to sweating.

Internal ultrasound technique treats hyperhidrosis; Cosmetic Surgery Times, Aug 1, 2009; Donley-Hayes, Karen
Very Superficial Ultrasound-assisted Lipoplasty for the Treatment of Axillary Osmidrosis; Aesthetic Plast Surg. 2000 Jul-Aug;24:275-279; Park S
Characteristics of Refractory Sweating Areas Following Minimally Invasive Surgery for Axillary Hyperhidrosis; Aesthetic Plast Surg, Volume 33, Number 3 / May, 2009; Falk Georges Bechara, Michael Sand and Peter Altmeyer
Treatment of Axillary Hyperhidrosis/Bromidrosis Using VASER Ultrasound; Aesthetic Plast Surg, Volume 33, Number 3 / May, 2009; George W. Commons and Angeline F. Lim

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