Percutaneous ethanol injection for the treatment of axillary osmidrosis

BACKGROUND: The development of body odour, especially in the armpits, a condition known as axillary osmidrosis, is a common condition that is annoying to patients and can cause them considerable social embarrassment. Ablation of the apocrine glands is the mainstay of treatment, and various methods have been used to achieve this; however, most involve some form of surgery or invasive treatment, and can result in complications. AIM: To evaluate the effectiveness and complications of percutaneous ethanol injection (PEI) for the treatment of axillary osmidrosis. METHODS: In total, 165 patients were treated with PEI for bilateral axillary osmidrosis. After local anaesthesia, 90% ethanol was injected into the subcutaneous layer near the interface of the dermis, where the sweat glands are located. The average amount of ethanol injected per side was 8.9 mL. RESULTS: The mean follow-up period was 14.5 months (range 10-28). Of the 165 patients, 80 (48.5%) had their outcome rated as 'excellent', 72 patients (43.6%) as 'good', 10 (6.1%) as 'fair' and only 3 (1.8%) as 'poor'. The majority of the patients having excellent to good results considered themselves satisfied with the results [152/165 (92.1%)]. Two patients developed necrosis of the axillary skin, for which surgical repair was performed. Superficial epidermolysis or local skin necrosis occurred in 15 patients; they were treated conservatively with antibiotic ointment, and the lesions healed without sequelae. CONCLUSIONS: Treatment of osmidrosis with PEI seems to be a valid alternative approach to open surgery. It has advantage of minimizing recovery time and postoperative immobilization. It is also inexpensive, relatively safe, and can be performed on an outpatient basis.