A single session of high‐energy microwave axillary hyperhidrosis and osmidrosis therapy: Key pretherapeutic assessment and outcome analysis

Abstract Background Microwave therapy is used to treat axillary hyperhidrosis and osmidrosis. Even while a “danger zone” has been identified and reports of potential complications from nerve injury have been made, there has been little real‐world discussion regarding whether there is any pretreatment evaluation key factor that may lower the risk. Furthermore, the efficacy of a single treatment and the safety of high‐energy therapies have not been well investigated. Objective The aim of this study is to demonstrate the key aspects of pre‐therapeutic assessment, efficacy, and suitability of a single treatment, as well as the safety of high‐energy treatments. Methods Fifteen patients with axillary hyperhidrosis (AH) and axillary osmidrosis (AO) between ages of 20 and 50 had pretherapeutic ultrasonography and clinical assessments performed followed by a single‐pass microwave treatment using the miraDry system at energy level 5. The severity of AH and AO was evaluated using the Hyperhidrosis Disease Severity Scale and Odor‐10 scale, respectively, at baseline, 1 month, 3 months, and 1 year after treatment. Adverse reactions were recorded at each point of evaluation. Results Out of 30 treatment areas, 14 have a danger zone. Female gender, a small mid‐upper arm circumference, and a low body mass index (BMI) are all associated risk factors. The average Hyperhidrosis Disease Severity Scale score decreased from 3.1 ± 0.7 to 1.3 ± 0.5 ( p < 0.001), while the odor‐10 score declined from 7.1 ± 1.6 to 3.0 ± 1.6 ( p < 0.001), indicating a significant improvement in AH and AO. Most of the unfavorable treatment effects disappeared within the first month. Limitations This study has no objective quantitative measurement of axillary odor severity and sweat assessment. Conclusion Female patients, those with a smaller mid–upper arm circumference, and those with a low BMI should be treated with extra caution, and the tumescent anesthetic dose may be increased based on safety. A high‐energy microwave treatment procedure performed in a single session is a safe and effective therapeutic option with good recovery.