Effectiveness and Safety of Suction Curettage Surgery for Axillary Bromhidrosis: A Prospective Cohort Study

BACKGROUND: Axillary bromhidrosis leads to substantial psychosocial burden. This study compares the efficacy and safety of suction curettage surgery (SCS) versus small-incision direct-vision trimming surgery (SIDVTS) for moderate to severe cases. METHODS: In this prospective cohort study, 196 patients with Park-Shin grade 2 or 3 disease underwent SCS ( n = 96) or SIDVTS ( n = 100). Primary outcomes included 6-month cure rates and postoperative complications. Secondary outcomes encompassed healing time and Patient and Observer Scar Assessment Scale scores. Propensity score matching (PSM) balanced baseline confounders; multivariable analysis identified risk factors. RESULTS: Pre-PSM cure rates were comparable (SCS 89.6% versus SIDVTS 92.0%; P > 0.05). Post-PSM analysis confirmed no significant difference (89.7% versus 86.8%; P = 0.791). SCS demonstrated significantly fewer complications, including cutaneous necrosis (10.3% versus 27.9%; P = 0.015), long-term pigmentation (5.9% versus 16.2%; P = 0.045), infection (2.9% versus 11.8%; P = 0.049), and hematoma (1.5% versus 10.3%; P = 0.029). Recrudesce rates were similar (8.8% versus 7.4%; P = 0.753). SCS yielded superior scar outcomes ( P < 0.05) and faster healing (8.03 ± 1.30 versus 11.57 ± 1.75 days; P < 0.05). Multivariable analysis revealed body mass index of 28 kg/m 2 or higher, age older than 31 years, fasting glucose level greater than 6.0 mmol/L, and surgical area greater than 17 cm 2 as independent risk factors for complications in both groups. CONCLUSIONS: SCS achieved noninferior cure rates to SIDVTS with fewer complications, reduced scarring, and quicker recovery. Elevated body mass index, age, glucose level, or surgical area increased complication risks. These findings support SCS as a safer alternative for axillary bromhidrosis.