Ann Dermatol.  2014 Apr;26(2):184-188. 10.5021/ad.2014.26.2.184.

A Prospective, Long-Term Follow-Up Study of 1,444 nm Nd:YAG Laser: A New Modality for Treating Axillary Bromhidrosis

• Jung SK
• Jang HW
• Kim HJ
• Lee SG
• Lee KG
• Kim SY
• Yi SM
• Kim JH
• Kim IH

• KMID: 2171653
• DOI: http://doi.org/10.5021/ad.2014.26.2.184

Abstract

BACKGROUND
Surgery for bromhidrosis has a high risk of complications such as hematoma and necrosis. New nonsurgical methods may reduce the burden on surgery and the risks for the patient.
OBJECTIVE
This study was performed to evaluate the efficacy and side-effects of the 1,444 nm Nd:YAG interstitial laser for treating axillary bromhidrosis.
METHODS
Eighteen bromhidrosis patients were treated with a 1,444 nm Nd:YAG laser at Korea University Ansan Hospital. The post-treatment follow-up was 6 months. After the procedure, we confirmed apocrine gland destruction through histopathological examination. At each follow-up, we measured the severity of the remaining odor, postoperative pain, degree of mobility restriction, and overall satisfaction.
RESULTS
After 180 days of follow-up, malodor elimination was good in 20 axillae, fair in 12 axillae, and poor in four axillae. At the end point of the study, 14 patients were totally satisfied with the laser treatment, three patients were partially satisfied, and one patient was disatisfied. Pain and limitation of mobility were significantly reduced within 1 week post-operatively, and were almost resolved within 4 weeks post-operatively. A histopathological examination revealed decreased density and significant alterations to the apocrine glands.
CONCLUSION
Subdermal coagulation treatment with a 1,444 nm Nd:YAG interstitial laser may be a less invasive and effective therapy for axillary bromhidrosis.

Keyword

Bromhidrosis; Interstitial laser; Solid-state lasers; 1,444 nm

MeSH Terms

Apocrine Glands
Axilla
Follow-Up Studies*
Gyeonggi-do
Hematoma
Humans
Korea
Lasers, Solid-State
Necrosis
Odors
Pain, Postoperative
Prospective Studies*

Figure

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  Fig. 1 Intraoperative photography showing the puncture site at one side of the affected area.

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  Fig. 2 Malodor elimination assessment results at study follow-up visits.

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  Fig. 3 Patient satisfaction assessment results at study follow-up visits.

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  Fig. 4 Post-operative findings at days 1 and 8. (A, B) Right and left axillae 1 day following the laser operation. No significant side effects were evident. (C, D) Axillae from another patient 8 days following laser surgery. Mild ecchymosis was observed.

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  Fig. 5 Pre- and post-operative histological findings. (A, B) Pre-operative histological appearance (H&E, A: ×40 and B: ×200). (C) Histological appearance after 6 months of follow-up. Decreased density of apocrine glands (arrows) is evident (H&E, ×40). (D) Histological appearance after 6 months of follow-up. Dystrophic apocrine glands (arrows) are present (H&E, ×200).

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