While the term ‘axillary hyperhidrosis’ might be unfamiliar, the condition itself is all too familiar to the 4 or 5 million people affected in the U.S. alone. Excessive underarm sweating is not a serious condition, but for those who suffer from soaked clothing and odor, it is often so stressful and embarrassing that it goes untreated. “In some cultures, the social implications are even more significant than what we see here,” says Dr. David Caplin of Parkcrest Plastic Surgery. “In some countries, there is such a profound sense of embarrassment that people are willing to endure surgery that involves cutting out skin from under the arms. This aggressive approach is fraught with complications.” Other treatments for the condition, including topical anti-perspirants or medication, he adds, are not very effective.

     Caplin has successfully treated patients with Botox injections, which work by blocking the nerve endings that control sweat production. “It’s extremely effective, but costly, and the effects are not long-lasting,” Caplin says. “It is sometimes covered by insurance, but if not, it can become too expensive to keep repeating the treatments long-term.”

    One of the newer treatments for the condition involves the use of the SmartLipo laser. Commonly used for the removal of excess fat, the laser treats hyperhidrosis by destroying the sweat glands just under the skin. Caplin’s patients, as well as other surgeons’ patients, have had long-term success with the laser. “We have seen dramatic reductions in sweating—as much as 70 to 80 percent—and we’ve found the results to be very long-lasting. It’s theoretically possible to have the treatment a second time, but so far we have not had to do that.”

    While the traditional SmartLipo technology is effective, Caplin says a new laser tip manufactured by Cynosure refines the technique even further. “It’s called a side-firing laser fiber. Instead of having the light come out at the tip of the fiber, it is emitted from the side of the end of the laser fiber. There’s a narrow metal cannula and the laser fiber goes through that channel. It can be aimed more directly at the undersurface of the skin where the sweat glands are located, so it may have real advantages for treating hyperhidrosis.” The new laser also shows potential for the treatment of cellulite, he adds.

    Caplin currently is recruiting patients to participate in a research study to test the effectiveness of the new side-firing laser. “There are studies from several countries, some of them going back 10 years, researching the use of the traditional laser fiber, but not  for this new device,” he explains. “We’re looking for 15 candidates. They’ll be treated at no cost, and also will be compensated for follow-up visits.” The procedure is done under a local anesthesia, with little or no downtime, Caplin adds. “The first two patients we treated with this new fiber were college students who went right back to school. Patients should avoid vigorous sports for a week or two after being treated, but that’s about the only restriction.”

    For information about participating in the study, call Parkcrest Plastic Surgery at 569-0130.  LN

On the Cover: Dr. David Caplin of Parkcrest Plastic Surgery is seeking candidates to participate in a research study on the effectiveness of a new laser treatment for excessive underarm sweating (axillary hyperhidrosis). Study participants will be treated at no cost and compensated for follow-up visits. For more information, call 485-4965 or visit parkcrestplasticsurgery.com