Comparison of microwave ablation, botulinum toxin injection, and liposuction-curettage in the treatment of axillary hyperhidrosis: A systematic review

Background: Primary focal axillary hyperhidrosis is a disorder of excessive sweating that can strongly impact quality of life. Objective: To compare microwave ablation, botulinum toxin injection and liposuction-curettage in the treatment of primary axillary hyperhidrosis based on subjective and objective criteria. Methods: A systematic review of the literature published in French or English between January 1st 1991 and February 1st 2015 was completed using PubMed and Embase databases. Results: 16 out of 775 articles were selected based on relevance and criteria of inclusion and exclusion. The three methods proved to be efficient and safe however microwave ablation and botulinum toxin had better results when compared to liposuction-curettage on the short term. Both microwave ablation and liposuction-curettage showed longer lasting results when compared to botulinum toxin. However, on the long term, microwave ablation was superior to liposuction-curettage. Conclusion: Microwave ablation, liposuction-curettage and botulinum toxin injections are safe and efficient minimally invasive alternatives for the treatment of axillary hyperhidrosis. Well-designed randomized controlled trials are needed to further compare the efficacy of these techniques.