Original Research Articles
Vol. 33 No. 1 (2026)
https://doi.org/10.4081/ltj.2026.429

Tumescent-assisted interstitial (intradermal/subcutaneous) 1470 nm diode laser treatment for primary axillary hyperhidrosis: a prospective single-center series of 23 cases with 12-month follow-up

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 1 April 2026
40
Views
29
Downloads
Axillary hyperhidrosis, 1470 nm laser, tumescent anesthesia, interstitial laser, clinical outcomes

Authors

Luigi Mazzi
drluigimazzi@gmail.com
Independent Researcher; Plastic Surgeon, Verona, Italy.

Primary axillary hyperhidrosis (AH) is a chronic condition that significantly impacts quality of life. The 1470 nm wavelength, characterized by high hydro-absorption, offers the potential for more confined photo-thermocoagulation of the glandular compartment when energy is delivered interstitially under tumescent anesthesia. We conducted an uncontrolled single-center prospective series on 23 adults (16 men, 7 women; aged 21-53 years) treated using a 1470 nm diode laser (LASEmaR 1500®, Eufoton®, Trieste, Italy) connected to a 400 μm optical fiber inserted into a hollow cannula with an open tip and blunt end through 2-3 access points per axilla. Follow-up was carried out at 6 and 12 months. Outcomes included Hyperhidrosis Disease Severity Scale (HDSS; primary endpoint), gravimetry (mg/5 min), local humidity (%), Dermatology Life Quality Index (DLQI), Global Aesthetic Improvement Scale (GAIS), and safety. The protocol allowed selective retreatment at 6 months in patients with clinically relevant residual activity/high functional demands. All patients achieved HDSS ≤2 at both 6 and 12 months. Mean gravimetry decreased from 128.8±27.7 to 38.4±10.8 and 32.0±9.4 mg/5 min; humidity from 75.3±5.8% to 45.7±3.3% and 43.4±3.6%. DLQI fell from 15.9±4.4 to 5.0±1.1 and 4.3±1.1. At 12 months, overall assessment was excellent in 82.6% (19/23), good in 8.7% (2/23), and fair in 8.7% (2/23). Adverse events were mild and transient, with no infections or burns. Of the 23 participants, 16 underwent a single treatment session, while 7 received a retreatment at 6 months. In this prospective case series, interstitial 1470 nm laser with tumescent assistance was associated with clinically relevant improvement up to 12 months and a favorable tolerability profile. Given the uncontrolled observational design and selective retreatment in a subset, these findings should be considered hypothesis-generating and warrant confirmation in comparative studies.

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
1. International Hyperhidrosis Society. Primary focal axillary hyperhidrosis (clinical guidance). 2018. Available from: https://www.sweathelp.org/treatments-hcp/clinical-guidelines/primary-focal-hyperhidrosis/primary-focal-axillary.html
2. Cervantes J, Perper M, Eber AE, et al. Laser treatment of primary axillary hyperhidrosis: a review of the literature. Lasers Med Sci 2018;33:675-81. DOI: https://doi.org/10.1007/s10103-017-2434-0
3. Lowe NJ, Yamauchi PS, Lask GP, et al. Botulinum toxin type A in primary axillary hyperhidrosis: a 52-week multicentre double-blind, randomised, placebo-controlled study. J Am Acad Dermatol 2007;56:604-11. DOI: https://doi.org/10.1016/j.jaad.2007.01.009
4. Grove GL, McHugh M, Rockenbach JS, et al. Botulinum toxin A versus microwave thermolysis for axillary hyperhidrosis: long-term side-by-side comparison. JAAD Int 2024 (ahead of print). DOI: https://doi.org/10.1016/j.jdin.2023.12.011
5. Glaser DA, Coleman WP III, Fan LK, et al. A randomised, blinded clinical evaluation of a novel microwave device for treating axillary hyperhidrosis. Dermatol Surg 2012;38:185-91. DOI: https://doi.org/10.1111/j.1524-4725.2011.02250.x
6. Hong HCH, Lupin M, O’Shaughnessy KF. Clinical evaluation of a microwave device for treating axillary hyperhidrosis. Dermatol Surg 2012;38:728-35. DOI: https://doi.org/10.1111/j.1524-4725.2012.02375.x
7. Kaminaka C, Yamamoto Y, Tsuboi R. Clinical and histological evaluation of a single high-energy microwave treatment for axillary hyperhidrosis and osmidrosis. Lasers Surg Med 2019;51:635-43. DOI: https://doi.org/10.1002/lsm.23073
8. Hsu TH, Chen YT, Tu YK, Li CN. A systematic review of microwave-based therapy for axillary hyperhidrosis. J Cosmet Laser Ther 2017;19:275-82. DOI: https://doi.org/10.1080/14764172.2017.1303168
9. Nasr MW, Jabbour SF, Haber RN, et al. Comparison of microwave ablation, botulinum toxin injection, and liposuction-curettage in the treatment of axillary hyperhidrosis: a systematic review. J Cosmet Laser Ther 2017;19:36-42. DOI: https://doi.org/10.1080/14764172.2016.1248438
10. NICE. Interventional procedures overview: Microwave thermolysis for primary axillary hyperhidrosis (IPG601). London: National Institute for Health and Care Excellence; 2017.
11. Roychowdhury S, Aslam R, Nip T. Microwave-based therapy for axillary hyperhidrosis: a review. Shanghai Chest 2019;3:19. DOI: https://doi.org/10.21037/shc.2019.03.04
12. Pariser DM, Ballard A, Hebert AA, et al. Topical glycopyrronium tosylate for primary axillary hyperhidrosis: results from the ATMOS-1 and ATMOS-2 phase 3 RCTs. J Am Acad Dermatol 2019;80:128-38.e2. DOI: https://doi.org/10.1016/j.jaad.2018.07.002
13. Hebert AA, Glaser DA, Pieretti L, et al. Long-term efficacy and safety of topical glycopyrronium tosylate cloth 2.4%: 44-week open-label extension. Pediatr Dermatol 2020;37:711-8. DOI: https://doi.org/10.1111/pde.14135
14. Kirsch B, Lohse J, Jackson J, et al. Efficacy and safety of topical sofpironium bromide gel for axillary hyperhidrosis: phase II randomised trial. J Am Acad Dermatol 2020;82:1150-8. DOI: https://doi.org/10.1016/j.jaad.2020.02.016
15. Yokozeki H, Abe M, Fujimoto T, et al. Phase 3 randomised study of 5% sofpironium bromide gel in Japanese patients with primary axillary hyperhidrosis. J Dermatol 2021;48:451-9. DOI: https://doi.org/10.1111/1346-8138.15668
16. International Hyperhidrosis Society. Sofpironium (SOFDRA) topical gel 12.45%: FDA approval update. 2024. Available from: https://www.sweathelp.org/treatments-hcp/sofdra-sofpironium-bromide-topical-gel.html
17. Grove GL, Kirtland S, Ballard A, et al. Impact of microwave thermolysis energy levels on patient-reported outcomes. Lasers Surg Med 2023;55:105-15. DOI: https://doi.org/10.1002/lsm.23610
18. Chang CK, Tung YC, Lin YT. Brachial plexus injury after microwave-based treatment for axillary hyperhidrosis and osmidrosis. J Cosmet Laser Ther 2017;19:439-41. DOI: https://doi.org/10.1080/14764172.2017.1342039
19. Puffer RC, Spinner RJ, Amrami KK, et al. Bilateral brachial plexus injury after microwave procedure for axillary hyperhidrosis: case report. World Neurosurg 2019;124:370-2. DOI: https://doi.org/10.1016/j.wneu.2019.01.093
20. Ibrahim DA, El-Basiouny MS, Elwakil TF, AboEitta MR. Diode laser 1470 nm versus diode laser 980 nm for treatment of primary axillary hyperhidrosis. Int J Curr Res Rev 2022;14:51-60. DOI: https://doi.org/10.31782/IJCRR.2022.14514

How to Cite



Tumescent-assisted interstitial (intradermal/subcutaneous) 1470 nm diode laser treatment for primary axillary hyperhidrosis: a prospective single-center series of 23 cases with 12-month follow-up. (2026). Laser Therapy, 33(1). https://doi.org/10.4081/ltj.2026.429
Copyright (c) 2026 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.