Subclinical effects of botulinum toxin A and microwave thermolysis for axillary hyperhidrosis: A descriptive study with line-field confocal optical coherence tomography and histology

Gabriela Lladó Grove*, Kevin Jacobsen, Nina Loeth Maartensson, Merete Haedersdal

*Corresponding author for this work

Abstract

Botulinum toxin A (BTX) and microwave thermolysis (MWT) are standard axillary hyperhidrosis treatments, but comparison of their subclinical effects is lacking. Line-field confocal optical coherence tomography (LC-OCT) is a promising non-invasive imaging tool for visualizing tissue-interactions. This study aimed to describe subclinical effects of BTX and MWT for axillary hyperhidrosis with LC-OCT-imaging compared to histology. This study derived from an intra-individual, randomized, controlled trial, treating axillary hyperhidrosis with BTX versus MWT. Subclinical effects based on LC-OCT images from baseline and 6-month follow-up (n = 8 patients) were evaluated and compared to corresponding histological samples. At baseline, LC-OCT visualized eccrine pores at the skin surface and ducts in the upper dermis (500 μm), but not deeper-lying sweat glands. Histology identified entire sweat glands. Six months post-treatment, LC-OCT revealed no detectable morphology changes in any BTX-treated axillae (100%), while recognizing obstructed eccrine pores and atrophy of eccrine ducts in most MWT-treated axillae (75%). Histology corroborated LC-OCT findings, while also showing substantial changes to entire sweat glands. LC-OCT enabled visualization of subclinical alterations of superficial eccrine ducts after MWT and unchanged morphology after BTX. LC-OCT is a promising tool for non-invasive assessment of treatment-specific tissue-interactions that can be complementary to histology.

Original languageEnglish
Article numbere15110
JournalExperimental Dermatology
Volume33
Issue number6
Pages (from-to)e15110
ISSN0906-6705
DOIs
Publication statusPublished - Jun 2024

Keywords

  • Hyperhidrosis/drug therapy
  • Humans
  • Tomography, Optical Coherence/methods
  • Axilla
  • Microwaves
  • Botulinum Toxins, Type A/administration & dosage
  • Adult
  • Female
  • Male
  • Sweat Glands/diagnostic imaging
  • Young Adult
  • Middle Aged
  • Eccrine Glands/diagnostic imaging

Fingerprint

Dive into the research topics of 'Subclinical effects of botulinum toxin A and microwave thermolysis for axillary hyperhidrosis: A descriptive study with line-field confocal optical coherence tomography and histology'. Together they form a unique fingerprint.

Cite this