• Falk G Bechara, Thilo Gambichler, Armin Bader, Michael Sand, Peter Altmeyer, and Klaus Hoffmann.
• Departments of Dermatology, Ruhr-University Bochum, Germany. f.bechara@derma.de
• J. Am. Acad. Dermatol. 2007 Aug 1; 57 (2): 207-12.

BackgroundFocal axillary hyperhidrosis (FAH) is a benign functional disorder that may lead to social and psychologic handicap. Hence, the improvement of quality of life is a major aim of therapy. Several studies evaluating the quality of life before and after application of topical agents, injections with botulinum toxin, and thoracoscopic sympathectomy have been reported. However, changes of quality of life after minimally invasive surgical procedures such as suction-curettage (SC) have not been investigated so far.ObjectiveWe sought to evaluate the quality of life in patients with FAH before and after SC using the validated Dermatology Life Quality Index (DLQI).MethodsIn all, 51 patients who underwent SC were followed up for 9 months. The DLQI was completed by the patients before and 9 months after surgery. In addition, scores for patient satisfaction and improvement of FAH were applied.ResultsThe median DLQI score before treatment was 12 (range: 9-18). Nine months after surgery a significant decrease of the DLQI score was observed (median: 4; range: 2-8) resulting in a relative reduction and improvement of the DLQI score of 63.4% (range: 33-83; P < .05), respectively. A significant sweat reduction was reported in 68.6% of patients experiencing a decrease of sweating of at least 75% after SC. Moreover, 78.4% of the patients were very or completely satisfied with the surgical procedure.LimitationsOnly severe cases of hyperhidrosis, refractory to conservative therapy, were included. No objective outcome measure (eg, gravimetry) was included.ConclusionOur data support results of previous studies demonstrating that FAH is associated with considerably reduced quality of life. SC is an effective surgical therapy option that can largely reverse the disabilities experienced by patients with excessive axillary sweating.

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