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A comparative study between intradermal botulinum toxin A and fractional microneedle radiofrequency (FMR) for the treatment of primary axillary hyperhidrosis


Microneedle radiofrequency (FMR) for the treatment of primary axillary hyperhidrosis radiofrequency (RF) technology is a new modality that applied deep heat energy directly affecting the epidermis and dermis. Limiting data about FMR for axillary hyperhidrosis is concerning. To compare clinical efficacy between fractional microneedle radiofrequency and intradermal botulinum toxin type A injection. This study was a randomized, intraindividual split-side comparative study. Twenty female subjects clinically diagnosed of primary axillary hyperhidrosis were enrolled. All subjects randomly assigned to receive either FMR device on one side of axilla or 50 units of intradermal botulinum toxin A on contralateral side of axilla. Treatment with FMR device was scheduled for 2 sessions for 4 weeks apart. After treatment, mean Hyperhidrosis Disease Severity Score (HDSS) of both groups revealed remarkably better reduction from the baseline (p < 000.1). By comparing between the two groups at the endpoint visit (12th week), the botulinum toxin A group had significantly better reduction of mean HDSS score than the microneedle RF group with 1.60 (0.59) versus 2.05 (0.68), respectively (p = 0.0332). At the week-12 visit, the botulinum toxin A group had significantly better participant’s satisfaction score by quartile rating scale than the microneedle RF group (2.55 + 0.69 versus 1.70 + 1.03, respectively, p = 0.004). Therefore, the botulinum toxin A group also demonstrated with significantly better improvement for their quality of life by DLQI score at the 12th week than the microneedle RF group (p = 0.013). Intradermal botulinum toxin A had better efficacy than fractional microneedle radiofrequency for the treatment of primary axillary hyperhidrosis.

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We are very grateful for research participants and would like to thank The Thai Aesthetics Physicians and School of Anti-aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand.

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Correspondence to Thep Chalermchai.

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This study was conducted according to the International Conference of Harmonization (ICH) Good Clinical Practice (GCP) guidelines and the Declaration of Helsinki. This study was approved by the independent Ethics Committee (IEC)/Institutional Review Board (IRB) of Mae Fah Luang University on August 1, 2016, and registered with (identification number: NCT03054480).

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The authors declare that they have no conflict of interest.

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Rummaneethorn, P., Chalermchai, T. A comparative study between intradermal botulinum toxin A and fractional microneedle radiofrequency (FMR) for the treatment of primary axillary hyperhidrosis. Lasers Med Sci 35, 1179–1184 (2020).

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  • Fractional microneedle radiofrequency
  • Intradermal botulinum toxin A
  • Primary axillary hyperhidrosis