[ZKKL] Academic Presentation | Comparative Efficacy of Radiofrequency and Surgical Treatments for Axillary Odor

The prevalence of axillary osmidrosis in the Chinese population is as high as 6.41%, making it a common condition in cosmetic and plastic surgery; however, no study has yet clearly elucidated its pathogenesis. The development of axillary osmidrosis is associated with abnormal secretory function of the apocrine sweat glands, which, influenced by genetic and endocrine factors, typically increase markedly during puberty and subsequently atrophy with aging, leading to a corresponding reduction in odor. Individuals with axillary osmidrosis experience substantial psychological and physical burdens in social interactions; therefore, there is an urgent need for treatment modalities that are simple, minimally invasive, aesthetically pleasing, allow rapid recovery, and deliver long-lasting results.

At present, conventional treatments for axillary osmidrosis are diverse, each with its own advantages and disadvantages. Topical medications and injectable therapies alleviate body odor by inhibiting apocrine sweat gland secretion; while they offer rapid relief, quick recovery, minimal discomfort, and limited invasiveness, their effects are short-lived because the apocrine glands remain intact, necessitating repeated sessions to maintain results. Surgical approaches aimed at removing the apocrine glands provide more definitive outcomes—for example, axillary skin excision. Although this method can achieve a permanent cure, the substantial postoperative trauma often leads to hypertrophic scarring and, in some cases, scar contracture.

With the continuous advancement of medical technology, minimally invasive techniques such as small‑incision subcutaneous trimming, small‑incision curettage and suction, and aspiration are being increasingly employed. These procedures offer significant advantages, including minimal trauma and rapid recovery; however, because they rely on blind removal of apocrine sweat glands, they are prone to incomplete excision, which may lead to complications such as infection, hematoma, and skin necrosis.

The radiofrequency therapeutic device utilizes the reciprocating flow of radiofrequency current between the transmitting and receiving electrodes, combined with the electrical resistance generated by the tissue, to induce frictional heating of water molecules within the tissue, thereby ablating cells. ;  Alternatively, the thermal effect can induce protein denaturation within the cells of the apocrine sweat glands, leading to cell lysis and thereby achieving the goal of removing these glands.

This study employed both radiofrequency ablation and surgical excision to treat patients with axillary osmidrosis, comparing the efficacy and incidence of complications between the two approaches. The results indicated that, compared with radiofrequency therapy, surgical treatment showed no statistically significant differences in either therapeutic efficacy or recurrence rate. ( P All > 0. 05) ; However, the incidence of complications in patients undergoing radiofrequency ablation was significantly lower than that in patients undergoing surgical treatment, with a statistically significant difference. ( P < 0. 05) 。 The results indicate that radiofrequency treatment for axillary osmidrosis is comparable in efficacy to conventional surgical therapy; however, radiofrequency ablation is easier to perform, has fewer contraindications, offers improved safety, and is less likely to leave scars, thereby preserving postoperative cosmetic outcomes. ;  Surgical treatment, by contrast, inflicts greater trauma on patients and is prone to postoperative complications such as infection, scarring, and skin necrosis, which not only compromise cosmetic outcomes but may also impose functional limitations on the upper limb. Zhang Zhiping et al. have likewise reported that both surgical and radiofrequency ablation achieve cure rates approaching 70%, with no significant difference in efficacy; however, surgical intervention often entails postoperative complications, including scarring.

However, Zhu Guang also indicated that radiofrequency therapy yields significantly better outcomes than surgical treatment in patients with axillary osmidrosis. It also points out that radiofrequency ablation is associated with fewer complications and better safety; the reasons for the differing conclusions may largely stem from variations in the specific surgical techniques employed. At present, there are few reports on post‑treatment recurrence rates following either approach. This study indicates that the recurrence rate after both treatments was 22. 22% Although there is no significant difference between the two, the recurrence rates remain high—this remains a pressing concern for many patients and clinicians. These findings underscore the need for further research and refinement in the treatment of axillary osmidrosis, with the aim of helping patients more effectively address this condition and promptly alleviate the distress and burden it imposes.

In summary, radiofrequency therapy for axillary osmidrosis is easy to perform, highly effective, minimally invasive, associated with few complications, and offers long-lasting, reliable results.