Dr Ayham Al-Ayoubi of London Medical and Aesthetic Clinic has pioneered the use of Smartlipo laser to treat axillary hyperhidrosis in the Uk since 2006.
The technologically advanced system is intended to provide a gentle, minimally invasive and permanent alternative for the treatment of excessive underarm sweating, a medical condition known as “severe primary axillary hyperhidrosis”.
What is Excessive Sweating ?
Normal sweating helps to keep the body temperature steady in hot weather, during a fever, or when exercising. Excessive sweating (hyperhidrosis) means that some people sweat much more than normal. Even when they are not hot, anxious, or exercising, they make a lot of sweat.
Excessive sweating is classified into three types – Read more . It is important to know the different type of excessive sweating, as the causes and treatments are very different.
Approximately 1% in the UK are affected by significant excessive sweating (hyperhidrosis), usually involving the palms, the armpits, the soles of the feet, and sometimes the face. Axillary hyperhidrosis is a common but difficult-to-treat medical condition with major social, labour, and emotional consequences affecting work productivity, daily activities, emotional well-being and personal relationships.
When the body heats up – from weather, exercise or stress – the brain sends the message that the system is overheating. The message travels to nerves that lead to the more than 2 million sweat glands that lie under the skin. And that’s when they send moisture through the sweat ducts to the skin’s surface.
In some people, the body’s mechanism for cooling itself is overactive – so overactive that they may sweat four or five times more than is necessary, or normal. When sweating is this extreme it can be embarrassing, uncomfortable, anxiety-inducing, and disabling. It can ruin relationships, affect career choices and damage your self-esteem.
Generally antiperspirants are the first-line treatments and people would apply perfume or products to disguise the hyperhidrosis problem but this is a superficial treatment that doesn’t affect the production of sweat.
The surgical solution was to make an incision under the arm, lift the skin and then damage or destroy the glands. The problems with this procedure are that it obviously leaves a large scar and there is a long recovery time. Also this is a very sensitive area with a strong nerve supply so you can risk doing unnecessary damage. The sweat glands are so small that it is hard just to tackle them and not damage other important tissue or muscles.
Up until now, one of the only minimally invasive procedures to help stop sweating was through the use of Botox, which blocks the nerves that control sweating. However as new nerves grow back, the sweating begins again.
Botox is a more well known treatment for hyperhidrosis. A starch test is performed to locate the sweat glands and then a small amount of Botox is injected into approximately 12 to 15 places under each arm.
The poison blocks the action of the nerves in the sweat glands – sweat slowly returns as nerve endings grow back in 6 to 12 weeks and a new treatment is usually required after seven months. This is the main disadvantage of Botox; it is only a temporary solution so can be expensive if you’re having regular top ups.
The focus then turned to other various non-surgical procedures to see if one of them was suitable for dealing with hyperhidrosis in a permanent way.
Radiofrequency was explored but this didn’t work well for a very simple reason. Radiofrequency works by applying heat to the surface of the skin, so there was possible risk of damaging or scarring the surface of the skin before even reaching the glands. Also working blind and going through vascular and fat tissue before reaching the target could risk overheating this tissue on the way through.
In contrast, Dr Ayham Al-Ayoubi’s Smartlipo laser technique was invented. The laser-assisted axillary sweat termination method, uses the Smartlipo to destroy and remove the sweat glands from the armpits. Without sweat glands no sweat is produced in the area thus the excessive sweating is stopped for good and usually there is no need of repeating the procedure.
SmartLipo’s main function is for body contouring because it fractures the fat cell membranes. But what sets it aside from other treatments and why it is so good at removing superficial, vascular fat is that it also cauterises the blood vessels at the same time. It is this function that Smartlipo is invaluable for when dealing with hyperhidrosis.
The procedure is done under local tumescent anesthesia. Tiny incisions hidden in skin folds in the armpit are made and the area under the hair-bearing skin is infiltrated with anesthetic solution. The multiple wavelength SmartlipoMPX laser fiber is then used to destroy the sweat glands in the layer just under the skin.
The laser fiber is passed back and forth from two directions until sufficient energy is delivered, and tissue resistance to passage of the fiber is achieved.
The Thermal Guide on both laser systems (the Smatlipo MPX and Smartlipo Triplex platform) is programmed to raise the temperature to the therapeutic level and shut off if this level is exceeded, thus preventing any thermal injury or burn to the skin.
The glands in the armpit that produce sweat are all dependent on a blood supply. The SmartLipo cuts the supply of blood to the glands. The procedure is very simple, by making a small 1mm incision, through which the local anaesthetic is infltrated. A small spinal needle which is very precise and delicate is used so the patient doesn’t feel the injection.
Then the Smartlipo laser cannula will be inserted through the same incision under the skin and laser the sweat glands. The structure under the arms is skin, a layer of fat, the sweat glands, another layer of fat, then muscle. Finally a gentle suction is used to suck out the local anaesthetic, the damaged gland and any little bit of fat.
Hence the procedure is done under local anesthesia and the downtime is very limited and risks are very rare. Treatment can be a tremendous and immediate improvement in the lifestyle on those whom are affected by this condition.
The recovery is quick and post-operative pain is minimal. Swelling could last about a week, there is a temporary decrease of sensation for about 3 weeks, which gradually returneds to normal in all patients. Temporary hair reduction could be noted in some patients.
Wth our long experience in laser Assisted liposuction and the addition of Smartlipo MPX to our clinic in early 2008 and the Smartlipo Triplex in 2010 and Cellulaze in early 2011, we are pleased to offer patients with the problem of excess sweating, whether or not accompanied by excess underarm odour, the benefits of this technology.
Dr Ayham Al-Ayoubi of London Medical and Aesthetic Clinic has pioneered the use of Smartlipo, Smartlipo MPX and Triplex systems to treat axillary hyperhidrosis in the UK since 2006. The results of the treatment are life changing, and the aftercare service is continuously of the highest quality.