armpit odour

Suddenly, are you concerned about the smell of your armpits (armpits)?

You may be more likely to find that you don't mind your own odor and that none of your family or friends have an odor problem.

Worldwide, only a minority of the world's population has a low armpit odor, and only in some parts of Asia.

In the West and the Middle East, armpit odor is considered physiological. This may be why deodorant culture has matured.

The percentage of Japanese with axillary odors (so-called armpit odor) is about 10%, or 1 in 10 people.

The fact that people with axillary odors are a minority of the population is deeply troubling to those involved and can affect their school and social lives.

apocrine sweat gland

The cause of axillary odor is the apocrine sweat glands, which are ducts under the skin.

In addition to the armpit, apocrine sweat glands are also present in the ear canal, nipple area, and vulva, and people with axillary odor have a higher number of apocrine sweat glands.

Apocrine sweat glands develop after puberty, so some people start having problems in the upper elementary school years.

In fact, sweat from the apocrine sweat glands itself is odorless. However, when combined with sebum and broken down by indigenous skin bacteria, it releases a characteristic odor described as chili sauce or rag smell. In addition to the odor, the pigmentation of sweat can also cause yellowing of clothing.

Some people may not be concerned about armpit odor but may be concerned about armpit perspiration. Sweating to regulate body temperature is physiological, but armpit sweating to the extent that it has a negative impact on daily life can reduce the quality of life.

eccrine sweat gland

Sweat is secreted by eccrine sweat glands, which are ducts located deep in the dermis. Unlike apocrine glands, eccrine sweat glands are distributed almost throughout the body and do not increase in number during growth.

Both axillary dyshidrosis and hyperhidrosis, if severe enough, can reduce quality of life.

treatment

Treatment options include topical antiperspirants, topical anticholinergics, oral anticholinergics, oral antipsychotics, Botox injections, and surgical treatment, depending on symptoms and wishes.

Surgical treatment should be considered if semi-permanent improvement is desired.

When I became a doctor about 20 years ago, the surgical treatment for axillary odor was pruning.

The treatment involves making one or two incisions in the armpit and removing apocrine and eccrine glands with scissors while visually checking them. The hardest part is after the surgery, when a band of gauze is stitched to the armpit with thread to prevent hematoma. In addition, I had to wear a band to put pressure on the armpit to keep the wound at rest. Hospitalization was common, as it was difficult to change clothes by oneself due to the limited movement of the arms and shoulders. Scars are another problem with the pruning method. While some people heal very nicely, others have visible scars or pigmentation due to skin damage. My impression of the surgery was that if the odor improves, the scar is unavoidable to some extent.

The black ship MiraDry, which came from the U.S. in 2010, revolutionized this situation.

Amazing! MiraDry!

MiraDry is a treatment device that uses microwaves to cause thermal damage to the deep dermis and subcutis, where eccrine and apocrine sweat glands reside, to semi-permanently suppress the function of the sweat glands. It leaves no scars and does not require postoperative bed rest or hospitalization.

The FDA (U.S. Food and Drug Administration), the equivalent of Japan's Ministry of Health, Labor and Welfare, has approved it for the treatment of axillary odor, axillary hyperhidrosis, and reduction of axillary hair. In Japan, it has received regulatory approval for severe armpit sweating.

The normal course of the procedure is a few days of internal bleeding, edema, and pain, but there are no restrictions to daily activities. A rare complication is the risk of neuropathy associated with brachial nerve injury (e.g., tingling inside the upper arm), but this usually resolves spontaneously within a few months. This is a minor complication compared to skin necrosis, which is a serious complication of pruning.

When it comes to the treatment of axillary odor, we have been educated about the pruning method, and from the standpoint of actually performing the surgery, I wonder if it is effective even though it does not involve cutting. What about the long-term effects? I was skeptical at first. However, after actually performing the MiraDry treatment, my skepticism was dispelled.

If the pruning method were more effective, there would still be a reason to use pruning, but I feel that MiraDry is superior to pruning by a poor surgeon in terms of effectiveness. Above all, the fact that there is no scarring and no need for postoperative rest was a revolutionary advantage of MiraDry.

For this reason, the number of surgeries for axillary hyperhidrosis and axillary hyperhidrosis has gradually decreased, and it has been a long time since the last time we performed a pruning surgery.

summary

Surgery and treatment are updated on a daily basis, but they are basically an accumulation of improvements on the techniques established by our predecessors. Epoch-making events that completely change treatment methods do not occur often.

The current drawback of MiraDry is that it is not covered by insurance. Therefore, the pruning method is still an active treatment method under insurance. However, considering the effectiveness and post-treatment comfort, MiraDry treatment is a treatment method that provides more satisfaction than its price.

Although we are primarily a surgical clinic, we have two options for axillary hyperhidrosis and axillary hyperhidrosis: Botox treatment and MiraDry.

Some reports estimate that only about 20% of people suffering from axillary hyperhidrosis or axillary hyperhidrosis actually visit a medical institution and receive treatment. Compared to before MiraDry became popular, the hurdles to treatment have dropped dramatically, so I wanted to write this column to let those who are suffering from this condition know that "there is such good equipment available now! I wanted to write this column to let those who are suffering from this condition know that "there is such a good equipment now!

Assistant Director Daiki Kuroda

#Cosmetic Surgery Yoyamatogatari Series