COMPARATIVE ANALYSIS OF THE EFFICACIES OF BOTULINOTOXIN A THERAPY AND FRACTIONAL RADIO-FREQUENCY-LIFTING IN THE TREATMENT OF PRIMARY HYPERHYDROSIS.

Hyperhydrosis (HH) is a pathology of eccrine gland which is manifested by excessive sweating on the skin. It has a significant negative impact on an individual's quality of life (QoL). Primary HH is the most common idiopathic condition which is mostly localized. Botulinum toxin A therapy (BTX) treatment is one of the proven, minimally invasive methods for HH treatment; however, minimally invasive fractional RF-lifting with microneedles for primary HH is of great interest of researchers. The aim of our study was to compare the effectiveness of fractional RF-lifting with microneedles and botulinum toxin-A treatment methods in people with primary HH and to determine the role of these methods in HH management tactics based on the analysis. After signing the consent agreement 60 patients with HH participated in the study. 30 patients were selected for BTX (group 1), another 30 participants - for RF-lifting with microneedles (group 2). Target areas of treatment were the armpit, palm, and sole. The assessment of treatment efficacy was performed by the questionnaires of the Dermatology Patient Quality of Life Index (DLQI) and Hyperhidrosis Severity Score (HDSS). Mean value of DLQI-score before treatment in group 1 was 18.1±4.3, and in in group 2 - 13.3±5.6 (the difference was significant - p<0.001). After treatment these scores were 8.3±5.5 and 6.6±5.3, respectively (the difference was not significant - p=0.228). As for intragroup difference of DLQI-scores before and after treatment, they were decreased significantly (p<0.001 for both groups). Moreover, the percentages of the patients with high degree HH were significantly decreased in both groups. However, the difference between the DLQI-scores of groups both before and after treatment was not significant. Both methods proved to be significantly effective for all three locations, especially for the armpit. However, no significant differences were observed when comparing the methods. The results of the study based on the DLQI-questionnaire indicate that application of both methods improved QoL of HH patients and decreased the degree of severity significantly. Both methods may be applied in the tactics of HH treatment with equal success rates. Additional randomized trials are needed to make evidence-based conclusions.