ORIGINAL ARTICLE Reversibility of hyperhidrosis post axillary depilatory laser Josiane Helou & Maya Habre & Boutros Soutou & Ismael Maatouk & Tony Ibrahim & Roland Tomb Received: 27 June 2013 /Accepted: 15 July 2013 # Springer-Verlag London 2013 Abstract Hyperhidrosis and bromhidrosis were lately reported as novel side effects of laser-assisted removal of axillary hair. The goal of our study was to evaluate the reversibility of these two side effects. An observational, single-center cohort study included over a 30-month screening period 30 patients with newly reported hyperhidrosis and/or bromhidrosis related to axillary depilatory laser. After 26 weeks of follow-up, each patient was assessed for spontaneous reversibility. A 12-week duration treatment with topical aluminum chloride was evaluated in patients with persisting hyperhidrosis. Hyperhidrosis was assessed using the Hyperhidrosis Disease Severity Scale (HDSS). Spontaneous reversibility was observed in 20 % of patients. In total, 23 out of 30 patients recovered normal axillary transpiration either spontaneously or after treatment. Mean HDSS score was significantly lower in the treated group. It appears that axillary hyperhidrosis and bromhidrosis, secondary to laser dep- ilation, reverse either spontaneously or after using topical antiperspirant. Keywords Axillary hyperhidrosis . Depilatory laser . Bromhidrosis . Reversibility Introduction Laser treatment has recently become the treatment of choice for hair removal. In general, laser treatment is a safe and effective method with some side effects. The majority of these side effects are benign and transient, such as erythema, perifollicular edema, pain, hypopigmentation, hyperpigmentation, blistering, crusting, erosion, purpura, folliculitis, and paradoxal hypertrichosis [1–6]. Other side effects are rarely reported—scarring, superficial thrombophlebitis, and reticulate erythema [3, 7]. Our team re- ported in 2009 on novel side effects of laser-assisted axillary hair removal, namely hyperhidrosis, bromhidrosis, and leucotrichia [8]. Eleven percent of female patients treated with laser diode and/or alexandrite laser for axillary hair removal reported hyper- hidrosis, and 4 % reported bromhidrosis [8]. In addition, a study conducted in Turkey showed a significant difference in hyperhidrotic activity before and after treatment of axillary hair by using the 1,064-nm Nd:YAG laser; this difference persisted 1 year after the last session [9]. Hyperhidrosis has a significant impact on patient’s recrea- tional, occupational, and social activities [10], and quality of life is majorly affected. Thus, causing hyperhidrosis to pa- tients expecting improved well-being from depilatory laser is a new concern. The aim of this study is to evaluate the reversibility of the hyperhidrosis and bromhidrosis reported after depilatory laser treatment. Materials and methods This observational, single-center cohort study was approved by the ethics committee of Hôtel-Dieu de France, our univer- sity hospital. Patients who were having axillary laser depila- tion at our center with a minimum of three completed sessions and who newly reported axillary hyperhidrosis—with or with- out bromhidrosis—were included. Two types of laser were used in our center: a pulsed diode laser (LightSheer™; wave- length 810 nm, fluence 20 to 60 J/cm 2 ) and a pulsed alexan- drite laser (Apogee™; wavelength 755 nm, pulse duration 20 ms, spot size 12.5 mm, and fluence 16 to 34 J/cm 2 ). Patients were enrolled after excluding all other usual causes of hyperhidrosis (familial cases, menopause, chronic fever, J. Helou : M. Habre : B. Soutou : I. Maatouk : T. Ibrahim : R. Tomb Faculty of Medicine, Saint Joseph University, Achrafieh, Lebanon J. Helou : M. Habre (*) : I. Maatouk : R. Tomb Dermatology Department, Hotel Dieu de France Hospital, Boulevard Alfred Naccache, Beirut 166830, Lebanon e-mail: maya.habre@usj.edu.lb Lasers Med Sci DOI 10.1007/s10103-013-1404-4