Laser Sweat Ablation LSA

The sweat glands in the skin are situated just below the surface in a region called the dermis.

The LSA operation is a local anaesthetic operation performed in a walk-in walk-out local anaesthetic clinic.

Suitable patients who wish to have the operation are taken into the local anaesthetic theatre.

The procedure starts with a test using iodine and starch to show exactly where the sweat glands are located in the armpit.

Local anaesthetic is injected under the skin to make the whole of the procedure painless.

Under sterile techniques, two small incisions, approximately 5 mm long, are made in the armpit. A blunt instrument is used to gently separate the dermis (skin) from the underlying subcutaneous fat, making room for the procedure to be performed.

A special suction tool is then inserted under the dermis and is passed backwards and forwards, removing the lower part of the dermis and most of the eccrine sweat glands. It is important to note that subcutaneous fat is NOT removed to do this properly, it is NOT a liposuction technique.

In the past, some doctors have not understood the anatomy correctly and have used laser liposuction procedures to remove the subcutaneous fat - as the sweat glands are not in this fat, the operation does not work and the patients having this liposuction ended up with exactly the same sweating as they had originally. Hopefully this has stopped now.

Once the sweat glands have been removed using the LSA technique, the laser is then used to treat the area where the sweat glands used to be. It appears that doing this removes more sweat glands that might have been smaller and therefore missed, and it appears to be that using the laser reduces the risk of the sweat glands growing back or functioning again.

The whole laser sweat ablation operation is performed under local anaesthetic as a walk-in, walk-out procedure. It takes just over one hour to perform and when performed in The Whiteley Clinic, it reduces the sweating on average by 82% in people with axillary hyperhidrosis. The aim is not to stop the sweating completely, but to reduce excessive sweating to normal levels.

History of laser sweat ablation (LSA)

The concept of laser sweat ablation was started by Dr G Blugerman in Buenos Aries, Argintina. He started performing a procedure "subdermal laser ablation" (SDLA) in 1999. Mark Whiteley went to train with him in 2008 and brought the procedure back to the UK.

However the original procedure did not work as well as Mark Whiteley wished and so the procedure order, instruments and technique were modified on his research to produce the laser sweat ablation procedure.