腋臭症と腋窩多汗症—要因と各種治療法の概略—

Overview for a Comprehensive Understanding of Axillary Osmidrosis and Axillary Hyperhidrosis

はじめに

　腋臭症と腋窩多汗症はいずれも「わき汗」によって生じる疾患である。そして一般人のみならず，医療者であっても両疾患の違いを正しく理解している人は少ない。しかも，特に多汗症に対する各種の治療法については，皮膚科，形成外科，美容外科，胸部外科，麻酔科，精神科など多数の診療科に分散している複雑さがある。本稿では両疾患についての正しい知識を提供したうえで，形成外科・美容外科分野に限定しない各種の治療法について概略を紹介する。

　Axillary osmidrosis and axillary hyperhidrosis are diseases defined as sweating by the apocrine and eccrine glands, respectively. The treatment of these two axillary sweat diseases must be based on a thorough knowledge of the diseases’ differing characteristics and the differences between apocrine and eccrine sweat glands.

　It is difficult to improve severe axillary osmidrosis by conservative treatment, but some cases may be resolved by surgery or the use of electromagnetic waves. As treatments for axillary hyperhidrosis, options such as the application of anticholinergic agents and the local injection of botulinum toxin have expanded and are often covered by health insurance. Flap surgery is less effective as a curative treatment for axillary hyperhidrosis, and sympathetic blockade surgery has the unsolved side effect of compensatory sweating. Under such circumstances, a curative treatment method that destroys sweat glands using electromagnetic waves is now becoming widespread, although it is not covered by health insurance.