Subdermal Laser Ablation (SDLA)

Subdermal laser ablation is the name given to a series of techniques to treat excessive sweating (hyperhidrosis). Subdermal laser ablation is particularly useful in the axillary area (the armpit).

How is subdermal laser ablation (SDLA) performed?

Subdermal laser ablation is usually performed under local anaesthetic although some people do use sedation or general anaesthetic. This adds costs and potential complications to the procedure and is not necessary - although some surgeons prefer this particularly when learning the techniques.

Usually subdermal laser ablation is a minimally invasive or "keyhole" procedure using only 2 or 3 tiny scars that are easily hidden.

There are some people who still cut open the skin using one or two big incisions, so that they can work directly on the underside of the skin (the dermis). However this is totally unnecessary and leads to unnecessarily large scars, longer recovery and an increased risk of potential complications.

The actual subdermal laser ablation procedure is to try and destroy the sweat glands (eccrine sweat glands) which are on the underside of the skin - an area called the dermis. Therefore treating the skin from below is termed "subdermal".

The eccrine sweat glands are then destroyed using a laser hence the name subdermal laser ablation. Unfortunately experience has shown us that laser alone doesn't have the required effect. It is necessary to also remove some of the sweat glands either before or after the laser ablation - the most common technique being called retro-dermal curettage.

Retro-dermal curettage simply means scraping the back of the dermis - i.e. using an instrument like a mini cheese grater to remove the underside of the dermis and most of the big eccrine sweat glands.

Problems with subdermal laser ablation (SDLA) and the solution - Laser Sweat Ablation (LSA)

The problem with the subdermal laser ablation is that there are several different ways this can be done, all of them with varying success rates. In 2009, Mark Whiteley from The Whiteley Clinic started developing Laser Sweat Ablation (LSA) which is a specific type of subdermal laser ablation.

Mark took the underlying principles of subdermal laser ablation, and then started developing the technique to improve results, decrease complications and to standardise the procedure, to make it reproducible. The results of this work is the operation called Laser Sweat Ablation (LSA).

More information about laser sweat ablation can be found on the website www.lasersweatablation.co.uk