The History and Development of Laser Sweat Ablation (LSA)

The development of Laser Sweat Ablation in the UK was kept on a blog as it happened - so if you want to read some of the original entries, please look up http://markwhiteley.blogspot.com. The following is the whole story of Laser Sweat Ablation.

In the late 1980's and 1990's, a few doctors around the world were using laser under the skin, to see if they could destroy the sweat glands in the armpits, to stop Axillary Hyperhidrosis. One Japanese report in the late 1980's suggested success using a Carbon Dioxide (CO2) laser.

In Buenos Aries, a very innovative surgeon, Dr. Guillermo Blugerman (pictured right with Mark Whiteley), started trying to do the same using an Nd:YAG laser - this produces a wavelength of 1064 nm. He did his first cases around 1999 and published a series of 52 patients treated between 2003 and 2007.

In 2008, a Croatian surgeon, Dr Dusko Maletic went to train with Dr Blugerman, and started doing the procedure in Croatia in April 2008. In September 2008, Mr Mark Whiteley, a consultant surgeon from the UK heard about the technique and realised its potential in his hyperhidrosis patients.

Between Christmas and the New year in 2008, Mark Whiteley stayed with Dr Blugerman at his clinic in Buenos Aires and was trained in the procedure, performing the procedure himself with Dr Blugerman.

On returning to the UK in January 2009, it took 2 months to get approval from the regulatory bodies for this new procedure to be done in the UK.

There was no recognised name for this procedure and so Mark Whiteley initially called this LATAH - Laser Assisted Treatment of Axillary Hyperhidrosis. However this name had 2 problems - firstly it meant that if the procedure was ever developed to be used elsewhere on the body the name would have to be changed and secondly, LATAH was not an easy name to remember.

Therefore just before the launch of this new procedure to the press in March 2009, Mark Whiteley changed the name to Laser Sweat Ablation - LSA.

On 5th March 2009, Mark Whiteley performed the first LSA in the UK on a male patient, Richard Brydon. This was not only announced by several newspapers, but was filmed by the BBC for the BBC website.

Shortly afterwards a second patient was operated on. Despite using the taught technique, both patients had a difficult post-operative recovery complicated by the breakdown of the skin and a lot of inflammation.

Mark Whiteley put a halt on the Laser Sweat Ablation procedure and re-examined the whole process. He contacted Dr Blugerman and the manufacturers of the laser equipment.

Although there were no obvious problems with the performed technique, Mark Whiteley changed the protocols, using logic and basic scientific understanding of the laser and the anatomy and physiology of the axilla.

The changes from the taught technique included:

• Changing the laser settings
• Changing the laser delivery process
• Adding obligatory skin cooling
• Adding a defined pattern of applying laser energy
• Setting up a database to capture and analyse all the measurable factors and the outcomes - including any complication if any arose.

Having changed this protocol, the the procedure was restarted - the third Laser Sweat Ablation being the first to use the new protocol. The changes turned out to be highly effective - giving excellent results in terms of decreased sweating and few side effects.

The third patient has written of her experiences as a testimonial which can be read on the testimonials page of this website.

Now that the modifications have shown to be successful for the Laser Sweat Ablation, our plans are as follows:

• To continue to collect as much data as possible from our Laser Sweat Ablation patients to try to identify ways to further improve the results for our patients
• To present and publish our results to scientific meetings and in scientific journals so that the wider scientific community know of this new procedure and who might be suitable for it. Decisions as to whether it might be funded by the NHS or Private Medical Insurers in the future will depend upon good scientific evidence such as this.
• To start teaching the Laser Sweat Ablation procedure as Mark Whiteley has modified it, so that practitioners in the future don't have to have sub-optimal results when they start the procedure.
• To publish the names of those who we have trained in our technique - Laser Sweat Ablation (LSA) - on this website
• To collect results from those who we have trained and who continue to use our treatment protocols - these doctors will be identified specially as they will also be given regular updates, feedback and any modifications we might make in the future.