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<p>Bromhidrosis significantly impacts individuals’ social, professional, and emotional well-being. Traditional treatments such as en bloc excision and alcohol injections are now less favored due to associated complications and suboptimal outcomes. Current evidence identifies botulinum toxin A (BTX-A) as the first-line treatment for mild to moderate cases (Grade 0–2), attributed to its high efficacy, excellent safety profile, and minimally invasive nature. BTX-A achieves effectiveness rates exceeding 90%, with results persisting for 3–8 months. A standardized grading system guides treatment selection, reserving surgical interventions for severe cases (Grade 3) or situations where BTX-A is contraindicated. Modern surgical approaches, such as hydrosurgery and endoscopic-assisted procedures, have shown improved outcomes and significantly fewer complications compared to traditional methods. Energy-based therapies, including laser, radiofrequency, and microwave treatments, also provide viable alternatives for patients unsuitable for BTX-A, demonstrating documented efficacy and minimal invasiveness. This review proposes an evidence-based treatment algorithm for bromhidrosis management, highlighting the central role of BTX-A while detailing alternative strategies. The framework integrates disease severity assessment, patient preferences, and cost considerations to support optimal clinical decision-making. By adopting this systematic approach, clinicians can enhance treatment selection and improve patient outcomes.</p><p><i>Level of Evidence V</i> This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors&#xa0; <a href="https://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Contemporary Algorithm for Treating Bromhidrosis: A Review of Treatment Available

  • 期刊论文

  • 发表日期：

    2025年1月2日

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  • Qian Lin,
  • Beichen Cai,
  • Lu Chen,
  • Xiaofen Wan,
  • Ruonan Ke,
  • Xuejun Ni,
  • Xiuying Shan,
  • Biao Wang

摘要

Bromhidrosis significantly impacts individuals’ social, professional, and emotional well-being. Traditional treatments such as en bloc excision and alcohol injections are now less favored due to associated complications and suboptimal outcomes. Current evidence identifies botulinum toxin A (BTX-A) as the first-line treatment for mild to moderate cases (Grade 0–2), attributed to its high efficacy, excellent safety profile, and minimally invasive nature. BTX-A achieves effectiveness rates exceeding 90%, with results persisting for 3–8 months. A standardized grading system guides treatment selection, reserving surgical interventions for severe cases (Grade 3) or situations where BTX-A is contraindicated. Modern surgical approaches, such as hydrosurgery and endoscopic-assisted procedures, have shown improved outcomes and significantly fewer complications compared to traditional methods. Energy-based therapies, including laser, radiofrequency, and microwave treatments, also provide viable alternatives for patients unsuitable for BTX-A, demonstrating documented efficacy and minimal invasiveness. This review proposes an evidence-based treatment algorithm for bromhidrosis management, highlighting the central role of BTX-A while detailing alternative strategies. The framework integrates disease severity assessment, patient preferences, and cost considerations to support optimal clinical decision-making. By adopting this systematic approach, clinicians can enhance treatment selection and improve patient outcomes.

Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266.