What are the Radiofrequency Applications in Hyperhidrosis Treatment?
Hyperhidrosis (HH) is a chronic disorder characterized by excessive sweating that seriously affects a person's quality of life. It has two main forms: Primary and secondary. Secondary hyperhidrosis usually occurs due to an underlying disease or medication use and can be widespread or local. Primary hyperhidrosis is seen in approximately 2% of the population and usually manifests itself as symmetrical and localized sweating in areas such as the armpit, palm, sole or face, due to triggers such as stress and temperature.

Effects of Hyperhidrosis on Quality of Life
Excessive sweating can negatively affect individuals' social, professional and psychological lives. Due to sweating, people can limit their daily activities, experience self-confidence problems and encounter difficulties in their business life. Therefore, it is important to develop effective and reliable treatment options.

Current Methods in Hyperhidrosis Treatment
In the treatment of primary hyperhidrosis, lifestyle changes and behavioral recommendations are first offered. Topical aluminum salts, iontophoresis and botulinum toxin injections are frequently preferred, especially in localized sweating. In more widespread and resistant cases, systemic anticholinergic drugs can be used. In addition, with technological developments, minimally invasive methods such as radiofrequency (RF) energy have also become effective treatment options.

The Place of Radiofrequency Applications in Hyperhidrosis Treatment
RF energy was first used in the treatment of hyperhidrosis in 1984. Percutaneous RF thermocoagulation method is used to ablate the sympathetic nerve and is offered as a minimally invasive alternative to surgery, especially in palm sweating. However, today, new generation devices such as microneedle RF have been found to be quite effective in reducing the amount of sweating by providing thermal energy directly to the eccrine sweat glands.

Microneedle RF: An Innovative and Minimally Invasive Method
Microneedle RF delivers bipolar RF energy to the lower layers of the dermis through thin insulated needles without damaging the skin surface. This way, the size and number of eccrine and apocrine sweat glands are reduced. During the procedure, patients may experience temporary side effects such as mild pain, redness and swelling.

Findings of Clinical Studies
In a study conducted in Iran in 2015, 3 sessions of microneedle RF were applied to one axillary region of 25 severe primary HD patients, while the other region was left as a control. The results showed a significant improvement in the intensity of sweating in the treated area and in the satisfaction of the patients. Histologically, a decrease in sweat glands was also detected.

In the same study, in the follow-up conducted 1 year later, no recurrence was observed in approximately 42% of the patients, while it was determined that the treatment effectiveness decreased in those with a high body mass index (BMI). Therefore, a careful approach is recommended in patients with a high BMI.

Different studies conducted in Germany and Korea have also shown that microneedle RF reduces sweating by around 70%, and the side effects are minimal and temporary.

Another study compared microneedle RF with botulinum toxin injection and found that both methods reduced sweating intensity, but botulinum toxin was slightly more effective.

Conclusion and Recommendations
Radiofrequency applications, especially microneedle RF, are increasingly gaining importance as a safe, minimally invasive and effective option in the treatment of primary hyperhidrosis. High satisfaction rates and long-term effectiveness have been reported among patients. However, it should be kept in mind that individual factors such as BMI may have an effect on treatment effectiveness, and personalized treatment plans should be created for each patient.