Possible Sweat Gland Damage After Laser Treatments

Question

I had a full facial MicroLaser Peel (20 micron depth) and 20% ProFractional Laser Resurfacing (200 micron depth) done 16 days ago. I'm worried that the laser treatment could have damaged my sweat glands because even when I work out vigorously, there is no perspiration on my face. Is this normal, and will my sweat glands begin functioning again with time?

Steven H. Williams, MD · Answer

Laser treatments typically only penetrate the first few layers of skin.  Depending on the type of laser and the specifics of your treatment will vary the depth of your treatment.  Most "resurfacing" or "fractional resurfacing" laser treatments penetrate relatively deeply into the dermis and are called "ablative therapy" because they are actually causing some degree of tissue destruction.
Sweat glands are typically in the very deep dermis or hypodermis and have channels that penetrate through the dermis and epidermis to allow sweat out when signaled by the underlying nerves.
As the sweat glands and nerves that supply them are deeper that a typical laser treatment should be able to penetrate they are likely still intact. 
Hope this helps.

Otto Joseph Placik, MD · Answer

Dr. Goldstein has explained the anatomy in a pertinent, clear and succint manner.
This is most unlikely to last. The sweat glands are located at a level at which any significant injury would incur scarring.
If you have healed uneventfully from the laser then it is not likely you sustained any additional damage.
Is it possible you underwent Botox treatments to the forehead around the same time. Some physicians like to pretreat with Botox to relax the wrinkles and allow more effective response to the laser treatment. Botox is known to stop sweating and this your lack of sweating could be related more to that than the laser treatment.

David Goldberg, MD · Answer

The Micropeel ProFractional laser treatment you had is a fairly conservative approach. This is a very good laser and, if used appropriately, is highly unlikely to lead to problems. The sweat glands are deep in the skin and the laser usually will not damage them.

Hratch Karamanoukian, MD, FACS · Answer

I have a large hyperhidrosis practice and have seen patients get laser resurfacing for scars, and have never seen any long term effects in terms of reduction in the amount of sweating. If this were true, thousands of patients with excessive facial sweating would have found nirvana.
Hundreds of thousands of patients suffer from facial sweating in the U.S. and this would be a life savior for them, however, this has not been found to be the case. Patients with facial sweating have social embarassment from constantly dripping sweat from this area and usually carry a towel to wipe their faces. It has significant social consequences and to date, only sympathectomy and rarely anticholinergic medications have been shown to be successful in eliminating or reducing the amount of this sweating.

Stephen A. Goldstein, MD · Answer

The laser treatments you received (MicroLaser Peel and 20% ProFractional Laser Resurfacing) were directed to the deep superficial layer of the dermis.  From the diagram below which illustrates the anatomy of the skin, the body of the sweat gland is located in the deeper layer of the dermis with the duct (tubule) penetrating the skin surface.

Following the clinical treatments at 16 days, you are still in the early healing phase.  No doubt, your face is still red indicative of new skin and there is still a degree of persistent swelling. This will temporarily occlude the sweat gland-ductal system.  Give it more time.  Your ability to sweat after a laser treatment should ultimately be unchanged.  
 
Thanks for your question.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Here is why- even if you had 3 times the depth of ProFractional, you are still only at 600 microns. Sweat glands reside in at least 3000-4000 microns- that is, in the fat layer of your skin. Eccrine ducts certainly can get ablated, but they grow back very quickly. So the answer is NO, laser did not do any damage to sweat glands. You may have heard of a new 'laser' that targets sweat glands- actually it is NOT a laser but electromagnetic energy. This is called miraDry, and it s energy levels are concentrated in the fat layer of the skin, several mm deep. Hope that clarifies thingsDr Davin LimAesthetic and Laser DermatologistBrisbane, Australia.

Brooke R. Seckel, MD, FACS (retired) · Answer

Laser resurfacing leaves dead skin cells and debris on the skin after treatment. This debris coupled with swelling of the skin can block sweat glands and oil glands and can lead to acne outbreaks and milia, dilated sweat glands.
Good skin care can solve this problem. Microdermabrasion helps.
This is a temporary phenomena and will resolve as you heal.

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