Abstract: In recent years, the demand for minimally invasive and fast-recovering non-surgical treatments among patients with axillary osmidrosis has been increasingly growing. Schemes such as microwave, laser, botulinum toxin type A, and radiofrequency microneedling have become important components of the graded treatment system for axillary osmidrosis due to the disadvantages of traditional surgery, such as significant trauma and more postoperative complications. Compared with microwave, radiofrequency microneedling has more advantages in mild to moderate axillary osmidrosis patients with low BMI and who wish to retain axillary hair. This review focuses on radiofrequency microneedling as a representative technique, synthesizing current evidence on its mechanism of action, clinical efficacy, and safety profile to evaluate its value, strengths, and limitations within the non-surgical treatment armamentarium for axillary osmidrosis. The aim is to provide a theoretical foundation and clinical insights to support the refinement of stepped and personalized treatment strategies.

Key words: axillary osmidrosis, radiofrequency microneedles, non-surgical treatment, stepped care