Helping Hyperhidrosis
You are sweating extensively and it’s not even summertime yet. You are sweating through your armpits, hands, groin, legs, you name it. You have to carry a washcloth just to absorb some of the sweat. You could have hyperhidrosis.
Hyperhidrosis is excessive sweating that interferes with your life. The person will sweat through their undershirt, shirt or blouse. The person will be afraid to shake hands because of sweating in the palm of the hands. You have to carry multiple socks in your bag for fear of sweating through your socks because of your feet.
There are no secondary causes, meaning that patients do not have an identifiable cause to explain it. They are not diabetic, they are not on medications that increase sweating. Typically, those patients don’t sweat at night, so it’s a problem during the day. It typically presents earlier in life, before the age of 25 and there is a family history of excessive sweating.
We live in a society where body odor is not universally accepted, making deodorant or antiperspirant a part of our daily hygiene routine. There is also a stigma surrounding wetness of clothes because of sweat, which has pushed antiperspirants into daily skincare routines.
Deodorants neutralize body odor, while antiperspirants reduce wetness on the skin. Both are offered in one product.
Despite the commonly accepted reasons why people wear deodorant, natural body odor isn’t necessarily considered unpleasant by everyone.
One reason why someone might find a certain person’s natural scent more attractive than those of others is due to differing immune systems.
There’s no right or wrong answer when it comes to your personal preferences and what—if any—products you might use to mask body odor.
It is important to remember that sweat has a purpose. We sweat to control our body temperature. However, in some situations we sweat beyond what is necessary. Sweat itself is odorless. Bacteria on the skin breaks down the sweat, creating a foul smell.
When we become hot, a part of our brain called the hypothalamus signals to little nerves in the skin to tell the sweat gland to produce sweat. The liquid then cools us when it evaporates.
People can sweat more when they have infections, take medications (such as antidepressants) or go through perimenopause or menopause, among other causes.
With hyperhidrosis, sweating is often spontaneous and unrelated to triggers like stress, emotion, exercise, and environmental triggers like heat. People with hyperhidrosis may sweat excessively around their armpits, hands, feet, scalp or any combination of those body parts.
For some people with hyperhidrosis, sweating can be so intense that they must change clothes multiple times a day. If their hands sweat, they may have trouble using touch screens, computer mice and steering wheels unless they wear heavy gloves.
If their feet sweat, they go through a pair of shoes quickly because they are constantly wet and start to get smelly and fall apart.
For those who sweat a lot, they should get loose, moisture-wicking clothing. Many athletic brands offer fast-drying layers and outerwear. It may also help to spend time in air-conditioned, well-ventilated spaces.
Antiperspirants can also reduce sweating. These topical treatments are typically made of aluminum compounds that plug the pores of the sweat glands and prevent sweat from coming out.
Antiperspirants made of 15 percent aluminum chloride are sold over the counter but doctors can also prescribe stronger prescription formulations. These products can not only be used under the arms but also on the hands, face and feet.
Iontophoresis is an at-home treatment that can reduce hand, foot and underarm sweat. It is sometimes covered by health insurance. After soaking the affected skin in water, patients use a small device that produces an electric current that blocks their sweat glands. The procedure typically has to be done three times in the first few weeks to see initial results and then once a week to maintain them.
If you’re up for a series of visits to your dermatologist’s office, another treatment that can eliminate underarm and hand sweat is Botox, which prevents the brain chemical that initiates sweating from activating the sweat glands. Botox is sometimes covered by health insurance. Its effects wear off after four to six months around the armpits and two to three months in the hands.
A treatment called miraDry can also be used to reduce underarm sweat in particular. After doctors have numbed the skin with lidocaine, they use a device to apply heat to the area to destroy its sweat glands. Patients may see results after one treatment, but two or three treatments may be required. MiraDry is not covered by health insurance and can cost several thousand dollars.
Minor outpatient surgery, called endoscopic thoracic sympathectomy, is a last resort, but it can effectively reduce sweating that affects specific body parts, especially the hands. During the surgery, doctors make small incisions under the arm and then either cut, clamp or excise nerves that stimulate sweat glands.
It’s an effective therapy in eliminating bothersome hand sweating. But sometimes people sweat more on other parts of their body afterward.
Few people—including primary care physicians—know that so many treatment options for excessive sweating are available. The condition is underdiagnosed and underreported, but thankfully it can be managed.
