14 Jul Excessive Sweating
There’s Help For Excessive Sweating
Hands down, there is nothing a dermatologist can do more to help someone’s quality of life than stop their excessive sweating.
If you find that statement ridiculous, you probably do not have a sweating problem. Excessive sweating can make you appear uncomfortable, nervous or even ill. It can be a socially disabling condition and lead to isolation and insecurity. An estimated 3 percent of Americans suffer through the day trying to hide and mask their sweating. The incidence is possibly higher, but the degree of embarrassment people experience likely limits self-reporting of this condition.
Do You Have Hyperhidrosis?
Hyperhidrosis is the term used to define perspiration in excess of the amount necessary to maintain your normal body temperature. It usually begins in those younger than 25 and lasts a lifetime unless treated. Even toddlers can shows signs of the condition.
Most patients report a family history of it and it is believed to be a genetic disease. The armpits are the most common location of involvement, followed by the palms and feet. It tends to affect both sides of the body in a symmetric fashion. Sometimes the face, scalp or other areas are afflicted, but these are the minority of cases unless there is underlying medical condition.
And because excessive sweating can signify everything from cancer and tuberculosis to simple hyperhidrosis, it is important to discuss it with your doctor.
Suffering From Excessive Sweating
Let’s meet a few of the typical patients who suffer with hyperhidrosis. There is the young lady absolutely paralyzed over what prom dress will best hide her soaked armpits on the big night. The salesman who neurotically ensures he is holding something to avoid having to give sweaty handshakes. And the adult woman who wakes every day with the problem of how many layers she can mix and match to hide her drenched armpit rings from the world.
In the Air Force our daily uniforms were light blue shirts, and nothing quite accentuates armpit sweat rings like light blue fabric. In a world where military-bearing and appearance are paramount, excessive sweating could be a career killer. I’ll never forget the battle-hardened sergeant who wept tears of gratitude after a few easy treatments dried his underarms out.
Left-handed people, usually students, are especially affected. As they write, their damp hand is dragged across the paper. This can smear their handwriting and they often get blamed for “sloppy work.” Sometimes even gripping a pencil is problematic. To further enforce the insecurity of being sweaty, there is even a website featuring unflattering pictures of celebrities with glistening palms and dripping underarms.
Our sweat is made mostly of water and salt with trace electrolytes. Baseball players will often appreciate a white crusty ring of salt in their caps from evaporated sweat.
Our sweat cools us and regulates our body temperature. And since panting like a dog makes one appear lecherous, sweating is the method of choice in humans. The average person can sweat up to about 3 to 4 liters per hour while exercising. This results in tremendous electrolyte loss and, in turn, tremendous profits for Gatorade.
As our presidential election looms, it may be worth remembering what infamous role sweating played in the 1960 election. In the country’s first televised presidential debate, Richard Nixon refused to wear makeup against all advice. John F. Kennedy’s team, being more media savvy, powdered up their candidate. The hot studio lamps had Nixon looking nervous and shifty as he repeatedly dabbed the sweat from his face throughout the debate. Kennedy came off looking cool and calm, and the rest is history. Nixon’s sweaty and unsteady appearance is still taught in political science classes as a case study in televised debate. From various reports I’ve read about his life, it is not inconceivable to believe Nixon suffered from hyperhidrosis before the condition had been given a name.
Treating Excessive Sweating
If you have excessive sweating you may want to look at your deodorant. Try to ensure you have a combination antiperspirant and deodorant. Deodorants are simply fragrances to hide our natural scent. Antiperspirants actually block the sweat ducts and keep you dry.
Most contain aluminum or zirconium salts that clog pore openings and indirectly tell the gland to stop making sweat. They should be applied to dry skin for maximum benefit. If applied to wet skin (either from sweat or showering), the aluminum salts combine with the water to make hydrochloric acid. If you’ve ever experienced irritation from your antiperspirant, this is probably why. Interestingly, most antiperspirants are sold in America. The rest of the world evidently buys deodorant but doesn’t place the same social emphasis on being dry.
Some controversy exists about the application of aluminum salts being associated with Alzheimer’s disease and breast cancer. Nationally recognized organizations like the American Cancer Society and the National Institutes of Health have released statements against these relationships. I personally use them, enjoy being dry, and don’t think twice about it.
Without a doubt the most effective treatment for hyperhidrosis is Botox. It is quite challenging to get approval from insurance companies for this, but it hits a home run every time. Within three days virtually all sweating ceases where it is injected.
I’ve witnessed swampy armpits on Monday turn Sahara dry on Friday. Effects can be enjoyed for up to eight or nine months before having to battle the insurance company for re-treatment. Several other solid treatments exist that don’t involve injections, and you should talk with your dermatologist about these. In extreme cases, a surgeon can clip the nerves to your sweat glands but this often makes other areas just sweat more in a compensatory reaction. Luckily there are many less dramatic treatments to try first.
And like anything in life, a little humor goes a long way. I have a male patient whose favorite pickup line with the ladies used to be, “Ever since I laid eyes on you, I just can’t stop this sweating!” Needless to say, he is happy to have moved on to other tactics since his hyperhidrosis is now controlled.
Dr. Derrick Adams is a board-certified dermatologist and the Medical Director of Vita Dermatology and Laser Institute, a division of Lassen Medical Group in Red Bluff. His office can be reached at 528-VITA or you can click here to request an appointment.