No sweat!

Does excitement and stress make you sweaty and sticky even when it’s not that hot outside? Is your clammy handshake making you feel uncomfortable and self-conscious? Here’s what to do if you’ve shed one bead of sweat too many

By Dr Bets Breedt, Health24

Almost all of us sweat heavily from time to time as a natural response to heat, exercise, stress or even spicy food. But when being drenched in sweat becomes a social problem, chances are you’re one of around three per cent of people worldwide who suffer from primary hyperhidrosis, otherwise known as excessive sweating.

Hyperhidrosis can be such a huge embarrassment that sufferers are reluctant to seek help from their doctors. But that would be a big mistake. There’s a good chance your condition can be cured and at the same time your GP can make sure your sweating isn’t the result of a disease that needs urgent attention.

Most cases of excessive sweating are caused by an overactive sympathetic nervous system which controls, amongst other things, the sweat glands in the torso and groin. People with overactive sympathetic nervous systems are almost always dripping with sweat irrespective of the weather or other triggers such as stress.

Sweat is most prevalent in the armpits, the palms of the hands and the soles of the feet. It stains clothes, makes your shoes smell bad, gives you a clammy handshake and even makes it difficult to drive or hold a pen or knife tightly. This can make social, work and romantic situations really tricky.

Primary hyperhidrosis is treated on different levels. The simplest therapy will be tried first and if that doesn’t work a more drastic treatment will be proposed.

Solutions

1. Solution 1: Antiperspirants

Over-the-counter products The first step is to try an antiperspirant – but choose one that lists aluminium chloride as one of its ingredients. These form tiny plugs in the pores that temporarily block the sweat glands. They must be applied every 24 to 48 hours and you should see an improvement after three weeks.
If necessary, there are stronger antiperspirants containing aluminium chloride hexahydrate that you can try. Examples are Drichlor, PerspireX, Drysol and Xerac AC and they vary in price from between R100 and R150 a bottle.
How well do they work? Antiperspirants are moderately successful and offer short-term relief. Try different brands to find the one that works best for you.
Drawbacks The products can cause skin irritation and a burning sensation.
2. Solution 2: Iontophoresis therapy

Your hands or feet are placed in ordinary tap water and a weak electrical current is passed through your skin. This causes sweat glands to secrete less perspiration. The procedure is done by dermatologists and at beauty salons and costs about R310 a session. Unfortunately it’s not covered by medical aids.
You start off with two to three sessions of 10 to 20 minutes each a week or an hour-long session once a week. As the problem improves you’ll only need a session every one to three weeks. A normal perspiration pattern usually develops after six to 10 treatments.
In South Africa only hands and feet are currently treated with iontophoresis. It’s not painful but it isn’t suitable for pregnant women or people with pacemakers. You can buy your own iontophoresis machine for about R2 500.
How well does it work? It’s just as effective as antiperspirants.
Drawbacks Some find it a bother and it has to be constantly repeated. It can also cause skin irritation.
3. Solution 3: Medicine

Prescription drugs can be used to keep the neural impulses governing sweat glands under control. They include Pro-Banthine, Ditropan, Dixarit, Paroxitine, gabapentin, amitriptyline, propranolol and diltiazem. The cost varies from R30 to R200 a month and the medicine is available from pharmacies on prescription.
How well does it work? It decreases sweating but doesn’t stop it entirely.
Drawbacks Side effects can include a dry mouth, dulled vision, water retention, constipation and palpitations. People with certain conditions such as asthma and low blood pressure can’t take these drugs at all.
4. Solution 4: Botox

The same substance used against wrinkles and muscle spasms can also improve excessive underarm sweating. A total of 50 units of botox are injected into about 20 spots under the arm and provide about six months’ relief from underarm hyperhidrosis.
The injections are a little painful but an extremely fine needle is used. Botox has not yet been approved for the treatment of palm and sole sweatiness. A dermatologist, plastic surgeon or doctor specialising in botox treatments does the procedure.
How well does it work? It reduces sweating substantially and sometimes stops it entirely.
Drawbacks It’s expensive – about R4 500 per treatment – and must be repeated every six months or so. Some medical aids pay, but not all of them.
5. Solution 5: Surgery

A scalpel can effectively stop excessive sweating but it should be a last resort. There are always risks attached to surgery and your doctor will discuss them with you at length. For these operations you should budget for R25 000 or more and the reimbursed amount varies from one medical aid to another.

Keyhole operation through the chest

What happens? Sympathetic nerves or nerve bundles are removed, burnt or tied off. Your chest has to be opened and a lung deflated to provide access.
How well does it work? Hand sweating improves by more than 85 per cent. It helps with face and arm perspiration to a lesser degree.
Drawbacks It’s a big operation with several possible complications including a collapsed lung. Your skin could feel warm and dry afterwards. Hyperhidrosis could start occurring in other parts of your body – this happens to 30 to 50 per cent of patients. About five to 10 per cent of patients could begin to struggle with excessive sweating when they eat and there’s a one per cent chance of eyelid paralysis.

Removing nerves in the groin
What happens? Nerves and nerve bundles in the groin are removed, burnt or tied off.
How well does it work? There’s a 90 per cent success rate for foot hyperhidrosis.
Drawbacks Sometimes you start sweating more in other places because you can no longer perspire through your feet. Sexual dysfunction is also a possible complication and this procedure should therefore be a final resort.

Sweat-gland removal
What happens? Thirty per cent of the sweat glands are removed through tubes in a similar procedure to liposuction.
How well does it work? You’ll permanently perspire less in the treated areas.
Drawbacks You could have scars under your arms.

Medical conditions that can cause excessive sweating


• Hormonal fluctuations due to menopause or hormone treatments


• An overactive thyroid


• Diseases such as TB, leukaemia and inflammation of the colon or tonsils.

These conditions cause night sweats.

Did you know?
Excessive sweating is not only a result of psychological reactions; sometimes the nervous system works overtime.

Keep your cool


• Tannin in tea can help with sweaty feet. Soak your feet in a bucket of tea solution.


• Wear loose clothes made of materials that don’t stain.


• Change your socks or stockings several times a day.


• Wear absorbent inner soles in your shoes and change them often.


• Wear leather or cotton shoes and cotton socks.


• Don’t wear the same shoes two days in a row – give them a chance to dry out.


• Apply powder after a bath.


• Avoid coffee, tea, chocolate, spicy foods and foods containing caffeine. They speed up your heart rate and breathing, which can make you sweat more.


• Keep a glass of water at hand to press your palms against to cool them down.


• There’s nothing wrong with using a handkerchief to wipe your face and hands when necessary.

Excessive sweating

Hope for heavy sweating