Skin

02 September 2010

Excessive sweating

We all sweat, what's the big deal? For some people sweat is more than just a nuisance - excessive sweating is having a devastating effect on millions.

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We can all deal with a little sweat on a hot day, when exercising and when we are nervous.

But for some people, sweat is more than just a nuisance. Excessive underarm sweating, sweaty palms and feet and body odour have them living in constant anxiety and embarrassment. It affects every aspect of their lives.

At a product launch for an antiperspirant that combats excessive sweating, Anne Kirstine Riemann, MD of Riemann & Co, said excessive sweating - hyperhidrosis - is a clinical disorder that leads to the over-production by the sweat glands. It causes large amounts of visible sweat to gather, impossible to hide, and potentially also results in body odour. It affects millions of people around the world.

Why do we sweat?
We sweat to regulate body temperature. As sweat evaporates, it cools the body. We have anything from 1,6-million to 4-million sweat glands on our bodies. The highest concentration is found in the underarms, soles of the feet, palms of the hand and the upper lip.

Sweat is a colourless, odourless, watery solution. The odour is caused by bacteria on the surface of the skin when the components of sweat are broken down.

Routine sweating can be exacerbated by emotional situations, stress, obesity, hormonal changes, diseases and hyperhidrosis.

What causes excessive sweating?
There is no single cause. It can be a symptom of an underlying medical condition. It is a serious condition and needs proper diagnosis and treatment.

The hypothalamus, the part of the brain that regulates sweat-related functions, sends signals to the sweat nerves, which relay them to the sweat glands. With hyperhidrosis, the glands produce large amounts of sweat that seek outlets on the underarms, face, palms and feet.

According to a study done in the US in 2004, an average of 2.8% of the population suffer from hyperhidrosis.

The condition does not occur in children. If children suffer from excessive sweating, it could be another medical condition and a doctor should be consulted.

Treatment for excessive sweating
No one has to go around sweating their life away. There are a number of different treatments available.

  • Antiperspirants – the most common treatment for sufferers of hyperhidrosis. They decrease the production of sweat. How long the effects last will depend on the efficacy of the product.
  • Anticholinergic drugs – these drugs dry up bodily secretions. However, they have significant side-effects including on the cardiovascular system, and can cause dry mouth, dizziness, somnolence and blurry vision.
  • Iontophoresis - this is a process in which the affected area of the body is immersed in a solution through which a low electric current is passed. After three to four treatments of 15-20 minutes each, perspiration will be reduced for a couple of weeks. The channels of the sweat glands become clogged with keratin during the treatment. The treatment needs to be repeated frequently.
  • Botox - Botox injections into the skin of the affected area is another option. Injections need to be repeated every month, they are expensive, and can cause muscle weakness when used on the hands.
  • Surgery – in severe cases of hyperhidrosis, surgical removal of the sweat glands is performed. It is usually performed in the armpit but severe hand and foot perspiration can also be stopped surgically.

 

Deodorants vs antiperspirants
Deodorants are used by almost everybody and are an important part of people's personal daily hygiene. However, deodorants do not stop sweat, they prevent bad odour. Their mild disinfectant effect counteracts the malodorous production of waste products by bacteria in the armpits. When the disinfectant wears off, an added perfume may help cover the smell of bacterial waste products.

Antiperspirants decrease or stop the production of perspiration in the sweat glands. This happens because the opening of the gland is blocked due to a change of the surface cell production, keratin. The transformed keratin exfoliates anything from half a day to five days later. Depending on the efficacy of the product, perspiration production resumes thereafter.

They are available as creams, lotions, sprays or liniments and often contain perfume. The active ingredient in antiperspirants is usually aluminium salts.

Tips on coping with excessive sweating
There are a number of things you can do to reduce sweat and body odour:

  • Wear light-coloured clothing. It reduces sweat visibility
  • Wear loose-fitting clothing to allow air to circulate near to your skin
  • Be careful of wearing polyester, silk and artificial fibres. These can cling to the skin and restrict air flow
  • Wear clothing shields and natural fibres
  • A daily bath or shower lowers the amount of bacteria formed on the skin
  • Alternate and air out shoes
  • Use antiperspirants in the evening
  • Walk barefoot when possible
  • Change socks or pantyhose twice a day
  • Stay away from foods that cause you to sweat as well as foods with strong odour such as onions and garlic
  • Drink lots of water to replenish any moisture loss and to prevent dehydration

 

(Leandra Engelbrecht, Health24, updated August 2010)

Embarrassing things

Sources:
PerspireX fact file
www.healthline.com
www.sweatmanagement.ca/CopeWithSW
www.sweathelp.org

 

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Dr Suretha Kannenberg holds a degree in Medicine and a Masters in Dermatology from the University of Stellenbosch. She is employed as a consultant dermatologist by Stellenbosch University and Tygerberg Academic Hospital, where she is involved in clinical duties and the training of medical students and dermatology residents. Her areas of interest and research include vitiligo, eczema and acne. She also performs limited private practice work in the Northern suburbs of Cape Town in general and cosmetic dermatology.

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