Summer is the season of sweating. As the heat index climbs, our bodies work hard to keep us cool. “When we become hot, a part of our brain called the hypothalamus signals to little nerves in the skin to tell the sweat glands to produce sweat,” said Dr Whitney Bowe, a dermatologist in New York City in the US. The liquid then produced cools us when it evaporates.

But while sweating is helpful for cooling us down, few people enjoy having smelly underarms, stinky feet and clothes stuck to their back and groin. And some people sweat excessively no matter the time of year, and even in the absence of typical triggers such as heat and physical activity.

Here’s why some of us get extra swampy as well as a few methods to help cut down on chronic sweating.

Prone to perspire

People can sweat more when they have infections, take specific medications (such as certain antidepressants) or are going through conditions such as perimenopause or menopause, among other causes, Dr Bowe explained.

Others may have a condition known as hyperhidrosis. With this disorder, sweating is often spontaneous and “unrelated to triggers like stress, emotion, exercise and environmental triggers like heat,” said Dr Mark Ferguson, a thoracic surgeon who treats excessive sweating at UChicago Medicine in the US.

It’s unclear what causes it, but it can run in families. People with hyperhidrosis may sweat excessively around their armpits, hands, feet, scalp or any combination of those body parts, Dr Ferguson said. Typically, the condition arises either in infancy or during puberty.

Some people sweat so much that it significantly affects their daily lives. “They don’t want to step out of the house anymore,” Dr Ferguson said.

What can help

For people who sweat a lot, Dr Bowe recommends loose, moisture-wicking clothing. Many athletic brands offer fast-drying layers and outerwear. Antiperspirants can also reduce sweating, Dr Bowe said. These topical treatments are typically made of aluminum compounds that “plug the pores of the sweat glands and prevent sweat from coming out,” said Dr Lyall Gorenstein, a thoracic surgeon and the surgical director of the Center for Hyperhidrosis at Columbia University Medical Center in the US. (Deodorants are different from antiperspirants: they do not affect sweat production, but can help reduce any accompanying odour.)

Antiperspirants made of up to 15 per cent aluminum chloride are sold over the counter, but doctors can also prescribe stronger prescription formulations, Dr Gorenstein said. These products can be used not just on the underarms, but also on the hands, face and feet.

“If you choose to wear antiperspirant, I recommend applying it at night before you go to bed, rather than in the morning after your shower,” Bowe said. “Antiperspirant is more effective when it is applied to dry skin rather than damp skin.”

Iontophoresis is an at-home treatment that can also reduce hand, foot and underarm sweat, Dr Gorenstein said, and it is sometimes covered by health insurance. After soaking the affected skin in water, a small device is used to produce an electrical current that blocks the 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.

In-office treatments

If you’re up for a series of visits to the doctor’s office, another treatment that can reduce underarm and hand sweat is Botox, which prevents the brain chemical that initiates sweating from activating the sweat glands, Dr Gorenstein said. Its effects typically wear off after four to six months around the armpits, and two to three months in the hands, Dr Gorenstein said. People can also become resistant to the effects
of Botox after a few treatments, Dr Ferguson added.

A treatment that is 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. Often, patients see results after one treatment, but two or three treatments may be required, Dr Bowe said.

Minor outpatient surgery, called endoscopic thoracic sympathectomy, is usually a last resort, but it can effectively reduce sweating that affects specific body parts, especially the hands, Dr Ferguson said. During the surgery, doctors make small incisions under the arm and then either cut, clamp or
excise nerves that stimulate the sweat glands.

Few people — including primary care physicians — know that so many treatment options for excessive sweating are available, Dr Gorenstein pointed out. The condition is “underdiagnosed and underreported”, he said, but thankfully, it can be managed.

NYTNS