Dear Emily, I sweat a lot. I mean, a lot. It's ruining my clothes and killing my social life! What can I do?
-P.U.
Excessive sweating, also known as hyperhidrosis, is a common problem that affects an estimated 1 percent of the population (or more, considering most people probably sweat in silence). Will Ferrell, Old Spice's newest spokesman, would have you believe "if you don't smell good, you'll probably never get the chance to spoon or European-style kiss a woman." There is hope yet, however.
Back in the old days (the old, old days, you children of the '90s) sweating was a ritualistic, even bonding event and a very important part of certain cultures. The Russian banias, Native American sweat lodges and Turkish saunas were revered as places of cleansing and relaxation, often reserved for the privileged classes. Back in the caveman days, some speculate sweating allowed our ancestors a better grip on vines or rocks to ensure their survival. Nowadays, our day-to-day survival is less dependent on rock-hurling, yet still many of us struggle with excessive perspiration.
Basically, your body has two distinct types of sweat glands. Eccrine sweat glands are located everywhere, but are concentrated on your palms, soles (the most populated area, actually) and your forehead. They make the watery type of sweat used for thermoregulation. Apocrine sweat glands are mostly found in the armpits and in your nether-regions; they make a sweat that contains fatty material. The lovely and unmistakable aroma of "B.O." comes from bacteria breaking down the organic products in the latter type of sweat. Normally, we make between 0.5 and 1.5 liters of sweat per day, which seems like a lot until you consider that camels can sweat 8 liters per day, and Gary Williams seems to sweat twice that much.
The cause of hyperhidrosis is largely unknown. While sweating normally serves to regulate your body's temperature through evaporation, excessive sweating is thought to be due to an overactive sympathetic nervous system (of fight-or-flight fame). Indeed, anxiety and nervousness can exacerbate the problem and lead to a vicious cycle of sorts, with the sweating increasing the anxiety and vice versa. Spicy foods, drinks, nicotine, caffeine and even some smells can make you sweat more, as can simply being overweight. If your sweating problem started suddenly or later in life, it's probably best that you see your doctor, especially if you've noticed any weight loss, tremor or headache.
If you're ready to end the underarm deluge, there's no time like the present. According to Mr. Ferrell, "only a banned-in-12-states, weapons-grade antiperspirant with powdered cobra fangs and other scientific mysteries inside will help us win the 24/7 cockfight against odor and wetness." I beg to differ, but there are several potent options.
First, start by wearing looser-fitting ("breathable") clothes and avoiding spicy foods or caffeine. If body odor is an issue, it may be worthwhile to invest in an antibacterial soap and use a combination deodorant/antiperspirant. Many deodorant companies offer "prescription-strength" options nowadays, but if these don't work, your doctor can prescribe you many topical treatments such as highly concentrated (greater than 15 percent) aluminum chloride solutions (e.g. Drysol) that can be applied at night and will decrease perspiration for several days. Side effects include skin irritation at the site of application, which can be severe, but many people stay loyal due to the efficacy of this option.
Oral medications can be used, but often have discouraging side effects. Local botulinum toxin (Botox) injections inhibit neural impulses and can provide four to nine months of relief, depending on the site (the jury's still out as to whether your armpits will feel any younger). If your palms and soles are your chief concerns, a process called iontophoresis, wherein an electrical current is passed through a liquid in which your hands or feet are submerged, may help. Surgical options are usually reserved for patients who fail to benefit from the previously mentioned options.
While sweating is as natural and necessary as breathing, excessive perspiration can stop even the most confident person in his tracks. Don't waste your time sweating it out; ask for help if you need it and get back out there.
Emily is a University Medical student. She can be reached at egraham@cavalierdaily.com.
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