August 6, 2016

Excessive Sweating

Sweating is a natural body function. It is through the skin that we sweat to regulate body temperature and release toxins. Normally we sweat more in response to excessive heat and this is how the body regulates temperature to cool down. Normally mild sweating occurs all over the body. Excessive uncontrollable sweating is a medical condition which affects mainly the palm of the hands, sole of the feet, underarms, groin and face. This excessive sweating is called hyperhidrosis. There is very little data to support the prevalence of this condition in the general population. We do know however that the condition of excessive sweating affects males and females of all ages. Individuals consult with health professional for remedies as the excessive sweating can affect social and intimate relationships and result in psychological issues. Let us examine the common excessive sweating complaints, causes, symptoms and treatment.

Sweaty feet

Sweaty feet also called plantar hyperhidrosis, is a fairly common condition characterized by excessive sweating on the soles of the feet. Each foot has more than 250,000 sweat glands which make the feet sweat lightly all the time. Excessive sweating results from overactive sweat (eccrine) glands. This condition can lead to other health and social problems including athlete’s foot (a fungal infection) and smelly feet due to bacterial infection of the skin. Some of the contributory factors which cause sweaty feet include:

  1. Hereditary (a medical condition common in members of the same family and across the family’s generations))
  2. Type of footwear worn habitually, especially those made of synthetic material
  3. Emotional stress, anxiety and excessive physical exertion
  4. Sympathetic nervous system over activity is considered by some health professionals to be a trigger for excessive sweating

The family doctor and podiatrist will usually suggest non-invasive treatment to minimize the sweating. Antiperspirants of prescription strength are usually recommended in the first instance. Botox injection to block nerve signals to the sweat glands is another therapy that is tried. An extreme measure is called lumbar sympathectomy which is the surgical cauterization of the nerves thereby interrupting the stimulation of the sweat glands. This treatment has yielded a success rate of over 90%.

Sweaty hands

Sweaty hand is referred to as palmar hyperhidrosis. This is the most common type of hyperhidrosis that persons will visit a doctor for medical consultations. The condition can be so severe it can prevent an individual from working. The psychological distress can result in personal and social issues for both men and women.

Everyday activities which we take for granted are challenging for persons with sweaty hands. Some of the personal embarrassments include the inability to firmly grasp objects, drive, grip a door knob, type on the computer and the inability to do other mundane activities. The emotional distress and embarrassment drives men to keep their hands in the pockets of the pants. Being told frequently how moist or wet the palms are during a handshake is a source of embarrassment and this can shake the self-confidence of persons who are otherwise interesting, pleasant and attractive. Intimate relationships can be ruined by the excessive sweating. There is nothing romantic about being touched by wet cold hands. Sweaty hands can cause high levels of anxiety, nervousness, embarrassment, distress, stress and depression.

Sweaty groin

The groin area also has clusters of sweat glands. Men in particular who have this condition are at times embarrassed by the sweating which soaks through clothing and is visible for all to see. It is also just plain uncomfortable to feel moist in and around the scrotum. Breathable fabric underwear and loose clothing help to keep the area cool. Care must be taken with personal hygiene to avoid body odor.

Excessive underarm perspiration

As in the case of sweaty feet, hands and groin, uncontrollable heavy underarm perspiration is due to over active sweat glands. These glands are stimulated by similar triggers which include when your body is overheated, doing heavy manual work or during exercising. Non-physical stimuli can trigger sweating such as when you’re feeling emotional, or as a result of hormones. One of the triggers for excessive sweating is overstimulation of the sympathetic nervous system which is a part of the autonomic nervous system and it is located within the chest cavity. Unlike the voluntary nervous system i.e. the motor and sensory functions which we have control over, the sympathetic system is involuntary. Some of the triggers are:

  • Emotional situations
    • Anxiety
    • Mental tension
    • Stress
    • Nervousness
  • Hormonal surges
  • Physical exertion
  • Warm climates

Self-help home remedies for sweaty feet

  • Wash feet daily
  • Dry feet thoroughly and especially in-between the toes
  • Use a drying agent such as talc powder to keep feet dry
  • Apply antiperspirants
  • Wear socks and stocking made of breathable material

Self-help home remedies for sweaty hands

  • Doing an apple cider soak
  • Applying talcum powder
  • Soaking hands for half an hour in cold water
  • Soaking hands in a mixture of vinegar and rosewater
  • Soaking hands in baking soda or cornstarch
  • Applying a lotion made of vodka and lemon juice
  • Soaking hands in a mixture of honey and apple cider

Self-help home remedies for heavy perspiration

There are scores of antiperspirants and deodorants available for men, women, teenagers and persons with sensitive skin. Antiperspirants usually contain aluminum chloride which suppresses sweating. On the other hand deodorants only mask the odor of perspiration. They do not reduce sweating. Choosing light natural fabric keeps you cool during the warm summer months.

Other remedies include:

  • Reduce anxiety with relaxation exercises such as meditation and yoga

Relaxation exercises focus on the breath, visualization and slow controlled movements to relax the mind and body.

  • Dietary changes

It is recommended to reduce the intake of caffeine. The ultimate goal should be to eliminate caffeine.

  • Herbal teas such as chamomile, green tea or sage

These are some of the herbal teas which are calming and caffeine-free.

  • Consuming apple cider in the morning is an effective detox
  • Drinking wheatgrass juice up to 4 times daily is another natural detox
  • Charcoal consumed on an empty stomach in the morning is used to remove certain toxins from the body

Medical Treatment

There are non-conservative treatments which are recommended when all other treatments fail. Some require invasive surgery.

  • Botox

Botox injections curtail the activity of the sweat glands when the toxin Botulinum toxin A is injected in the glands. This therapy is more popular for the treatment of underarm hyperhidrosis. This treatment is offered by many general practitioners and some hospitals

  • Iontophoresis

Mild electrical current is applied to dramatically reduce sweating. This technique is called electro antiperspirant

  • Surgery

Thanks to Dr. Reisfeld the surgical procedure called sympathectomy is done by laparoscopic technique to incise the nerves. He has had a high success rate of >90% to reduce plantar hyperhidrosis. The procedure is performed using a fiber optic camera to enter and visualize the chest cavity. The 1-2 cm incisions made on each side of the chest cavity are small but adequate to allow for the passage of the endoscope and other surgical instruments. The sympathetic chain of nerves is resected, coagulated, or clamped.

The solutions for excessive sweating range from personal hygiene and lifestyle adjustments to conservative non-invasive methods to dramatic surgical procedure. We recommend starting with the simple self-help external topical measures to reduce sweating. The natural herbal concoctions are also worth incorporating in your diet. The surgical interventions should be reserved for persons whose lives are seriously disrupted because of profuse sweating.

By pursuing the solutions for excessive sweating it is possible to take back control of embarrassing damp, smelly feet, wet hands, underarms and groin, to regain control and confidence.

References:

  1. Hyperhidrosis, available at: webmd.com/skin-problems-and-treatments/hyperhidrosis-causes Accessed 30 July, 2016
  1. Botulinum toxin A for axillary hyperhidrosis, available at: Botulinum toxin type A in treatment of bilateral primary axillary hyperhidrosis: randomised, parallel group, double blind, placebo controlled trial, M Naumann, NJ Lowe – Bmj, 2001 – bmj.com, Accessed 03 August, 2016
  2. Impairment in quality of life of patients seeking surgery for hyperhidrosis, M Amair, A Avish, Y Weinstein, M Pfeller,
  3. Thoracic endoscopic sympathectomy in palmar and axillary hyperhidrosis Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limbs. A critical analysis and long-term results of 480 operations., F Herbst, EG Plas, R Függer, A Fritsch – Annals of surgery, 1994 – ncbi.nlm.nih.gov
  1. Hyperhidrosis | American Academy of Dermatology, available at: https://aad.org/public/diseases/dry-sweaty-skin/hyperhidrosis, accessed 03 August 2016
  1. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: Results from a national survey David R Strutton
  2. David R Strutton
  3. Search for articles by this author
  4. Botulin toxin for palmar hyperhidrosis, M Naumann et al
  5. Benjamin Weaver, Sweaty feet: Causes, Prevention and Treatment
  6. Hyperhidrosis | American Academy of Dermatology, available at:              https://aad.org/public/diseases/dry-sweaty-skin/hyperhidrosis, Accessed 3 August 2016
  7. Hyperhidrosis – Mayo Clinic available at mayoclinic.org/diseases-conditions/hyperhidrosis/basics/ accessed 03 August 2016.
  8. Endoscopic transthoracic electrocautery of the sympathetic chain for palmar and axillary hyperhidrosis, J Byrne, TN Walsh, WP Hederman – British journal of Surgery, 1990 – Wiley Online Library

 

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