Do you suffer from excessive sweating?

I used to suffer from excessive sweating. No matter what the weather was, cold or hot, I sweated a lot. I don't know why, I just sweated like a pig.   To avoid showing the sweat stains, I wore an undershirt, pads, and shields for sweating.  Sometimes I would change them several times a day. And I also took several showers daily.  But these could not stop my sweating.  I tried different antiperspirants and other medicines.  Unfortunately, I still sweated heavily.  I almost lost all of my confidence.  You know, that feeling of being embarrassed, frustrated, anxious, you name it.  

 DR’S RESPONSE:  Excessive sweating is called hyperhidrosis.  “Hyper” means an over abundance of and “hidrosis” means sweating.  Thus, the medical term hyperhidrosis simply refers to excessive sweating.  Hyperhidrosis can affect many areas of the body.  A person may sweat excessively wherever there are sweat glands.  The most common areas of complaint are located in the armpits, palms, soles, and forehead. 

 Sweating naturally occurs when a person is excited, anxious, or afraid.  Grossly simplified, sweating acts as a natural air conditioner for the body.  As sweat, a liquid, is excreted, air molecules in very close proximity to the skin attach to the liquid, creating a cooling effect.  Because the air molecules are drawn closer to the skin, they in effect cool the skin.  Mother nature has cleverly created a mechanism that will allow the body to cool itself.  There is very little immediate negative return for excreting the sweat, but the long term outlook is quite poor if the sweat is not replaced by drinking fluids. 

 But there are other ways to create sweat.  Inflammation of sympathetic nerves can cause local hyperhidrosis.  An example would be an athlete who has cold wet feet for a long period of time.  Also, generalized sweating can occur if a person takes certain medications, ingests alcohol, or consumes certain foods.  Specific diseases such as typhoid fever, malaria, tuberculosis, hyperthyroidism, and diabetes can cause generalized hyperhidrosis. 

 The feet are the most common area of over sweating prompting a visit to a physician’s office.  The patient usually comes to the doctor at the behest of the significant other or parents with the complaint of foul smelling shoes and feet.  The patient has often tried a variety of different treatments, all of which have failed up until this point. 

 Conservative measures to alleviate excessive sweating all are aimed at reducing symptoms, not eliminating the problem.  The first line of defense is often anti-perspirants and deodorants.  Yes, apply them to your feet like you do your armpits.  Patients are advised to change their socks several times a day.  They are also recommended to change their shoe type to a more breathable material.  For instance, leather steel toed work boots may not be ideal.  Another useful measure is to sprinkle baby powder in the shoes to help absorb some of the moisture present.  Lysol is to be sprayed once weekly in all shoes, regardless of use. 

 Another promising treatment is botox injections.  This is an extract of the botulin toxin that temporarily blocks the chemical signals sent by the brain to the nerves that control the sweat glands itself.  By blocking the arm that turns on the faucet, the sweat is never released. 

 Other, more controversial treatments include iontophoresis, surgery, and other alternative therapies such as biofeedback, acupuncture, hypnosis, and relaxation techniques.  There is little research proving the effectiveness of alternative therapies at this time.  Surgery is often only in severe cases where other treatment methods have failed.