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Do you ever do any of the following?
If you do, you may suffer from a condition of excessive sweating called hyperhidrosis. Although accumulated sweat sometimes provides a home for fungal infections, by far the most serious problem associated with hyperhidrosis is the limitation of social interactions imposed by fear of smelling bad. Fortunately, several simple antiperspirant remedies can make hyperhidrosis a thing of the past.
Perspiration is regulated by the hypothalamus, a gland deep inside the brain. The front of the hypothalamus contains thermosensitive neurons that receive information from temperature sensing nerves in the skin. A sensation of heat from the skin causes the hypothalamus to send signals to the sweat glands to release perspiration that cools the surface of the skin as the sweat evaporates. Different kinds of heat signals, however, generate different levels of response.
Eccrine sweat glands (also called merocrine sweat glands) are located all over the body. An adult's skin is covered with approximately 2 million eccrine glands. These glands release a clear, salty fluid in response to a signal from the hypothalamus that lowering body temperature is needed.
Apocrine sweat glands, scientists now know, actually release sweat the same way as eccrine sweat glands, by "leaking" fluid out of cells (rather than sending out packets of fluid coated with proteins). The apocrine sweat glands are concentrated under the arms, around the anus and genitals, and around the nipples. They have minimal impact on the regulation of body temperature, but they emit pheromones that help us send chemical signals to people around us.
Just how sweaty is excessive sweating? One researcher found that a single square centimeter of underarm skin might produce 0.2 cc of sweat every minute. In terms of the average adult underarm, that is the equivalent of up to a liter (4 cups) of underarm sweat every hour, which is an enormous volume of perspiration, far more than can evaporate from the skin.
Perspiration can be localized to just one part of the skin. A good example of this is the reaction most people get to eating chili peppers. The sensation of gustatory heat resulting from the release of capsaicin as the pepper is being chewed triggers a specific nerve reflex that causes sweating on the forehead, tearing from the eyes, and runny mucus from the nose.
People who have poorly controlled type 2 diabetes sometimes develop a condition called neuropathy, in which the protective layers of nerve fibers literally "caramelize" as they react with glucose in the blood. These sufferers of diabetic neuropathy will often develop a similar kind of reflex to eating high-carbohydrate foods, causing gushing of sweat from the forehead, face, and neck.
Shingles also causes localized sweating near its blisters as the shingles virus travels up the nerve leading from the spine to a sweat gland. Since shingles most often break out of the face, they most often cause excessive sweating of the face and forehead.
The most common localized sweating is the sweating that causes sweaty, smelly hands and feet. The nerves that control the sweat glands in the hands and feet connect to a different part of the hypothalamus, away from the nerves that control the sweat glands on the rest of the surface of the body. This part of the hypothalamus responds more strongly to stimulation by emotional stress, while the rest of the hypothalamus responds more strongly to stimulation by temperature. Emotional stress may make the hands and feet gush perspiration while the rest of the body stays dry.
If you were to ask an academic specialist in the physiology of perspiration why some people pour perspiration from under the arms, you probably would get an answer on the lines of "Oh, we know that there really aren't any health conditions that cause excessive underarm perspiration." But we all know people-or we are the people-who sweat profusely from the armpits. What really is going on with excessive underarm perspiration?
Doctors would typically describe excessive hyperhidrosis symptoms as physiological, symptomatic, or idiopathic.
The solution for physiological sweating is very straightforward. Turn on the air conditioner! Simply finding a cooler location will help reduce sweat.
Symptomatic sweating resolves with disease treatment you work out with your health care provider. And if you take one of the medications that induces heavy perspiration, at the very least you will know to use extra antiperspirant.
There is a common confusion between antiperspirants and deodorants. Antiperspirants stop sweating. If there is no sweat, then odor-causing bacteria will not have a medium in which to grow. But because perspiration itself has no odor, antiperspirants will not reverse body odor once it occurs.
Deodorants stop odor. They kill the bacteria that cause odor but they do not stop perspiration. Most of the time, the place to start is with an antiperspirant.
Most antiperspirants contain a chemical called aluminum chloride hexahydrate. This chemical changes the chemistry of sweat glands so that they retain fluid rather than releasing it as sweat. Antiperspirants are typically only used to treat the apocrine sweat glands under the arms, or less commonly around the genitals or nipples, where odor-causing bacteria feed on both liquid perspiration and fatty secretions that carry pheromones.
Aluminum-based antiperspirants in a 20% strength (available with a prescription) actually don't have to be used every day, but they are effective only in milder cases of underarm hyperhidrosis. For persistent cases of hyperhidrosis, modern medicine offers a variety of increasing invasive procedures.
Another way to shut down the sweat glands is to shut down the nerves that activate them. This can be done with a class of medications that are known as anticholinergics, such as propantheline, which is also used for irritable bowel syndrome and irritable bladder syndrome. The problem with using an anticholinergic drug is that it shuts down the activity of the sympathetic nervous system all over the body, so turning off the process of perspiration may also stop urination, tear secretion, and salivation, and also cause constipation.
It is possible to shut down a smaller number of nerves with Botox injections. A Botox shot stops the production of neurotransmitters in a radius of about an inch (25 mm) around the injection site. Botox is expensive, up to US $500 per injection, and the injections can be very painful. Muscles around the injection site can be paralyzed, including the muscles of the shoulder and the upper arm. The effects of the injection wear off after 3 to 6 months.
There is a surgical procedure to cut the nerves leading to the sweat glands under the arms. The side effect of surgery to stop sweating on one part of the body usually is increasing perspiration somewhere else! Surgery for hyperhidrosis simply does not always work. So what can you do if you don't want to use heavy-duty antiperspirants, you don't want to get Botox injections, and you don't want surgery. Here are 10 home remedies for hyperhidrosis.
It's actually possible to stop excessive sweating by drinking sage tea, but an adult would need to drink about a liter (2 cups) a day to get significant relief. And there are also other natural approaches to controlling underarm sweating that actually work.
One is homeopathy. I've written about my own misgivings about homeopathy and how I changed my mind after I was privileged to spend some time observing at the clinic of the late, great French allergist and homeopathic researcher, Dr. Jacques Benveniste. I'll just say that since there are no side effects of homeopathy for excessive perspiration, and the product I'm going to recommend here comes with a one-year money-back guarantee, why not try it?
You don't have to track down and buy all five homeopathic remedies separately. Native Remedies offers all five homeopathic solutions for excessive perspiration in a single product, Sweat-Less. And while you are gradually sweating less, there is also a product to help you generate less odor. It's called DeodoRite.
Q. Won't underarm sweat pads take care of hyperhidrosis?
A. Not if each armpit is producing 500 cc (2 cups) of sweat every hour. However, sweat pads and other garment shields are a good idea when you wear expensive clothes or clothes that show sweat. Just don't expect them to be enough to soak up sweat when you are in a hot, humid, stuffy room.
Q. What is "axillary hyperhidrosis?"
A. Excessive sweating under the arms.
Q. What is the difference between bromhidrosis and hyperhidrosis?
A. Bromhidrosis involves an offensive odor, while hyperhidrosis involves excessive sweat. Hidradenitis is a recurring infection of the apocrine sweat glands, usually manifesting itself as yellow-topped pimples.
Q. Is hyperhidrosis an inherited condition?
A. No, only about 25% of people who have hyperhidrosis have a family member who also has the condition, Israeli researchers report. People of Asian heritage tend to develop the condition earlier, even in early childhood, while people of most other racial heritages tend to develop excessive sweating either at puberty or with hormonal changes (menopause in women or testosterone deficiency in men) after midlife.
Q. What is "ETS?"
A. Endoscopic thoracic sympathectomy is hyperhidrosis surgery. The surgeon makes tiny, endoscopic incisions in the armpit to install titanium clips to block transmissions of signals from the central nervous system to sweat glands. The procedure is conducted under anesthesia and generally pain is minimal.
Q. Does iontophoresis work for underarm sweating?
A. Iontophoresis is a procedure in which sponges are soaked in tap water and then wrapped around metal electrodes inserted into sweat glands. An electrical current is passed through the electrode and the sponge until there is a stinging sensation. The procedure is repeated several times a week until enough sweat glands are destroyed that excessive sweating is reduced.
It is possible to use this procedure on the armpits, but it is difficult to keep the sponges from dripping so that the current flows all over the skin with the flow of water. Moreover, destroying sweat glands under the arms may just lead to excessive sweating on some other area of the body that is even more difficult to control.
Q. Can hyperhidrosis be treated with radiation?
A. Yes, but this is in effect treating an overactive sweat gland as if it were a cancer. And since radiation can actually cause cancer, very few doctors anywhere would consider offering this procedure.
Q. I heard sometimes people are put in microwaves to stop excessive sweating?
A. No, dermatologists are experimenting with a hand-held microwave generator called miraDry. The dermatologist injects a temporary tattoo made with metallic ink into the armpit, and then holds the microwave generator over the armpit to microwave sweat glands. The procedure is more painful than Botox injections and not covered by insurance, but preliminary reports are that it stops excessive underarm perspiration for at least a year.
Q. Does breast cancer cause underarm sweating?
A. Before the tumor is treated, there may be additional perspiration around the nipples. If the breast is removed, then there may be compensatory sweat production under the arms. Add to this the hot flashes caused by treatment with tamoxifen (Nolvadex) for estrogen-sensitive breast cancers, and excessive underarm perspiration is a common problem for many women who have had breast cancer.
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