Sweating is a normal reaction that cools the body prevents it from overheating in hot climate or during physical activity. But excessive sweating becomes annoying as it interferes with day to day life. It is embarrassing, stains clothes, complicates social interactions and affects quality of life. In such cases, treatment becomes necessary and you should consult a dermatologist. In this post, we would discuss about various treatment options to control excessive sweating.
Dr. Monika Misra
If excessive sweat is secondary to any medical condition, specific treatment of underlying disorder are recommended:
- heart, thyroid, respiratory problems or infections causing excess sweating should be treated
- drugs implicated in causing excessive sweating should be recognised and replaced by other drugs
- treatment of anxiety
In some cases there is no evident cause of excessive sweat. In such instances, it is diagnosed as primary hyperhidrosis. Then sweating is controlled by various life style changes and use of antiperspirants. In severe cases, iontophoresis and Botox injections are recommended.
- avoid wearing tight fitting clothes
- wear cotton clothes preferably of white or black colour that minimise signs of sweating
- avoid triggers that worsen your sweating as spicy food, alcohol or coffee
- wear armpit shields that absorb sweat and prevent clothes from staining
- wear socks of sweat absorbing material as sport socks
- change your socks, footwear or clothing when damp
- use antiperspirant
Antiperspirants and deodorants
Antiperspirants contain aluminium salts that control excessive sweat. They block the sweat glands and prevent sweat from reaching the skin’s surface. When you apply antiperspirant, the aluminium salts dissolves in the sweat on the skin, forming a gel that acts as a type of plug to stop more sweat from being released. This does not interfere with sweat production or thermoregulation.
Antiperspirants are readily available on the market as sprays (aerosol), sticks, creams or roll-ons. Bathing and washing removes the antiperspirant gel. Re-application of antiperspirants is required to help reduce sweating and keep fresh throughout the day.
Antiperspirant preparations are usually coupled with deodorants. Deodorants do not prevent sweat release, but contain antiseptics and fragrance that masks the foul odour of sweat. Anti microbial present in deodorants inhibit growth of bacteria that flourishes on sweat and causes bad odour.
Iontophoresis technique helps to reduce sweating from hands or feet. It can also be used for controlling axillary sweat, though it is less effective for it. Iontophoresis involves passage of a weak electric current over effected area under water or through wet pads. This temporarily blocks sweat glands.
The procedure is painless, though there may be discomfort or mild pin or needle sensation or irritation on skin. Each Iontophoresis session lasts for 20-30 minutes. For initial few weeks, you are required to undergo 2-4 sessions per week. Sweating began to improve in 2-3 weeks of starting the treatment. Then, maintenance sessions may be required at an interval of one to four week depending on the severity and response of treatment.
Iontophoresis is a safe, simple and cheap technique for controlling excessive sweating. But it is time consuming, number of sessions or visit to doctor are required and response may not be satisfactory in some patients.
Botulinum toxin or Botox is a neurotoxin obtained from bacteria that is purified for human use. It has a ability to temporarily block the secretion of chemical messenger that turns on sweat secretion. Thus, it temporarily blocks the sweat secretion. It is effective in treatment of excessive sweating from armpits, palms or soles.
Around 15-20 Botox injections are injected on the affected area as armpit, palm or soles. The procedure takes about 20-30 minutes. The results start appearing in about 2-4 days. The full effect is usually achieved within 2 weeks. Effect of Botox remains for 7-9 months. Repeat injections are required thereafter. Botox injection for excessive sweating is an effective, simple, and less time consuming procedure. But it is a costly procedure. It is most effective in cases of armpit sweating. In case, palm sweating, injections may cause weakness of thumb muscle that reverts back to normal in 2-3 weeks.
Endoscopic thoracic sympathectomy (ETS) is a surgical procedure that is done in cases if excessive sweat is severe that is not controlled by above mentioned procedures and is seriously affecting quality of life. It’s usually done to control excessive sweat on palms or armpits. In this surgery, small incisions are made on side of chest and nerves that control signals of sweat glands are cut or clipped. This procedure is usually done under general anaesthesia.
Various newer procedures are under exploration that destroy the sweat gland of a localised area using laser, electromagnetic waves or ultrasonic waves.
Why do I sweat too much?
When should sweating be called excessive? What are the causes of too much sweat? When should one consult a doctor for excessive sweating?