Too much sweat?

Question:  Is there such a thing as sweating too much? What can I do about it if I’m constantly soaking through my clothes? It’s so embarrassing, especially at work!

shutterstock_155697284Answer:   Yes, the condition definitely heats up during the summer months but can plague sufferers all year long with overly sweaty armpits, palms and even on soles of the feet. It  is called hyperhidrosis which just means “excessive sweating.”

Hyperhidrosis is simply abnormally heavy perspiration. Sweating is a normal bodily function, but some people may have overactive sweat glands that produce more sweat beyond what is required for regulation of body temperature. It can be most noticeable at the armpits because sweat can soak through clothing and become obviously embarrassing. Or you may also be aware your palms are often sweaty so you avoid shaking hands with others.  Hyperhidrosis can occur  in many parts of the body whether exposed to triggers such as heat, physical activity or exertion, embarrassment, stress or not.

How do we treat excessive sweating?

First, we’ll evaluate your excessive sweating for any potential causes of secondary hyperhidrosis (for example, an underlying disease that causes excessive sweating such as hyperthyroidism).

To gauge your sweating problem, we will try you on stronger prescription-grade antiperspirants which can also help block sweat glands to reduce sweating. Typical over-the-counter antiperspirants are 1-2% aluminum chloride but prescription products can contain up to a 20% solution of aluminum chloride hexahydrate or similar aluminum salts. While these can be irritating in those with sensitive skin and sweat glands, they do reduce perspiration, however they require continuous usage.

After a few weeks of trial, if the prescription products do not reduce your sweating problem well enough, we can now use Botox® (onabotulinumtoxinA), which is FDA approved for the treatment of excessive sweating of armpits. We also use Myobloc® (rimabotulinumtoxinB) or Dysport® (abobotulinumtoxinA) off-label as an alternative, especially for those who have excessive sweating on palms and soles of feet.

These injections work to temporarily de-nerve the sweat gland and results in a local reduction in sweating where injections have been administered for up 5 months. Injections must be repeated at regular intervals to keep excessive sweating at bay and you may still need to use an antiperspirant.

-Jodi

Can I use perfume as a deodorant?

Q.  I ran out of my usual deodorant, so in a pinch I sprayed my favorite perfume under my arms. Is that bad?

A. Possibly. Because underarms, especially in the summer, are more sensitive when susceptible to wetness from sweat, humidity, friction and heat. Your underarm skin could have a different reaction to a perfume you normally spray elsewhere like neck, hair and back of knees, so keep perfume away from delicate areas such as armpits and genital areas.

Can antiperspirant/deodorant cause itchy armpits?

Question: I’ve noticed that every time I use my antiperspirant/deodorant my armpits start itching the next day and they keep itching even if I stop using the product for a few days. Eventually it stops itching. Could my antiperspirant/deodorant be causing my itchy armpits?

Answer: Yes. It’s highly possible in both men and women.

What it’s like to be an armpit on a hot August summer day: There’s a thicker-than-usual amount of antiperspirant/deodorant on freshly-shaven skin to avoid sweat marks and odor. As you go rushing about your day, damp armpit skin rubs together along with some sweat, oil and your clothing. But underarm skin is sensitive from the shaving too and sweat glands are mostly blocked by irritating chemicals and perfumes in addition to the fabric, laundry detergent (and possibly chlorine bleach) from your shirt. What if you added sand, salt water and chlorine to that mix?

How antiperspirant/deodorant works: Underarm odor is not caused by the watery sweat that wets your shirt which is secreted by your eccrine sweat glands to lower your temperature through evaporation. The odor is caused by bacteria that break down fats secreted by your apocrine sweat glands.  An antiperspirant contains an aluminum salt chemical to block the watery secretion from the eccrine glands which can be a primary irritant, especially when skin is more vulnerable  in the summer or freshly shaven.  But, It’s deodorant that controls the odor with perfumes and sometimes an antibacterial chemical to inhibit bacterial growth such as triclosan, also a common skin irritant.

You can now see how your antiperspirant/deodorant could be exacerbating an already sticky situation in your armpits!

5 steps to avoid itchy armpits

Don’t worry. You don’t have to wing it like Matthew McConaughey or Julia Roberts, who both reportedly abstain from wearing deodorant. Just experiment with different ingredients and formulas until you find one that does not cause you itchy armpits.

1.  Read labels and switch underarm products, formulas. Many antiperspirant products contain a percentage (14-17) of the highly irritating ingredient aluminum zirconium tetrachlorohydrex GLY. Read product labels looking for a product in the lower percentage or for the least irritating antiperspirant ingredient, aluminum chlorhydrate. If excessive sweat is not your primary problem, switch solely to a deodorant to see if it was the sweat-gland blocking antiperspirant that caused your itching. If the deodorant product still causes itching, try an all-natural brand such as Tom’s of Maine which relies on botanicals such as aloe, sage and lemongrass to soothe skin and inhibit odor and irritation. Sometimes it’s the formula that causes the itching due to the drying nature of increased alcohol in a liquid spray, roll-on or clear versus a dry solid. Look for aluminum-free, alcohol-free and fragrance-free products.

2. Shave armpits at night. And don’t apply any antiperspirant/deodorant afterwards. Let skin breathe.

3. Go au naturel at the beach. Don’t apply any underarm products if you will be at the beach or swimming as excessive skin rubbing, sweating and salt, sand or chlorine can all further irritate sensitive underarm skin.

4. Switch laundry detergent, too. Try a dye- and fragrance-free laundry detergent to reduce exposure to irritants to your underarm area. Steer clear of chlorine bleach on T-shirts.

5. See your dermatologist if rash doesn’t clear.  If you notice bumps, rash or pustules that do not resolve within a few days, see your dermatologist as folliculitis or other bacterial or fungal infection could be at play.