I’M SO TIRED OF ALL THE SWEATING!!!

This article is placed in the Star Phoenix on November 25th

According to Lorraine:

"I can’t even wear a nice shirt without soaking and staining it. I have to wear a big sweater over top, or take several shirts with me and change frequently. I might have to change three or four times a day at work, and at the gym too. I certainly can’t drink coffee any more, and spicy foods are out as well. It is really humiliating at work. With just a little stress I feel drips down my sides, soaking once again, sometimes within minutes of changing. It happens in social situations as well. Precisely as I meet up with a new acquaintance,

I’M SO TIRED OF ALL THE SWEATING!!!

According to Lorraine:

“I can’t even wear a nice shirt without soaking and staining it.  I have to wear a big sweater over top, or take several shirts with me and change frequently.  I might have to change three or four times a day at work, and at the gym too.  I certainly can’t drink coffee any more, and spicy foods are out as well.  It is really humiliating at work.  With just a little stress I feel drips down my sides, soaking once again, sometimes within minutes of changing.  It happens in social situations as well.  Precisely as I meet up with a new acquaintance, I begin sweating like there’s no tomorrow!  The more I sweat, the more nervous I get, and the more I sweat!  I wouldn’t dare shake hands as they would be cold and wet.  It’s not like I haven’t tried a variety of products!  I tried all the best commercial deodorants.  I did try a prescription ointment but that didn’t do much for me.  Somebody told me about “the surgery” that cuts the nerves to my sweat glands, but I am not going to do that.  I am just not willing to go to that length for this problem.”      

According to Marlene:

“I sweat under my arms, but that is not as bad as the sweat down the middle of my back. I have always sweated excessively, but it is worse since my mid 30’s.  Nowadays, when I sit at my workplace desk I will feel the drip, drip, drip of sweat down the middle of my back where it pools and wets the back of my pants!  I feel so embarrassed that now I wear an absorbent pad at the base of my spine underneath the long shirt that covers the seat of my pants.  I visit the bathroom frequently and change into a duplicate pair of pants so that it is not a conspicuous change.  The worst part of it is the terrible rash that I get down at the bottom of my spine where the sweat pools.  The skin is a soft mess so my doctor gave me something to rub on.  The rash, in fact, got worse.  Now my bottom is so itchy and inflamed that I have highly visible scratches all over the treatment zone.  I am “crazy itchy” over the region of the prescribed topical ointment.  And it doesn’t work that well for me.  I am desperate.  I feel like I have a dark secret.  I do have a dark secret that I don’t feel like sharing with anyone.”

According to William:

Since I was a kid, many years ago, I had a sweat problem.  I sweat incessantly around my scalp-line night and day.  Even as I sit and read in bed, I will sweat.  It occurs along my forehead and behind my ears.  It runs down my neck to my back and chest, making me clammy and wet.  I feel embarrassed and very uncomfortable about my wet body as sweat drips from my head to my chest and back.  It is incessant and seemingly unrelated to anything I do.  I can’t figure out what is causing this.  I get physicals and blood work every year, but my doctor can’t find anything wrong with me.  He says I am a fit and healthy 80-year old. I have tried some other things, without much improvement, so now I am excited about trying Botox.  I just want it to go away, after so much frustration, for so long.  

COMMENTARY

Focal Hyperhidrosis is the fancy medical label that describes a condition of exaggerated sweating in one or more sites.  The most frequently affected zones are the underarms, but other commonly affected areas are the palms and soles, and the face and neck.  Of all those who do sweat excessively, some will discover an underlying medical problem, but most are just unexplained.  And they are often young and slim, contrary to the myth that you must be obese.  Of those with no obvious medical cause for the excess sweating, it is believed that the brain is hyperstimulating some of the specialized sweat glands.  For example, stimuli such as anxiety, heat, or exercise will send the affected patient into a frenzy of sweating.  Activities of daily living, previously taken for granted, are now precarious for those wishing anonymity.  The condition is fraught with emotional, social and occupational stigma, as outlined by the typical cases above. The patient is usually quite intent and relieved to imagine life without this problem.  The prevalence of people with this condition is estimated at 2.5 – 3.0 %, mostly of the underarms.  Most of them don’t report their symptoms, and don’t consult an M.D., presumably because they don’t recognize their diagnosis and are unaware of the successful treatments. 

The good news is that once recognized and diagnosed, it is possible to break the sweating cycles.  There are a variety of conservative treatment approaches that have been described.   Topical agents such as Aluminum Chloride may help mild cases after repeated and maintained applications, but the skin may be highly irritated and limiting.  Iontophoresis might help with the palmer and solar hyperhidrosis but the effect is usually transient, time consuming, dependent on maintenance, and costly. The surgical procedures must be done with complete understanding of the risk of treatment failure and other surgical complications.  Recently, Botox has become a standard of care in the management of Focal Hyperhidrosis.  It has a very high safety record.  The sweating remission that typically occurs is nearly complete, and lasts, on average, 7 – 8 months. The procedure is quick and there is generally no downtime.  It has provided dramatic relief for those described above, and others just like them, secretly enduring the embarrassment of excessive focal sweating.  . 

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