Dear Doctor,

I seem to sweat too much and it really bothers me. I’ve had this problem since I hit puberty I think and have tried everything to get it to go down but nothing works.

The funny thing is that I’m not even over weight. I’m actually kind of slim. But i find myself sweating in the mornings....and of course when the sun is out. When i walk a short distance, I sweat.

I don’t actually smell though, but it makes me uncomfortable. I use dry deodorant but it doesn’t help. Is there anything I can try?

Sophie

Dear Sophie

Excess sweating or hyperhidrosis is a problem which occurs in the armpits, palms, soles and even scalp. It is uncomfortable as well as embarrassing. Do you suffer from sweating in hot dry weather or does it occur around the year?

Normally, sweating occurs in hot weather to keep body temperature static. But excess sweating can occur due to over activity of the sympathetic nervous system. This may be genetic running in families and can affect both men and women at any age. It may be intermittent or occur throughout the year. Triggering factors may be anxiety, hot weather, mental stress, spicy food and hot weather. It can be one or more of these factors. Interestingly anxiety related to excess sweating can also aggravate sweating further. In about one to three per cent people, it can be without any apparent cause.

Generalised sweating can occur due to low blood sugar levels. Those with diabetes are more prone to it, particularly if they skip food after taking insulin or medicines for diabetes. Sweating in the morning can also be due to low blood glucose levels. Endocrine disorders as that of the thyroid gland can cause excess sweating as one of the manifestations. Some medications like those used for pain, depression, and some antihypertensive medications may cause excess sweating as adverse effect.

Chronic infections like tuberculosis, cancers like lymphomas present with sweating, more in evening or night. But these are associated with other symptoms like night fever, loss of appetite and loss of weight.

Excess sweating not only causes discomfort but makes one prone to fungal infections, due to dampness. The resulting itching and scratching can cause secondary infections manifesting as boils or abscess.

Learning to relax can help in reducing sweating due to stress. It is advisable to use cotton clothes because nylon clothes tend to aggravate sweating. If there is an underlying cause like diabetes or thyroid disorder, it can be detected by simple blood tests and is curable.

Use of dusting talcum powders helps to absorb the extra sweat. Anti perspirants containing aluminium chloride are recommended to be useful. Deodorants will not help much except cover the smell of sweat.

Some medications like atropine can reduce extra sweating but could cause uncomfortable side effects like dryness of the mouth, and blurred vision. Passing electric current to destroy the sweat glands is another option. Hyperhidrosis can also be reduced by injecting Botilinium toxin in the nerves to reduce their activity. In severe or persistent cases, surgical removal of the sweat glands or cutting part of the sympathetic chain is done to reduce the production of sweat.

Management can include one or more of these options.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.