No sweat: operation perspiration: extreme sweating can call for extreme treatment

Current Science, Sept 10, 2004 by Kirsten Weir

When Roberta Gualandi was a kid, her parents dragged her from doctor to doctor. Gualandi had an embarrassing problem: really sweaty hands and feet.

"Sometimes in the playground or at school, children didn't want to hold hands with me because of the sweating, which led to some bullying," Gualandi said. "This greatly affected my confidence in myself."

The doctors told Gualandi she perspired so much because she was shy and emotional. They prescribed creams, lotions, pills, and even Chinese acupuncture. Nothing helped.

Years later, Gualandi, who is now 32, found a doctor who recognized that she had a medical disorder called hyperhidrosis--extreme perspiration caused by overactive sweat glands. Sweating has an important function: It cools the body. But some bodies overdo that function. New treatments can now turn off the tap.

SWEAT STOP

About 8 million Americans suffer from hyperhidrosis. For some, the extreme perspiration is confined to the armpits. Others, like Gualandi, have super-sweaty hands or feet.

Excessive sweating can be embarrassing and can even interfere with daily activities. "I always felt uncomfortable shaking hands with people or even wearing sandals in the summer," Gualandi said.

Some people can control their hyperhidrosis with a doctor-prescribed antiperspirant. An antiperspirant is an aluminum-containing compound that slows down the production of sweat.

Many deodorants contain antiperspirants. When you swipe some Arrid Extra Dry onto your skin, the sweat glands take up the aluminum atoms. As the aluminum moves into the glands, it draws water in with it, making the glands swell and squeeze shut so that sweat can't escape.

Doctor-prescribed antiperspirants contain higher levels of the aluminum compounds. They are much better at plugging up sweat glands than over-the-counter varieties.

TEMPORARY FIXES

Prescription antiperspirants don't always stop hyperhidrosis, especially in places such as the hands and feet. A procedure called iontophoresis is another option, one that has worked for Gualandi. She soaks her hands and feet in lukewarm tap water while it is zapped with an electric current. The treatment doesn't hurt; it causes only a tingling sensation in the skin.

Researchers aren't sure how iontophoresis works, but they believe that the current somehow blocks the sweat glands temporarily. Gualandi owns her own iontophoresis machine. Using it every other day for two weeks curbs her sweating for the next six weeks. "My life with hyperhidrosis had been really bad," she said, "until I finally found [iontophoresis]."

Other hyper-sweaters have experienced improvements after getting injections of Botox, a drug that's currently all the rage for fighting wrinkles. Botox is a diluted, purified form of a toxin produced by the Clostridium botulinum bacterium. When the drug is injected into the skin, it weakens or paralyzes nerves. Injecting Botox into the forehead paralyzes facial muscles and smooths out wrinkles. Sticking it into the armpits or hands paralyzes the nerves that stimulate sweat glands.

Botox shots can hurt but have few side effects. The fix is temporary, however, and most people need to repeat the shots every six months or so to keep their sweat glands in check.

SURGICAL SOLUTION

For a permanent solution, some overperspirers have turned to surgery. In a procedure called endoscopic thoracic sympathectomy (ETS), a surgeon cuts the nerves that regulate the sweat glands. Nerve signals are no longer able to reach the glands, so the patient stays dry.

As with any surgery, ETS has risks. Inexperienced doctors can accidentally damage a patient's blood vessels or other nerves. Some patients develop compensatory sweating after the surgery. They no longer sweat in the areas where the surgery was performed, but they sweat in parts of the body that used to stay dry.

With so many treatments available to stay dry these days, it's easier than ever to live up to that popular motto: Never let them see you sweat.

IT'S THE PITS!

Thousands of tiny glands pump out perspiration.

A typical human body has about 3 million sweat glands, which come in two types--eccrine glands and apocrine glands. Both types are regulated by the symphatetic nervous system, a branch of the nervous system that acts involuntarily and is often activated by stress. Hot weather, exercise, and nervousness can all rev up the symphatetic nervous system, kicking the sweat glands into gear. When sweat evaporates from the skin, it removes excess body heat and cools the body.

Eccrine glands are located all over the human body (including the armpits) and make the majority of sweat. Openings in the surface of the skin, called pores, release eccrine sweat.

Apocrine glands are confined mostly to the armpits and become active at puberty. They piggyback onto hair follicles, the protective sacs in the skin from which hair develops and grows. Both eccrine and apocrine sweat contains water and salts, but apocrine sweat also includes proteins and fatty acids. Bacteria on the skin break down the proteins and fatty acids, releasing byproducts that stink. That stink is better known as body odor.

Vocabulary Challenge

Match each word or phrase with its correct description. Write the letter of the correct description in the blank provided.

-- 1. Botox

-- 2. antiperspirant

-- 3. hyperhidrosis

-- 4. pore

-- 5. sympathetic

-- 6. compensatory sweating

-- 7. eccrine glands

-- 8. hair follicle

-- 9. apocrine glands

-- 10. iontophoresis

A. excessive sweating caused by overactive sweat glands

B. an aluminum-containing compound that slows the production of sweat

C. a drug used to erase wrinkles or paralyze sweat glands

D. glands found mostly in the armpits, which produce sweat that contains fatty acids and proteins

E. glands found all over the body that make the majority of sweat

F. an opening in the surface of the skin

G. protective sac from which a hair develops and grows

H. a branch of the nervous system that acts involuntarily and is often activated by stress

I. a procedure to curb sweating in which an electric current zaps the skin

J. sweating in formerly dry areas of the body that occurs after surgery to block sweat glands

1. C, 2. B, 3. A, 4. F, 5. H, 6. J, 7. E, 8. G, 9. D, 10. I

COPYRIGHT 2004 Weekly Reader Corp.
COPYRIGHT 2004 Gale Group

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