Never Let Them See You Sweat

Hockey season is done for my five-year-old son Grant, but the aroma of sweaty hockey gear lingers. A veteran hockey mom told me she dumps pads and all into the washer without problem, so this is on my to-do list for the weekend. I’ve also noticed recent ads for deodorant regarding stress-sweat and its more pungent odor. Have you ever wondered about sweat?

Sweat is mix of water, salt, and other minerals that sweaty manevaporates from your skin. It cools you down, allowing your body to maintain its core temperature. There are two kinds of sweat glands: eccrine, which secrete a thin liquid that occurs all over the body when it’s hot outside or when you exercise, and apocrine, which emit a thick, oily secretion found mainly at your underarms. The apocrine glands develop around the time of puberty. These secretions have more odor and seem to be exacerbated by strong feelings like stress, fear, anger, embarrassment or nervousness. This is actually part of the “fight or flight” response and can increase the volume of sweat by up to 30 times.

Genetics have a lot to do with how much you sweat and where, though your diet, general health and emotions play a role too. Sweat can occur all over the body, but the highest number of sweat glands are found in the palms of your hands, soles of your feet, forehead and of course the underarms. The underarms also have more of the apocrine glands mentioned above, as well as hair and bacteria which also contribute to body odor. People who live in warm climates tend to adapt and sweat more efficiently, as do athletes.

Certain conditions like menopause, overactive thyroid and obesity can make people sweat profusely. There is also a condition called primary hyperhidrosis. With this condition, excessive sweating can happen anywhere on the body, but is most common for the palms, soles and underarms. Up to 3% of the population is affected, and it can be quite bothersome and socially problematic. People can go to great lengths to manage this problem, changing shirts several times a day or avoiding hand-shakes. One of my patients complained of dripping sweat on his important business documents. A woman patient always wore dark long-sleeved shirts or cardigans to cover up her sweating, even in the summer. These patients complain about big laundry and dry-cleaning bills, as well as the toll it takes on their self-confidence.

Staying dry and odor-free for most of us involves products. Deodorants curb odor, but not moisture, so most people choose an antiperspirant-deodorant combination. Studies show that consumers spend almost $2.7 billion per year to stay dry and odor-free.

One tip for making these products more effective is to apply at night before bed, so that they are well-absorbed, and to reapply in the morning, especially if you think you might have a stressful day. These products can be applied anywhere you sweat, but can cause skin irritation in some people. Baking soda used as a powder can be helpful for some people, especially under folds of skin. Dry shampoos can help scalp sweating. Shoe inserts and special fabrics that wick away moisture can also be useful.

A cool shower after a workout will help lower your core temperature and stop sweating more quickly. Be careful in humid conditions as cooling is more difficult since it prevents sweat from evaporating.

Prescription strength antiperspirants like Drysol contain high levels of the active ingredient aluminum chloride and can be used on palms, soles and underarms. Laser hair removal under the arms decreases the bacteria count along with hair reduction, which seems to decrease odor as well.

Injections of Botox can temporarily deactivate sweat glands. Depending on the regions treated, costs range from $800-$1,200. It is occasionally covered by insurance, and usually lasts 6-9 months.

Other treatments include iontophoresis, which can be used for hands and feet and involves using a low level electrical current in a water bath. MiraDry is a new device that involves numbing the underarms then applying pulses of deep heat to destroy sweat glands permanently. Surgery is also an option for those who struggle despite use of less-invasive methods.