‘You don’t want to be this wet person’: How to tackle extreme sweating

In a bid to pass as a normal adult woman, rather than looking like a safe cracker who’s dripping with sweat as she’s sure she’s about to be busted by the cops, I’ve tried it all. I’ve stuffed wads of Kleenex in the armpits of jackets and taped a panty liner inside a T-shirt. I’ve pinned my arms to my side in order to hide blooming underarm stains while reaching across a table at a fancy sushi restaurant for the soy sauce. I felt like the Tin Man trying to pass as a human.

Worst of all, I used to feel like I had a terrible secret I needed to hide. If people knew, surely they’d be repelled.

“Usually they can’t date, you know, so the younger ones are really embarrassed,” says Dr Adrian Lim of his patients who suffer from excessive sweating. Credit:iStock

This is the lot of those who suffer from hyperhidrosis, or excessive sweating.

And far worse.

“They can’t even handle an A4 page without the sheet sort of damping up,” says Dr Adrian Lim, a fellow with the Australasian College of Dermatologists, of some patients who sweat excessively from the palms of their hands. “And they leave trail marks of sweat on the table, and they can’t have contact with other people. Playing racquet sports is impossible, you know, handling instruments.”

The condition can even ruin intimate relationships, or halt them from the beginning.

“Yeah, dating is one of the biggest things, you just don’t want to be this wet person,” says Melbourne dermatologist Dr Shyamalar Gunatheesan, adding that the condition can lead not only to embarrassing wet patches on clothing but fungal infections in the groin region, and other parts of the body, “that can spread everywhere”.

“Sometimes, you [a patient] feel like, ‘I’m not actually that nervous’ at a job interview, but you’re sweating profusely and you’re kind of giving the wrong signal to people around you,” says Gunatheesan. “That’s when you feel your body failing you.”

There’s the stigma associated with it, too.

“People might associate it with being unhygienic, maybe malodorous, that, you know, ‘it’s dirty’,” says Lim, adding that many patients find the condition “very embarrassing”.

But it’s a common genetic condition – experienced by men and women equally – and it doesn’t discriminate.

“Colleagues of mine from overseas have claimed they’ve treated top-rank tennis players [for it],” says Lim.

The good news? It’s eminently treatable.

The condition is caused by an overactivity of the sympathetic nervous system, which controls our sweat glands. So, the first line of defence is an antiperspirant that blocks the sweat glands from producing too much sweat. Natural versions made of beeswax or coconut oil help some people, while others, like me, have found that aluminium-based antiperspirants successfully treat the problem.

But what about the concern that absorbing aluminium increases the risk of developing Alzheimer’s disease?

“It’s not conclusive,” says Lim. “I suppose the fact that you don’t have studies saying it’s definitely not a cause of dementia, or whatever, makes some people worry. But the fact is that it’s been theorised since the 1960s, and there’s still no convincing evidence… I reckon we’re pretty safe, I’m comfortable.”

Lim adds that though high levels of injected aluminium cause inflammation and injury to the body, our bodies are good at stopping aluminium from getting in and being retained. “The skin just doesn’t absorb it,” he says.

The next stop, if these don’t work, is topical glycopyrrolate, a medication applied to the skin to combat underarm sweating, or oral medicines that do the same.

Another option is ontophoresis, which delivers a weak electric current to the skin that’s affected by the condition. It can be done in a doctor’s office, or there are kits that can be used at home. “It may reset the point of sweating [so people sweat less],” says Lim, adding that it is not a cure, and needs to be done repeatedly, for patients to experience relief.

There’s also Botox. “So, Botox basically stops nerves from releasing the activating transmitters, for example, nerve impulses to facial muscles,” says Lim. “So, people are familiar with that. But it also does it to sweat glands,” he adds, explaining that sweat glands are controlled by sympathetic nerves. It’s remarkably effective for many people, and each Botox treatment – usually consisting of about 10 to 20 injections per armpit – can last for between six and 12 months.

“Different things work for different people,” says Gunatheesan.

The last resort is surgery is to cut the sympathetic nerve, which comes out of the spine. But this is only successful about a quarter or a third of the time, and even when it is, a patient might suffer from “compensatory sweating” afterwards, says Lim.“Meaning if you’re treating the armpit, and it dries up, then it [sweating] starts to happen on your forehead,” he says.

“This is something you don’t have to live with,” says Gunatheesan. But make sure to check with your doctor that your excessive sweating isn’t the result of a disease.

“You need to make sure you don’t have underlying thyroid issues, diabetes, hormonal problems, or [that you’re] deficient in a mineral or iron, or that you don’t have underlying cancer,” she says. “Because very rarely, excessive sweating that comes on all of a sudden, we have to think of a systemic cause.”

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