Q: I’m a female, 25 years old. This sweating thing is destroying my life. I have tried all types of products and creams to no avail. Do you know of any surgery or a doctor that can help me?

A: Excessive sweating (hyperhidrosis) is excessive sweating that affects at least 3% of the world’s population. While the percentage figure may appear small, that translates to more than 211 million individuals! It generally affects the palms of the hands, underarms, groin area, and soles of the feet. The actual act of sweating is the body’s means of cooling down. The nervous system automatically triggers the sweat glands when a person’s body temperature rises or when he or she is nervous. Sweating all over the body may also be the result of an overactive thyroid gland, specific medications, low blood sugar levels, an infectious disease, from a heart attack, from having low blood sugar levels, or naturally when the body is hot and trying to cool down.

Hyperhidrosis can be classified, depending on whether it begins prior to or during adolescence, or ant any later point during a person’s lifetime. The early form appears to be inherited as an autosomal dominant genetic trait, while the one that begins later in life may be due to such conditions as having diabetes, a thyroid or pituitary disorder, menopause, gout, or from taking specific medications. Outside factors that can play a role in sweating include drinking or eating products that contain caffeine, eating specific foods (called gustatory sweating) or simply smelling specific odors.

Probably the most difficult part of having hyperhydrosis is that a person feels out of control, making such things as dancing or even just holding hands next to an impossibility. A person may become an introvert as a means of hiding the condition from others.

Diagnosis may begin by having lab work performed. Such conditions as hypoglycemia (low blood sugar) or hyperthyroidism (an overactive thyroid gland) may be to blame. There is also a test known as a thermoregulatory sweat test that can be performed.

Other than addressing specific medical issues mentioned above, treatment may initially be in the form of prescription-strength antiperspirants, BOTOX injections, or oral medications. As a point of information, regular antiperspirants commonly contain aluminum chloride. Individuals with hyperhidrosis will likely require prescription solutions or gels with a much higher concentration in order to be effective, and those treatments may take several days before positive results are seen. BOTOX can block those nerves that trigger sweat glands to perform. On the downside, the injections are costly, painful and the sites may require several injections that don’t appear to last very long. Oral medications have the ability of blocking those chemicals that allow specific nerves to communicate with each other. On the downside, oral medications may cause blurred vision, bladder difficulties and dry mouth. When these somewhat conservative measures fail to help, a physician may suggest surgery – either to remove the sweat glands or to modify those nerves responsible for the excessive production of sweat.

On the home front, most of the procedures mentioned are on the practical side. Dry your feet well following each shower or bath. Bathe daily to control the amount of bacteria on the skin. Wear cotton or moisture-wicking socks and clothing that will absorb moisture and will allow your skin to breathe, consider biofeedback, and yoga.

Make an appointment to visit your primary care physician. A review of any other medical conditions, if they exist, will help him or her recommend a process that is right for you. Good luck.

DEAR DR. GOTT:
I am a 61-year-old male in what I think is great condition. However, for as long as I can remember, I have had a problem with sweating. If a warm breeze comes by, if I drink a hot cup of coffee or have a glass of wine, I sweat profusely.

I exercise a great deal and sweating isn’t a problem then. What is a constant source of embarrassment, though, is being out to dinner or at a party when the waterfall starts. Do you have any thoughts or solutions?

DEAR READER:
Hyperhidrosis is a medical condition in which a person sweats at unpredictable times and in excess. It affects up to 3% of our population, yet less than half with the diagnosis seek medical attention. As you have discovered, the discomfort is both emotional and physical.

Generally speaking, people sweat during exercise, when warm weather prevails, or when confronted with situations that bring on fear, nervousness, anger, or embarrassment. In times such as these, we expect to sweat. However, hyperhidrosis can occur because of medical conditions such as heart disease, hypothyroidism, menopause, Parkinson’s disease, stroke, and more. I am guessing, because of your “great condition”, that you do not fall into the latter category.

Perhaps your presence at a dinner or party presents more internal and unaddressed stress than you have been willing to admit. If so, you might want to determine what is causing the turmoil and find ways to combat it.

Treatment includes over-the-counter antiperspirants, prescription medication, Botox and Iontophoresis. The latter is an FDA approved procedure that uses electricity to turn off the sweat gland temporarily. This procedure is most effective for sweating of the hands and feet than for other body parts. Speak with your physician to determine which treatment might be appropriate for you.