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Sunday August 17, 2014 MYT 12:00:00 AM
Tuesday August 19, 2014 MYT 3:48:44 PM
by dr chen tai ho for aesthetically yours
In medical terms, it’s called hyperhidrosis. In practical terms, it leads to unsightly sweat stains and the inevitable funky smell.
Imagine you’re trying to write but the paper you’re writing on is wet from perspiration from your hands.
Or you’re attending a snooze-inducing meeting in your office’s freezing cold boardroom, but sweat stains from your underarms are showing through your shirt.
You’re meeting a hottie for a first date but you’re drenched in sweat and your date finds it more repulsive than a naked Mr Bean.
These are real everyday scenarios faced by anyone afflicted by excessive sweating, medically known as hyperhidrosis.
Everyone sweats after a bout of exercise or when it’s hot outside, but people who have excessive sweating experience so much sweating to the point that moisture may literally drip from their hands.
The condition causes them to sweat profusely when there’s no reason to. As you can imagine, sufferers may be affected by low self esteem and poor confidence.
Our sweat glands produce perspiration when the temperature is high or during physical exertion, such as during an evening jog at the neighbourhood padang.
When we are in stressful situations, such as forgetting to buy an anniversary gift for our spouse, or when we are meeting a hot guy or girl for the first time, we also perspire more.
But during other times, our sweat glands are dormant and inactive.
But for 2%-3% of the population who have hyperhidrosis, the sweat glands don’t shut off. These people are perspiring heavily even in air-conditioned rooms, while watching television or just lazing on the couch.
Some people even sweat while they are having a dip in the swimming pool.
There are two types of hyperhidrosis, namely primary hyperhidrosis, which causes excessive sweating in the hands, underarms, face, and feet without any apparent reason, and secondary hyperhidrosis, which causes excessive sweating all over the body and is caused by a medical condition.
People with primary hyperhidrosis sweat from a certain type of sweat gland called eccrine sweat glands. These sweat glands make up the majority of the two to four million sweat glands in your body. The eccrine glands are mainly concentrated on the face, palms of the hands, feet and underarms.
The cause of primary hyperhidrosis is unknown, although there are some studies which show that it may be hereditary. Many sufferers have this condition since childhood.
I personally have a close friend in secondary school who has this condition. He has cold clammy palms all the time and it felt queasy to shake his hands.
I also have a doctor friend who has hyperhidrosis. He is undergoing treatment as it is inconvenient when he has to examine his patients. A sweaty clammy touch from a physician isn’t comforting.
Secondary hyperhidrosis differs from primary in that the former causes generalised excessive sweating in the whole body, while in the latter, sweating occurs in focused areas such as face, palms, underarms and feet.
In the case of secondary hyperhidrosis, there is a medical problem causing it. Some of the medical conditions that can cause hyperhidrosis include diabetes, hyperthyroidism, obesity, gout and infections.
Even pregnancy can cause one to sweat excessively.
By getting the medical condition sorted out, the excessive sweating can be curbed. Therefore, it is vital for you to inform your doctor when you are experiencing too much sweating so that he or she can screen you for health issues.
There are various treatment options for this emotionally debilitating condition. Amongst them is adjusting your lifestyle.
Altering your lifestyle and activities would not cure primary hyperhidrosis, but it can improve your symptoms.
You may want to avoid known triggers that make your sweating worse, such as Auntie Rani’s delicious home-cooked curry, and alcohol.
Though tight, body-hugging outfits may be sexy and make you more appealing to your significant other, you may want to avoid them and go for looser clothes made from natural fibres such as cotton.
Avoid man-made materials with poor breathability such as nylon. Choose socks that have better absorbtion and air circulation such as those made from cotton. Change your socks at least twice a day.
And buy shoes made from natural material such as leather or mesh rather than synthetic material.
If the regular antiperspirant you bought has failed to control your sweating, your doctor may prescribe a more powerful one for you.
Aluminium chloride-based antiperspirants work by clogging up your sweat glands. This can be applied at night just before you sleep, and washed off the next morning. Common side effects are slight irritation, redness or tingling sensation over the applied area.
If lifestyle changes and prescription antiperspirants do not help with the symptoms, you may want to see a dermatologist, plastic surgeon or aesthetic doctor.
Iontophoresis is an effective treatment in up to 90% of cases if you have excessive sweating that affects your hands or feet. It may also be used to treat armpits, although this may be less effective.
For arms and feet, you place them in a bowl of water and a weak electric current is passed through the water. A wet contact pad is placed against each armpit and a small current is passed through the pad.
The current is thought to help block the sweat glands. This treatment is not painful but may cause some temporary discomfort such as skin redness and irritation.
Iontophoresis takes 30 minutes, and you will need to have two to four sessions a week. Your symptoms should improve after a few weeks, after which further treatment will be required at lesser intervals, depending on the severity of your condition.
When you think of Botulinum toxin, you might think of an injection to reduce wrinkles on the faces of movie stars. However, Botulinum can also be used to treat excessive sweating.
Botulinum is a protein that can be used safely in minute doses. Approximately 20 small injections are given in the affected areas of the body. This simple procedure takes less than half an hour to administer.
The toxin works by blocking the signals from the brain to the sweat glands, thereby reducing the amount of sweat produced. The results last up to eight months, after which further treatment will be necessary.
Video-assisted thoracic sympathectomy (VATS) is the most commmon surgery to treat hyperhidrosis. This is usually recommended after all other treatment options have failed.
A surgeon makes two small incisions on the side of your chest and remove some of the nerve tissue that runs from the nervous system to the affected sweat glands.
VATS is used for treating excessive sweating of the armpits, face and hands. The procedure produces good results.
However, as with any surgery, the VATS operation may have some side effects. The most common side effect is compensatory sweating, whereby excessive sweating may start to show up in another part of the body.
Dr Chen Tai Ho is an experienced aesthetic doctor who chills by the pool sipping espresso latte when he’s not attending to his beloved patients. For further information, e-mail firstname.lastname@example.org. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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