Dear Dr. Garner,
I really hope you can help guide me. I have a very embarrassing problem: I sweat too much.
This has been happening almost all my life. It turns my clothes yellow, and I am reluctant to go out in public sometimes. It is not just related to one part of my body – my whole body sweats.
I have tried extra strength deodorant, with no success.
Is there anything you can tell me about this problem? I read the column every week, and am so grateful that I can discuss this problem anonymously.
Sweating Bullets in Sheepshead Bay

Dear Sweating Bullets,
Your reaction to the problem is very typical. Fewer than half of the eight million people afflicted with this problem in the United States seek medical help. This is unfortunate, as there is a wide variety of treatment available.
As with most problems, doctors like to give fancy names to common things. For the condition of sweating too much, the name is “hyperhidrosis.” (Good for Scrabble.)
This problem affects the palms, feet, face, head and underarms. It’s more common in the Asian communities and countries, with the incidence being about twice as much as in the general population.
There are emotional complications, as you have described, as well as irritation and infections of the skin, like athlete’s foot. In addition, many people experience warts, bacterial infections of the skin and rashes.
Another fancy term, “bromhidrosis,” is used to describe foul body odor. This occurs as the sweaty liquid provides a perfect area for bacteria to grow and produce the unpleasant smell – another complication of your condition.
There are many reasons why people sweat excessively without having a malfunction of their sweating system. Some conditions include menopause and low blood sugar. Psychological factors, such as panic attacks, emotional stress and anxiety also may be culprits.
Certain medications have a sweat-inducing effect on the body, including antidepressants and pain killers.
When sweating is caused by one of the above causes, it is referred to as secondary hyperhidrosis.
In primary hyperhidrosis, the excessive sweating is not caused by another medical condition or as a result of a medication. It may happen as a result of too much of a chemical that the body to produces to make the nerves sweat. The other possibility is that the nerves are too sensitive to the chemical and even though the chemical is produced in normal amounts, the problem still occurs.
For some reason, in primary hyperhidrosis, people usually do not experience excessive sweating while sleeping.
It is a fairly easy diagnosis to recognize for your doctor. When he examines you, there will be beads of sweat over your body. Having parents or siblings with the condition also improves the chances that you will suffer from it.
The good news is that there are a variety of effective treatment options for hyperhidorsis.
There are high strength antiperspirant products that can be purchased over the counter (Certain Dri is an example) and used not only for the underarms, but also for the hands and feet.
Antiperspirants work by blocking or plugging the sweat ducts, thereby reducing the amount of perspiration that reaches the skin.
Sometimes a physician will suggest a prescription strength antiperspirant, such as Drysol, for people who do not respond to over-the-counter products.
Another treatment involves a process known as iontophoresis. Another fancy word, but it describes a simple process. A part of the body, such as the feet, are put into a basin of water. A mild electrical current is then delivered to the skin’s surface from an electronic device. It is believed that the electrical current somehow temporally blocks the sweat gland. This has shown to be highly effective and is approved by the FDA.
Another option available for treatment is Botox. Most of you are familiar with Botox for wrinkles. In that process, the Botox paralyzes nerves that cause your face to look wrinkled. In treatment of sweating, the Botox is injected into the area of concern, such as the underarms. The nerves that cause the sweat glands to fire are paralyzed, stopping the sweating. This is also approved by the FDA and is highly effective.
Another treatment is known as ETS surgery. This is a type of surgery used to treat mostly the palms. It involves identifying the problem nerve and then physically interrupting, or cutting it, so it cannot deliver the signal to sweat more. This is more invasive than the other options and should be used after other treatments have been tried.
There are some medications that may be effective in reducing sweating. Some names to ask your doctor about include Robinuk and Robinul-Forte.
They do have some side effects that include dizziness, dry mouth and urinary troubles.
I am so happy that you brought this topic up because it is treatable, and no one should have to live with the embarrassing consequences.
In summary, the condition hyperhidrosis can either be caused by a medical problem (menopause or hyperthyroidism are examples – in which case the treatment would be to correct the underlying medical problem) or due to a chemical defect that causes the sweat glands to overact.
Treatments range from heavy duty antiperspirants to surgery.
Thank you for your question. I hope that you have a great week ahead.

* Reprinted with permission of The Tablet