Don’t Sweat It!

The Singapore heat and humidity are enough to make the coolest individual break out in sweat within seconds. For those who are challenged with excessive sweating, help is at hand.

Sweating is how our body regulates its temperature, but excessive sweating, or hyperhidrosis, is sweating beyond what is required for this purpose. The condition can affect specific ‘focal’ areas such as the underarms, palms or soles, or even the entire body.

Hyperhidrosis is defined as sweating excessively and visibly for at least six months without any apparent cause and with at least two of the following characteristics:

• The sweating occurs in both palms, soles of the feet or underarms and is relatively symmetrical
• It impairs daily activities
• It happens at least once a week
• You are less than 25 years old
• You have a family history of excessive sweating
• The sweating stops when you are sleeping

Primary hyperhidrosis affects focal areas and is genetically determined, while secondary hyperhidrosis is triggered by drugs, substance abuse and underlying diseases such as an overactive thyroid, low blood sugar, menopause, lymphomas and infectious illnesses like malaria.

Hyperhidrosis affects both men and women and may predispose them to, or aggravate, eczema, fungal skin infections, viral warts and body odour.

How to treat it

Primary hyperhidrosis can be managed but not cured while secondary hyperhidrosis may resolve if the underlying cause is identified and treated.

Over-the-counter topical remedies include antiperspirants and deodorants to block sweat pores and reduce odour-causing bacteria. The effectiveness of these remedies varies and strong formulations can cause skin irritation.

For severe cases, injections of botulinum toxin or Botox® can reduce sweating in the underarms for up to six months. However, multiple injections into the palms or soles are painful and require anaesthesia.

In a procedure called iontophoresis, a mild electric current is sent through the skin to reduce sweating in the palms or soles of the feet, but the effect only lasts for a few days to a week.

For severe extensive primary hyperhidrosis, drugs that block the receptors on the sweat glands can lead to improvement in the quality of life. It does, however, put the patient at risk of heat stroke. Other side-effects include dry mouth, dry eyes, and possibly blurred vision or a pounding heart.

Surgical treatment options include:

• removal of the sweat glands in the underarms, which can cause significant scarring, and
• a procedure called endoscopic thoracic sympathectomy (ETS) in which the nerves which activate sweat glands in the underarms or palms are selectively destroyed.

miraDry® is a new and less invasive treatment option. It uses microwave technology to selectively heat and destroy the sweat and scent glands. It takes just two to three treatments for long-lasting results.

Some 90% of those with underarm sweating treated with miraDry® saw significant sweat reduction after treatment, while 94% of those with underarm odour had good to excellent results. Patients also reported a high satisfaction rate of 94% at 18 months.

As a non-invasive procedure, the side-effects from surgery and anaesthesia are avoided or short-term. Effectiveness combined with safety makes this an attractive option for those suffering from excessive sweating in the underarms.