DermDoctor: Sweating Q & A

Hyperhidrosis is a common condition that affects nearly 1 in 20 people. Unfortunately it is a commonly undiagnosed problem, and many patients who have the condition aren't aware of it, and have never even heard of the term hyperhidrosis.

Why does sweat stink?

Sweat itself is actually odorless. There are numerous bacteria that live on the skin which proliferate in the presence of sweat. This triggers the smell that is associated with body odor.

Why is it that my armpits sweat so much more than other areas of the body?

The armpits are where apocrine sweat glands are concentrated in humans. The apocrine sweat gland produces sweat efficiently, and the composition of the sweat itself is different. The sweat produced by apocrine sweat glands leads to more odor, and is speculated that it serves a function in sexual attraction.

My teenage son is concerned about excessive sweating, which I used to have a problem with in my teens. What would you recommend?

A tendency for sweating often runs in the family. During puberty, sweating is often increased. This should settle somewhat like it did for you, but in the meantime there are many practical and convenient solutions to control sweat. Start with antiperspirants or deodorants that contain antiperspirants. They are available over the counter, and if they don't work, a stronger one can be prescribed by a doctor. Baking soda and corn starch are home remedies that you can use in a pinch too.

What is the line between having a tendency to sweat too much, and hyperhidrosis?

The medical definition of hyperhidrosis is 20mg of sweat or more on the palm per minute. In practice, however, there is no merit in defining hyperhidrosis that way. Sweating is a spectrum problem, and unlike sweating too little, sweating too much is rarely a medical problem. Quality of life is the main concern. If sweating affects your life negatively, then you should seek solutions, and there are many available solutions, even for severe sweating.

For severe sweating, what are the treatment options?

If sweating is severe or widespread, traditional antiperspirants may not be effective or practical. If this is the case, consult your doctor for other treatment options. Some other options include BOTOX, tap water iontophoresis (TWI), and surgical excision of nerves that activate sweat. Treatments have varying costs, advantages and disadvantages, so weigh them with your doctor.

Ask DermDoctor