Seunga (Jasmine) Han, PharmD Student
Sweating
While it may seem like an annoyance during the summer, sweating is essential for regulating our body temperature. In fact, failure of this function may result in heat exhaustion, heat stroke, hyperthermia and even death. As our body temperature increases during warm and hot conditions, sweating plays an important role in cooling us down.
Environmental, dietary and emotional stimuli can cause sweating, common causes include:
- Hot environments, over-dressing and exercise usually causes sweating on the face and trunk
- Eating hot or spicy foods causes sweating around the lips or forehead
- Anxiety, embarrassment, fear, anger, excitement or mental stress cause sweating from the palms, soles, underarms and forehead
Hyperhidrosis
While sweating plays a critical role in regulating body temperature, just like anything else, too much of it can be just as much a problem for anyone. For example, over-sweating could lead to increased risk of infection due to constant dampness in a single area of the skin. Excessive sweating, also known as hyperhidrosis, can be divided into two different categories:
- Primary hyperhidrosis is excessive sweating likely due to a dysfunction in the autonomic nervous system. The armpits are the most commonly affected area (73%) followed by the hands, feet, scalp, and groin. While it can occur at any age, it’s common to see palmoplantar hyperhidrosis in children, axillary hyperhidrosis after puberty and none in the elderly.
- Secondary hyperhidrosis is more generalized and occurs over the entire body. It’s typically associated with menopause and other diseases such as diabetes, hyperthyroidism and obesity. However, it could also occur secondary to some respiratory disorders, infectious diseases, psychiatric disorders, fever, and alcohol or drug withdrawal. Additionally, some medications can also lead to hyperhidrosis:
- ASA
- Insulin
- Morphine
- Tylenol®
Bromhidrosis
As if sweating excessively wasn’t bad enough, some individuals experience bromhidrosis which is a condition where their sweat has an offensive odour. This is especially more likely in individuals with hyperhidrosis, obesity and poor body hygiene.
Where does the odour come from? Body odour is generally produced when bacteria on our skin decomposes fatty substances in apocrine sweat. This type of sweat is produced by apocrine glands which are slightly larger than their normal counterparts, and are found in the underarm, nipple and genital area. On the other hand, eccrine glands are the other type of sweat glands that primarily cool down the body, and are found on the palms, soles, face, head and trunk. Sweat produced by these glands are usually odourless unless your diet is particularly high in certain foods like garlic, onions or fish.
What about smelly feet? Any odour coming from the feet is likely due to footwear that does not allow proper air circulation, leading to excessive sweating and bacterial growth. In other words, sweating of the foot area is usually not due to sweat itself since eccrine glands are usually odourless.
What Can I Do About It?
Dealing with hyperhidrosis and/or bromhidrosis can be both frustrating and embarrassing, especially if you’re working in a professional setting or interact with people regularly. So we have a list of recommendations for you to try before trying any other treatment measures.
#1 Proper Clothing
First things first. Take a look at the types of clothing you have. Clothing that is light, porous and made from natural fibres which are more breathable will help with ventilation. Certain brands of clothing that come with underarm shields are also an option, and prevent moisture from causing stains. As important it is to wear proper clothing, it’s important to wash properly as well. Hot/warm water works best to eliminate odours.
#2 Avoid Triggers
If possible, avoid triggers that would either lead to hyperhidrosis or bromhidrosis. For example, avoiding spicy foods, alcohol, exercising in hot weather or stressful situations may help reduce excessive sweating, while avoiding garlic, onion, or fish may help prevent your sweat from producing an odour.
#3 Personal Hygiene
To manage body odour, a regular bath or shower using soap and water will help to prevent the buildup of bacteria, sweat and dead skin cells. A daily bath or shower may be necessary for some people. When a full bath or shower is not possible, simply sponging or washing the underarm and genital areas can help control the major source of body odour. Shaving the armpits can further reduce the propagation of body odour by reducing the available surface area for bacterial action.
#4 Foot Care
If the feet are the major source of the problem, regular washing, cleansing and drying works best. Drying your feet is just as important as washing them as wet feet can precipitate odours. For some, daily washing and use of absorbent foot powder may be necessary to control the odour. Additionally, make sure to wear non-occlusive footwear made of natural materials, such as leather shoes or sandals and wear socks that are made from cotton or wool. Alternating different pairs of shoes each day will allow them to dry thoroughly. Socks should be changed twice daily to ensure the feet remain dry and are not at risk of fungal infections (athlete’s foot).
#5 Iontophoresis
Unlike the tips mentioned above, iontophoresis is a little more complex. It involves a special water bath that uses a mild electrical current to bring ions into the skin, which blocks the sweat ducts and disrupts sweat secretion. It’s often reserved for hyperhidrosis of the hands and feet when other measures doesn’t work. While more evidence is needed, it’s commonly recommended as an alternative and can be done at home with commercially available products.
This may not be an option for everyone since it can be time-consuming and costly. Additionally, it’s not considered safe for pregnant women, those with orthopedic prosthesis or pacemakers. Initial treatment may involve 4 treatments each week with each treatment lasting about 30 minutes. Side effects are minor and include dry or cracked skin, tingling or burning, and rarely redness and small blisters. If any of these occur, they can be easily managed by:
- Using an emollient (e.g. lotion) for dry or cracked skin
- Using topical corticosteroid for redness
- Lowering the voltage for small blisters or any tingling/burning
Did you enjoy this article? Stay tuned for the next article where we’ll talk more about treatment options to manage hyperhidrosis or bromhidrosis. We hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.
RESOURCE
- RxTx
