Sweat & odour gets in the way of everyday life

Sweat & odour gets

in the way of everyday life

By Ilze Laurens, MD for dermaV Pharmaceuticals

Everyone sweats, but some more than others, which can be distressing. Statistics show one out of every ten people are bothered by sweat. New research shows that nearly 5% of the world’s population suffers from excessive sweating or are bothered by sweat. That’s right, 102 million people are struggling with extreme sweating!

Sweat glands

Hyperhidrosis is the medical term for excessive sweating. Patients report copious volumes of watery sweat despite not being physically active or in a hot environment. Humans have many sweat (eccrine) glands to effectively eliminate surplus heat from the body, and to produce sweat in the palms of the hands and soles of the feet to improve grip. The body’s eccrine glands are mainly controlled by the hypothalamus, a structure deep in your brain, which acts as a thermostat to regulate body heat. However, sweating of the hands and feet are mainly controlled by the sympathetic nervous system (fight or flight response).

Hyperhidrosis can be classified as primary or secondary, depending on its origin, and can be generalised (all areas of the body) or occur in specific areas such as the underarms, palms, soles, face, scalp and groin.

Secondary hyperhidrosis

Secondary hyperhidrosis can be a symptom of some other underlying disease, such as accelerated metabolism, certain medications or even cancer.

Axillary osmidrosis is a term to describe excessive malodour originating from the underarms. Malodour occurs with the interaction between odour gland (apocrine) secretion and bacteria. Osmidrosis is stressful and can lead to personal and social problems.

metabolism medications cancer

Primary axillary hyperhidrosis

Months 6

weekly

Primary axillary hyperhidrosis (PAH) is a chronic disorder of excessive sweating and tends to occur in areas with greater concentrations of eccrine glands. Although of unknown origin, it is thought to result from hyper-stimulation of eccrine glands by nerves of the sympathetic nervous system.

PAH is identified when patients report increased sweating for at least six months, where severe sweating happens at least once a week, they are younger than 25 years of age, they have difficulty in performing daily activities, they sweat profusely at least once a week, and have a family history of severe sweating.

younger 25

age

family history

What are the options to manage sweat and odour?

Various treatments for hyperhidrosis and osmidrosis have been developed from over-the counter antiperspirants, roll-ons and gels, prescription drugs, Botulinum toxin injections or microwave energy treatments (miraDry®) and finally, surgery.

Antiperspirants, roll-ons, and gels are the first option for the treatment of sweat and odour. These products contain aluminium salts which diffuse into the sweat duct. The salt is gradually neutralised in the skin and forms a gelatinous, insoluble protein gel that “plugs” the opening of the sweat gland. This physical block is responsible for reducing, but not stopping, the flow of perspiration. In addition, the salt penetrates the gland tube, causing functional and structural erosion of the sweat gland.

Botulinum toxin is used as injection directly to the underarm, palms or soles to supress the sympathetic nervous system. By preventing nerves to function normally, the sweat glands are not stimulated and sweat production stops. Although this type of treatment is effective, it is known to be extremely painful and expensive and needs repeated sessions as the effect is only temporary.

Microwave-based devices such as the miraDry® treatment can dramatically reduce underarm sweat by addressing the root cause of excessive sweat and its accompanying odour. The miraDry® treatment is a procedure performed by a trained medical professional. The underarm is cleaned, local anaesthetic injected to numb the area and then treated with the miraDry®. The miraDry® System uses thermal energy that targets and eliminates the sweat glands in the underarm. Once those glands are eliminated, they do not grow back. 