Do you dread the summer because of the extra sweating it brings? Excessive sweating can also be due to a medical condition called hyperhidrosis. Those affected sweat profusely on their hands and feet as well as underarms, even in cool weather.
Sweat regulation is the responsibility of an area of the brain called the hypothalamus. In a person with hyperhidrosis, it allows overproduction of the neurotransmitter acetylcholine, one of whose tasks is the stimulation of sweat glands in the skin.
For someone whose main problem is excessive axillary - armpit - sweating, a new treatment is now available. The bacterial toxin botulinum A has been tested on patients with hyperhidrosis.
Injected locally into the armpit in a series of 12 injections, the botulinum toxin binds to nerve endings and prevents the release of acetylcholine. Sweating is completely abolished in the injected area within two to three days, and the effect lasts for up to 11 months. Hyperhidrosis of the foot can also be treated in this manner, but the procedure is tedious and uncomfortable. Up to 36 injections are required to cover the entire undersurface of the foot and toes.
Botulinum cannot be used for hand sweating; initial tests showed a high risk of damage to the hand muscles. Muscle damage does not seem to be a problem in armpit or foot treatment.
So what treatment is available for the person with excessive palmar sweating? Surgical cutting of the nerves supplying the hands' sweat glands - a procedure called thoracic sympathectomy - is the answer.
Using a thoracoscope, the sympathetic trunk of nerves is cut at the level of the second rib. This procedure also has an initial success rate of 100 per cent, but hyperhidrosis may occur nine to 12 months later following nerve regrowth. Compensatory sweating - in which other parts of the body begin to sweat more - is a potential side effect of surgical treatment.
What about the rest of us who do not suffer with hyperhidrosis, but who find the sticky conditions of summer difficult to bear?
Anti-perspirants containing aluminum chloride are the best option for armpit and palmar sweating. Losing weight helps, as fat acts as an insulator and increases body temperature. Avoid lycra and polyester products. Spicy foods and caffeine also increase perspiration.
Sweating can also be a sign of hormonal imbalance. In 50 per cent of women approaching the menopause, flushes and sweats are a problem. Hormone replacement therapy is the treatment of choice. If sweating is accompanied by weight loss, anxiety, palpitations and diarrhoea, then you may have an overactive thyroid gland. Your GP will be able to diagnose hyperthyroidism with a simple blood test and start treatment to reduce the gland's activity. Anxiety alone is also a common cause of sweating.
If your problem seems to be confined to night-time sweating it can point to a serious blood disorder called lymphoma. Treatment results are good if this condition is diagnosed early.
Whatever the pattern of excessive perspiration, a visit to your family doctor is a good idea; there may well be a treatment to suit you.
Contact Dr Muiris Houston at mhouston@irish-times.ie or leave messages on 01-6707711, ext 8511