Beauty Clinic: Why do I sweat so much?
Q. Over the past five years I have frequently been perspiring profusely from my head and face. It is like an extremely hot shower, which soaks my hair and runs down my face. It is very embarrassing. I do not perspire elsewhere. Could Botox help? I’m 61. A. Hyperhidrosis, or excessive sweating, is ‘very traumatic’, agrees consultant dermatologist Professor Nick Lowe of The Cranley Clinic (www.drnicklowe.com), who has researched and treated this condition for over three decades.
Sweating is necessary to control body temperature when you get hot. But in about one in 100 people, this system is revved up, causing sweating in amounts far greater than necessary to control body temperature, as the Hyperhidrosis Support Group explains (www.hyperhidrosisuk.org).
Primary hyperhidrosis affects certain parts of the body, usually the armpits, hands, feet or, less frequently, face and scalp. The part of the brain that regulates the sweating process sends signals to the eccrine (sweat) glands to perspire, even though there is no need to cool the body.
The cause is not yet established but Professor Lowe believes it is primarily driven by emotions. Many of us sweat when we are anxious or worried and this mechanism may underlie the condition, he thinks.
A quarter of cases run in families, suggesting a genetic mutation is involved, according to consultant neurologist Dr. Marie-Helene Marion, who ran a specialist NHS clinic for ten years and now treats the condition privately (www.drmarion.co.uk).
Secondary hyperhidrosis affects the whole body: in this case there is an underlying cause such as menopause, an overactive thyroid gland, alcohol/drugs, prescription drugs including some antidepressants, fertility drugs and tamoxifen.
Treatment usually starts with prescription antiperspirants containing aluminium chloride. These help control underarm sweating but are not suitable in your case. Drugs developed for unstable bladders may help, says Dr Marion (but side effects include a dry mouth and urinaryretention). Prof. Lowe sometimes prescribes betablockers, which block the release of stress hormones, although drowsiness is a potential side effect.
Prof. Lowe recommends learning relaxation techniques such as meditation to control anxiety. He refers some patients for psychotherapy.
Botulinum toxin A has regulatory approval for hyperhidrosis. It effectively blocks the signal from the nerves to the sweat glands. Prof. Lowe recommends ‘multiple tiny injections into the dermis but not deeper or you risk sagging’. Botox may be available on the NHS (www.nhs.uk) from a consultant dermatologist, or from private clinics. The effects last from two to eight months.
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