3 ways to treat excessive sweating

Up to half a million people in this country suffer from hyperhidrosis. We ask three experts for their solutions

Dr Mark Goodfield is a consultant dermatologist at Leeds General Infirmary and President of the British Association of Dermatologists (www.bad.org.uk)
Hyperhidrosis, or excessive sweating, can have a big impact on quality of life. It affects about half a million people in the UK, men and women equally.
The normal role of sweating is to regulate body temperature, but people with hyperhidrosis sweat at inappropriate times whether they’re hot or cold. Anxiety can worsen it, as can other triggers. The main symptoms are visible sweat, wet clothes and a clammy handshake.
Localised symmetrical hyperhidrosis is the most common type and usually affects the palms, soles of the feet, skin under the arms, face and scalp or a combination – and both sides of the body equally. It tends to begin in adolescence. The cause is usually unknown, though it can run in families. Generalised hyperhidrosis affects the whole body and usually has an underlying cause, such as an infection or diabetes and an overactive thyroid gland, as well as certain medicines, such as Prozac.

If your hyperhidrosis is generalised, you may be referred to a specialist. If an underlying cause can be treated, so can your hyperhidrois. If it’s localised, your GP will offer lifestyle advice, and recommend a topical high dose aluminium chloride antiperspirant. Botulinum toxins can be injected into the skin in very small doses. This blocks the sweat glands and can last between two and six months. Or iontophoresis – passing a small electric current through skin – can be used, mainly for the palms and soles. Also try to avoid situations which trigger the sweating – such as hot places, stress and spicy food.

Dr Nicola Ridgeway is a clinical psychologist and an accredited cognitive behavioural therapist (www.westsuffolkcbt.com)
Regardless of what may be causing the hyperhidrosis, becoming anxious about sweating – a common reaction – simulates the sympathetic nervous system (our normal response to threat or danger) and actually makes people sweat more. This is where cognitive behavioural therapy (CBT) can come in.
A fundamental premise of CBT is that how we make sense of things affects the way we feel and behave. If someone with hyperhidrosis attaches meanings such as rejection, humiliation and disgust to sweating, they are more likely to become anxious when with others, and so sweat more. It is common to then avoid situations where they attach greater meaning to sweating, such as social situations, or intimate relationships. This may help them sweat less (they’ve avoided feeling anxious), but can have a very negative impact on their lifestyle. In CBT sessions for hyperhidrosis, individuals are helped to reflect specifically on the meanings they are attaching to sweating and the feelings and behaviours that follow. The result is that individuals learn their extreme ideas about how others will react to their sweating are just that – which reduces their anxiety about sweating in general. There is also a positive change in how individuals react to their own sweating and their negative feelings about it so it no longer carries the same threat. Ultimately, CBT reduces sweating related to anxiety about it. For mild to moderate cases, around 10 to 12 sessions of CBT would be usual. (Visit www.babcp.com for therapists nationwide.

Zoë Palmer-Wright is a naturopath specialising in nutrition and herbal medicine, and lectures at The College of Naturopathic Medicine (www.naturopathy-uk.com)
There are lots of helpful herbs and dietary advice for people with hyperhidrodis, but for best results, I suggest visiting a naturopath. By taking a full case history and using various diagnostic tests such as tongue diagnosis, we take into account the whole person and their spectrum of symptoms, aiming to identify and treat the causes.
Hyperhidrosis can be due to a number of reasons. If it was menopausal, a naturopath may recommend phytoestrogen-rich foods (such as chickpeas and miso) to help balance hormonal function, and may prescribe herbs such as sage, dong quai and black cohosh. The liver and adrenal glands often need support during the menopause, so various foods and herbs may also be given for this purpose. For example, Siberian ginseng to help nourish the adrenal glands, and bitter green herbs such as chicory to help support optimal liver function. If the excessive sweating was linked to blood sugar problems (in non-diabetics), the key element would be dietary changes more conducive to good blood sugar control. So that would include wholefoods such as brown rice, vegetables, lean protein and eating little and often. To help blood sugar regulation, naturopaths may also supplement with spirulina and chromium. Of course naturopaths acknowledge a person can have a genetic predisposition to develop hyperhidrosis, but we believe that certain foods, emotions and lifestyles can trigger the hyperhidrosis. So we will always look for what may be bringing on your symptoms.

Compiled: Aviva Ingram