Horses sweat but ladies glow, goes the old saying. But as “glowing” in Hong Kong’s hot summer can be uncomfortable and worse, Dr Lisa Chan suggests some possible remedies.
Summer is officially upon us, and with it the arrival of Hong Kong’s famously scorching yet humid weather. In the last month, the topic of sweat reduction has been a prevalent one among my patients. Some just want to stay relatively fresh and dry in the heat, while others suffer from an actual medical condition called hyperhidrosis. This is a condition in which sweat glands are over-active, resulting in excessive sweating not necessarily related to heat, stress or exercise.
Localised hyperhidrosis occurs over specific areas such as the hands, feet, underarms or face. In patients with thyroid disorders, diabetes, infections or cancer, generalised hyperhidrosis can also occur over the body, and the underlying disorder will need to be treated.
While localised hyperhidrosis is not usually related to serious medical issues, many patients find it inconvenient and embarrassing. This can impact their work and social lives, from developing a fear of handshakes to isolating themselves.
Options for treatment include:
- Topical antiperspirants containing aluminium chloride in the form of sprays, lotions or roll-ons. Aluminium chloride can cause skin and eye irritation, and care should be taken when used on the face.
- Oral medications such as anticholinergics, beta-blockers or antidepressants. These may be of limited use due to a variety of side effects, such as drowsiness, dry mouth, blurred vision and bladder problems.
- Iontophoresis, a procedure which involves the use of a low-level electric current to disable sweat glands over the hands and feet. This will need to be repeated several times and the effects are temporary.
- Injection of botulinum toxin type A has been approved by the US Food and Drug Administration to block neural impulses to sweat glands. The effects will take about a week to be seen and can last from three to nine months. There may be temporary muscle weakness over the treated areas.
- Devices that utilise microwave energy can also permanently destroy sweat glands in the armpit area. A local anaesthetic will be needed before the treatment, and there may be some discomfort with swelling or bruising afterwards. Some patients will need two treatments spaced three months apart.
- Finally, surgery can be done to remove the sweat glands in the armpits or to cut the nerves in the chest that cause sweating over the hands. In some cases, this can trigger compensatory sweating over other parts of the body. Rare complications include bleeding and injury to the lungs.
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