Excessive Sweating Has A Scientific Term

Hyperhidrosis is the medical term for excessive sweating. Many people suffer from excessive sweating. These individuals can sweat even when the temperature is cool and they are at rest. Although sweating normally occurs in response to heat, physical exertion, and tense emotional situations, excessive sweating occurs without these triggers. The uncontrollable sweating can lead to significant physical and emotional discomfort.

In some cases a medical disorder, such as an overactive thyroid, certain types of infections, and some hormonal conditions, can cause excessive sweating. For this reason, the first step in the treatment of excessive sweating should be a visit to your doctor for a complete medical evaluation to rule out a medical condition that may be causing profuse sweating. However, in most cases, no particular cause of excessive sweating is found. Excessive sweating without apparent cause is called primary hyperhidrosis, and approximately 2%-3% of the U.S. population has this condition (around 6-8 million people).

The treatment of excessive armpit sweating includes antiperspirants, medications such as anticholinergic drugs, surgery, and Botox. Generally, the first treatment tried for excessive armpit sweating is an antiperspirant. Antiperspirants reduce excessive armpit sweating by plugging the ducts of the sweat glands in the armpits. These products generally contain 10%-15% aluminum chloride and are available over-the-counter. Prescription antiperspirant products are also available containing higher concentrations of aluminum chloride. Antiperspirants can decrease the flow of underarm sweat by about 50%. Antiperspirants should be distinguished from deodorants, which do not prevent sweating, but which are helpful in reducing body odor when it is present. Generally, patients will use an aluminum chloride antiperspirant three to seven times a week. If the antiperspirant controls the sweating, the improvement can usually be maintained by ongoing use of the antiperspirant only once every one to three weeks.

When antiperspirants are not effective in controlling excessive armpit sweating, medications such as anticholinergic drugs can be tried. However, they may have side effects such as dry mouth, dizziness, and problems with urination.

In severe cases of sweating, a surgical procedure called sympathectomy can be performed. With this procedure, the nerve associated with the overactive sweat glands is cut. However, the procedure requires general anesthesia and a short hospitalization, and some patients may develop compensatory sweating at other sites on the body following surgical treatment. For these reasons, we do not recommend surgery to treat excessive sweating.

In our office, when excessive underarm sweating is not controlled by antiperspirants, we recommend the use of Botox. The FDA approved Botox in 2004 for the treatment of severe underarm sweating. Botox controls the excessive sweating for up to six months. In the clinical trials that led to the FDA's approval, 86% of treated patients showed a significant reduction in armpit sweating. When injected into the armpits, Botox acts by blocking the release of sweat by the sweat glands, resulting in a significant reduction in sweating within three to seven days. Our patients have been amazed by the reduction in armpit sweating they have had following the use of Botox.

What is hyperhidrosis?

Hyperhidrosis is the medical term for excessive sweating. Many people suffer from excessive sweating. These individuals can sweat even when the temperature is cool and they are at rest. Although sweating normally occurs in response to heat, physical exertion, and tense emotional situations, excessive sweating occurs without these triggers. The uncontrollable sweating can lead to significant physical and emotional discomfort.

In some cases a medical disorder, such as an overactive thyroid, certain types of infections, and some hormonal conditions, can cause excessive sweating. For this reason, the first step in the treatment of excessive sweating should be a visit to your doctor for a complete medical evaluation to rule out a medical condition that may be causing profuse sweating. However, in most cases, no particular cause of excessive sweating is found. Excessive sweating without apparent cause is called primary hyperhidrosis, and approximately 2%-3% of the U.S. population has this condition (around 6-8 million people).

The treatment of excessive armpit sweating includes antiperspirants, medications such as anticholinergic drugs, surgery, and Botox. Generally, the first treatment tried for excessive armpit sweating is an antiperspirant. Antiperspirants reduce excessive armpit sweating by plugging the ducts of the sweat glands in the armpits. These products generally contain 10%-15% aluminum chloride and are available over-the-counter. Prescription antiperspirant products are also available containing higher concentrations of aluminum chloride. Antiperspirants can decrease the flow of underarm sweat by about 50%. Antiperspirants should be distinguished from deodorants, which do not prevent sweating, but which are helpful in reducing body odor when it is present. Generally, patients will use an aluminum chloride antiperspirant three to seven times a week. If the antiperspirant controls the sweating, the improvement can usually be maintained by ongoing use of the antiperspirant only once every one to three weeks.

When antiperspirants are not effective in controlling excessive armpit sweating, medications such as anticholinergic drugs can be tried. However, they may have side effects such as dry mouth, dizziness, and problems with urination.

In severe cases of sweating, a surgical procedure called sympathectomy can be performed. With this procedure, the nerve associated with the overactive sweat glands is cut. However, the procedure requires general anesthesia and a short hospitalization, and some patients may develop compensatory sweating at other sites on the body following surgical treatment. For these reasons, we do not recommend surgery to treat excessive sweating.

In our office, when excessive underarm sweating is not controlled by antiperspirants, we recommend the use of Botox. The FDA approved Botox in 2004 for the treatment of severe underarm sweating. Botox controls the excessive sweating for up to six months. In the clinical trials that led to the FDA's approval, 86% of treated patients showed a significant reduction in armpit sweating. When injected into the armpits, Botox acts by blocking the release of sweat by the sweat glands, resulting in a significant reduction in sweating within three to seven days. Our patients have been amazed by the reduction in armpit sweating they have had following the use of Botox.

Body Thermage

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The Body Thermage procedure is a new method to tighten, lift, and smooth the skin of the body. The FDA approved the Body Thermage procedure in January of 2006. In our office, we are using the Body Thermage procedure to tighten and lift the skin of the abdomen (which is commonly loose after pregnancy) and the skin of the upper arms. Anyone with loose skin in these areas is a good candidate for Body Thermage.

During the Body Thermage procedure, the treatment tip simultaneously heats and cools the skin. The tip emits radio frequency energy to heat the collagen in the deeper layers of the skin, while protecting the top layers with a cooling spray. The heating action causes the collagen in the deeper layers of the skin to tighten immediately. Over the next few months, the procedure also stimulates the production of new collagen, further enhancing the result. The Body Thermage procedure does not use invasive surgery, chemicals, needles, or lasers.

The combined action of the immediate tightening of collagen and the production of new collagen results in a tighter smoother skin and a more youthful appearance. In addition, the results are longer lasting because the improvement from the Body Thermage procedure is due to the tightening of the patient's own collagen and the production of the patient's own new collagen. The optimum result is generally achieved approximately four to six months following the procedure. At that time, if a patient wishes, the procedure can be repeated in order to gain additional improvement. There is no significant recovery downtime following the Body Thermage procedure, and patients can resume their normal activities immediately after leaving the office.

Any of our patients who would like to tighten their abdominal or upper arm skin without surgery are invited to call our office to schedule a consultation.

Disclaimer: The image above does not reflect our the procedure it self. It is intended strictly for aesthetic purposes.

What You Should Know About Antioxidants

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Although it may seem obvious, an antioxidant is a chemical that prevents other chemicals from becoming "oxidized" and undergoing a chemical change. In the body, highly reactive substances called free radicals are constantly being produced. Free radicals can readily damage the body's own cells. In living tissues, antioxidants remove free radicals before they can damage normal tissues.

Although more research needs to be done, free radicals damage healthy cells by injuring DNA, proteins, and other structures within the cells. It is believed that this speeds up the aging process, weakens the immune system, and may contribute to the development of cataracts, heart disease, and various forms of cancer. For these reasons, it is important that everyone consume enough antioxidants. The best sources of dietary antioxidants, such as vitamins A and C, are vegetables and fruits. Carrots, broccoli, tomatoes, peaches, green peppers, strawberries, citrus fruits, and tomatoes are excellent sources of dietary antioxidants. In addition, wheat germ, nuts, and whole grains are good sources of Vitamin E, which is also an antioxidant.

From the dermatology perspective, exposure to ultraviolet radiation from the sun will result in the production of free radicals. Several studies have suggested that antioxidants help protect the skin from the damaging effects of the free radicals that result from sun exposure. For this reason, Dr. Amerian recommends that her patients use a topical antioxidant preparation as part of their daily skin-care program.

Hair Removal

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There are literally a myriad of reasons why many men and women choose to remove unwanted body hair. It might be a cosmetic, social, or cultural reason, or possibly a medical reason. Unwanted pigmented hair is an extremely common problem for both men and women. Many methods are available for temporary or permanent hair removal, and each method has advantages and disadvantages. In this month’s newsletter, we will review the various methods of treating and removing body hair.

Although excessive hair growth commonly occurs in the normal healthy population of individuals, at times it can be a manifestation of an underlying hormonal disturbance. For this reason, every patient who desires hair removal should first have a complete medical history and physical examination. If the doctor suspects that a hormonal problem may be contributing to or causing the excessive hair growth, a referral to an endocrinologist or a gynecologist is warranted.

Shaving:
Removal of body hair with a razor blade on wet skin using shaving cream or another lubricant is one of the most common methods of removing unwanted hair. The main advantage of hair removal by shaving is that it is fast, easy, and inexpensive. However, as every man knows, the results are temporary, lasting at most three days and often only one day. Because shaving removes hair at the skin surface, it is the most temporary method of hair removal.

Plucking, Waxing, Sugaring, and Epilation:
Epilation means the removal of the entire hair shaft. It is the most effective method for temporarily removing a hair. Epilation includes waxing and plucking, as well as some other methods that can be used for removal of the hair shaft. It is not known whether repetitive epilation results in permanent changes in the hair being removed. Epilation lasts longer than shaving because the hair is removed from below the surface of the skin.

Manual plucking is an easy way to remove single hairs and is useful for removing small amounts of unwanted hair. When the area of skin to be treated is too large for plucking, waxing techniques are more useful. Waxing involves the application of warmed wax to areas of hair bearing skin followed by removal of the wax and the associated embedded hairs.

Sugaring is similar to waxing and is an alternative to waxing for people who are sensitive to wax. A syrupy sugar mixture is prepared by heating lemon juice, water, and sugar. The syrup is then applied to the skin, after which it is quickly stripped away, removing the unwanted hair in the process.

Depilation:
Chemical depilatories remove part of the hair shaft, and are easy and painless. Depilatories work by breaking down the protein in the hair shaft, causing the hair to break in half, and allowing the hair to separate from the skin. They work best on the legs, bikini line, face and underarms. For a good result, the hair should be neither too long nor too short. Since some people are allergic to the chemicals found in a depilatory, a small spot should be tested prior to use to determine whether the product is safe to use in that person.

Eflornithine (Vaniqa):
This drug is used in a topical cream available only by prescription. It was recently approved by the FDA for the reduction of unwanted facial hair in women. The drug works by reducing the rate of hair growth. It can be used in conjuction with other methods of hair removal to prolong their efficacy. Eflornithine is generally used twice a day for six months. Unfortunately, once the drug is stopped, facial hair growth returns to pretreatment levels within 2 months.

Electrolysis:
Electrolysis involves the insertion of a thin needle into the hair follicle, after which a pulse of electric current is passed through the needle to damage and eventually destroy the hair follicle. Generally, multiple treatment sessions are required. During electrolysis it is important to insert the needle accurately into the follicle, and to choose an appropriate intensity and duration of the electric current.

Only hairs that are actively growing should be treated with electrolysis. This can be determined by shaving the area to be treated, then treating a few days later only those hairs that are visible on the skin surface. With electrolysis, each hair must be treated individually and the process is slow.

Laser Hair Removal:
Laser hair removal first became available in 1996, and since that time many advances have occurred in the technology. Lasers can treat large areas of skin at one time, making laser hair removal a cost-effective and efficient method of hair removal. Commonly treated areas include the legs, armpits, upper lip, chin, and bikini line. The effects of laser hair removal can last for several months to several years. Laser hair removal works by using laser energy to destroy the hair follicle, thereby inhibiting future hair growth from the follicle.

For the hair removal laser to be effective, the hair pigment should be darker than the surrounding skin pigment, so that the hair absorbs more of the laser light. If the skin is darker than the hair, the skin will absorb more of the laser light, potentially leading to adverse tissue reactions following the procedure. For this reason, it is important that patients undergoing laser hair removal not come to the office with a tan.

Over the last several years, laser hair removal has become very popular because the results are superior to hair removal using more conventional treatments such as waxing, shaving, and electrolysis. Approximately 80% of all patients respond well to laser hair removal. Patients may expect approximately a 30% decrease in hair with each treatment. For this reason, multiple treatments are generally necessary to achieve the desired reduction in hair in a given body area. In general three or more treatments are required at each site to achieve permanent hair growth reduction. Typically, treatments are spaced 1-3 months apart.

In our office, Karen Ballantyne performs the laser hair removal treatments. Karen is a registered nurse for fifteen years, and she has extensive experience in laser hair removal. Any of our patients who would like to undergo laser hair removal are invited to call the office and make an appointment with Karen.

Can Exercise Give You Hives?

Hives are itchy pink blotches that develop on your skin. They come up quickly, are extremely itchy, then disappear without a trace in minutes to hours. Many things trigger hives including foods, medicines, and sometimes exercise.

Exercise-induced hives (or urticaria) develop when your skin warms during exercise. Once your skin reaches a certain temperature, itchy welts suddenly bloom. The hives favor your stomach, back, or chest but can occur anywhere. One thing is for certain: They always intensify into a maddening itch.

Eating cheese, seafood, celery, or wheat within a few hours of starting exercise can trigger an outbreak. People who have exercise-induced hives also sometimes react when they take medications such as aspirin, ibuprofen, or naproxen before exercising.

In some people, exercise-induced hives occur when they exercise in cold weather. This often happens when they jog in cold weather, ski, or swim in the ocean (especially here in California where the water is always chilly).

If you’re exercising and you develop an itchy red rash, then stop exercising. If the hives don’t go away within 15 minutes, then stop your workout. Avoid eating cheese, celery, seafood, or wheat  for 4 hours before your workout. Similarly, avoid aspirin or ibuprophen for 4 to 6 hours before exercising. Taking antihistamines such as Benedryl or Zyrtec an hour before exercising may help block an outbreak. Antihistamines also hasten the resolution if taken immediately when the rash occurs.

In rare cases, exercise-induced hives cause swelling of the throat, difficultly breathing, and even death. If you develop swelling of your mouth or throat, or difficulty breathing or swallowing, then seek immediate medical help. Patients with high-risk allergic reactions should carry an epi-pen at all times and should never exercise alone.

Photo: Ernst Moeksis

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