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Don't sweat it: Botox, acupuncture among treatments for excessive perspiration

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TORONTO - Whether it's stifling, humid conditions, vigorous exercise or plain old stress that's the trigger, trickles or torrents of sweat streaming from the body will undoubtedly follow.

From cool beads dribbling from foreheads to the damp trails on chests, backs and underarms, the outbreak of patches of perspiration in response to anxiety, warm weather or workouts is inevitable. Yet some people cope with even more extreme amounts of sweat.

Primary hyperhidrosis may have a genetic or hereditary link and is typically characterized by excessive sweating of various regions of the body, including feet, hands, under breasts, the groin and armpits. When the cause of excessive sweating is correlated to another disorder — such as hyperthyroidism or menopause — it's known as secondary hyperhidrosis.

"Basically, if your sweating is enough that it interferes with your daily activities of your life, you probably have hyperhidrosis," Dr. Nowell Solish, a Toronto-based cosmetic dermatologist and assistant professor at the University of Toronto.

"It's not sweating when you exercise and work out — it's sweating all the time. Even in the winter, even when you're home watching TV."

Those with hyperhidrosis may have to change shirts repeatedly within a day, avoid raising arms in public or steer clear of shaking people's hands due to excessive sweating, Solish noted. He said the condition's cause remains unknown.

"It's probably something in the brain, we don't know exactly for sure," said Solish. "The glands are normal. It's just they're being signalled to sweat when they don't need to be.

"We think it's probably some signal from the brain coming down, or that the glands are too sensitive to the signal that they're sweating more than they're needed to maintain normal temperature and water control."

One of the treatments for hyperhidrosis is Botox. When used for cosmetic or medical reasons — like smoothing fine lines in the face — Botox blocks the signal from the nerve to the muscle to move.

"If you put Botox around the sweat gland, even if the nerve is signalling it to sweat, the signal doesn't reach the sweat gland, and you don't sweat as much," said Solish.

If the excessive sweating occurs in the underarms, Solish said the first line of treatment would be to try a clinical strength anti-perspirant, which doesn't require a prescription but is available behind the counter at pharmacies. If proven ineffective, Botox is an option. But if the injections don't work, Solish said those suffering can pursue surgery as a possibility to have sweat glands removed.

There are alternative treatments to address hyperhidrosis.

Elena Krasnov of Toronto Naturopathic Clinic said she has treated patients coping with excessive sweating with general detoxification. She uses a blend of different herbs that are somewhat diluted that patients can mix with water to sip throughout the day. The naturopathic doctor said this promotes cleansing of deep lymphatic tissues and said several patients she's treated have seen improvements.

Licensed acupuncturist Ellice Yang of Acutoronto said many people come to her clinic in search of a non-invasive treatment approach to not just address sweating, but its core cause.

"An emotional issue like stress can trigger (it), anxiety can trigger (it) — especially if it's a secondary hyperhidrosis. Somtimes it can be an autoimmune condition," said Yang, a doctor of traditional Chinese medicine.

"So all of these things acupuncture can help — not just the symptom of sweating, but addressing the root cause of the hyperhidrosis."

But first, Yang advises patients to ensure their hyperhidrosis is diagnosed with their doctor. She also recommends they have bloodwork and testing conducted to rule out certain root causes, such as a thyroid hormone issue.

Yang said acupuncture can be beneficial by helping to balance overstimulated nerves and prevent them from being overactive. That, in turn, helps to reduce sweating and aid the body to regulate temperature, she added.

She typically recommends patients participate in eight to 10 acupuncture sessions that can be combined with intake of herbs in pill format or granular or powdered teas ingested once daily.

"The herbs work in the same way as acupuncture to bring balance to the body."

As if the presence of perspiration wasn't enough to contend with, there are instances where some people may emit a particularly pungent odour. But Solish said the scent is not correlated to the amount of sweat but rather a buildup of bacteria.

"If you think of a pond and a stream, a running stream doesn't smell. But, around a pond where the water is more stagnant, it tends to smell a little bit more because bacteria and moss and things can grow around that stagnant water," said Solish.

"So the same thing is in the underarms. If there's a lot of flowing water, people sweating a lot, it tends not to be odour. But, if they're sweating a little bit and it's bacteria growing under there, then they can have a little bit of odour associated with it."

Solish said it doesn't have to take a long time for bacteria to grow — some people are just more prone to it. By controlling the sweating, the odour tends to disappear, he added.

For those looking to keep bacteria and bad odours at bay, they may consider opting for an herbal astringent, said Krasnov, a member of the Canadian Association of Naturopathic Doctors.

She recommends placing a couple of drops of an essential oil into a spray bottle with filtered water. The concoction can be used as a body splash following a shower or bath or throughout the day as needed, she noted. Both rosemary and tea tree oils have antifungal and antibacterial properties, as does Calendula flower extract.

"I don't think it will necessarily keep you drier — but it will keep you fresher," said Krasnov.




Canadian Association of Naturopathic Doctors:

Dr. Nowell Solish:

Toronto Naturopathic Clinic:

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