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Don't sweat it: Perspiration is nature's cooling system

| Monday, Aug. 22, 2011

It's August and many of us are schvitzing, sweating, perspiring or, if you're a Southern lady, glowing.

Whatever it is, we're damp. That's not a bad thing, when you consider that sweating's purpose is to cool the body, says dermatologist David Pariser of Norfolk, Va., a spokesman for the American Academy of Dermatology.

"It works the same as air conditioning," he says, cooling the skin as moisture evaporates. "There are other minor functions, such as balancing the body's electrolytes (minerals that help maintain body functions), but the vast majority of the purpose of sweating is thermal regulation."

Except for those with a dangerous condition called anhidrosis, which can be caused by nerve damage or certain medications, everybody sweats, some more than others.

"Men sweat four times more than women do," Pariser says, "and larger people sweat larger amounts than smaller people."

There are few downsides. Sweating doesn't flush nutrients from the body -- that happens as a result of dehydration -- and, surprisingly, it's odorless. The odor associated with sweatiness is caused when sweat or oils produced mainly in the armpits and groin are broken down by bacteria on the skin.

"There are special glands in the armpit, genital and groin area that are more likely to produce odor because the areas are more likely to be populated by skin bacteria," says dermatologist M. Alan Menter of Dallas, a spokesman for the American Academy of Dermatology. Sweat itself is 99 percent water, with a small amount of salt and other electrolytes.

Except for models in sexy art shots with beads of sweat adorning their rippling muscles, for most of us, sweaty brows and underarms aren't that hot. For some, it's a social nightmare. A medical condition, hyperhidrosis, causes dripping-wet sweating, regardless of the temperature. It can occur all over the body or in localized areas, usually hands, feet, armpits or face. Most people sweat up to a quart of fluid a day. In hyperhidrosis, it's four to five times that.

The condition affects 8 million people, or 3 percent of adults and children in the USA.

"It can be very severe and disabling," Pariser says. "People can't hold hands with their partner, can't shake hands with a businessperson, they have to change shirts two or three times a day, stuff paper towels under their arms."

He cites examples of a woman who dropped her baby and a policeman who dropped his gun -- both the result of sweaty palms.

The disorder is sometimes dismissed by family members and physicians. "It's a very disabling problem, even though nobody dies of it, but it is very, very treatable," Pariser says.

The International Hyperhidrosis Society website ( ) offers information and referrals to doctors who can use treatments including prescription-strength antiperspirants, oral medications, iontopheresis -- a device that uses water to conduct electricity to palms or feet, blocking sweat production -- and Botox injections.

Have sweat stains?

Here's laundry advice:

Take care. Sweat stains are caused by a combination of the chemicals in antiperspirants and the salt in sweat. To reduce the chance antiperspirant will rub off on your clothing, let it dry before dressing.

Act quickly. Wash or dry-clean the garment right away. Stains are easier to remove if they haven't been allowed to set in.

On light fabric. To remove yellow stains from underarm areas of light or white cotton, try a mixture of baking soda, peroxide and water in equal amounts. Test hidden areas of light-colored shirts first to make sure they don't change color. Apply to the stain and let it sit for 30 minutes, rubbing with a bristle brush to remove debris. Wash as usual.

On dark fabric. Soak dark shirts in a mixture of cool water with white vinegar, about 1 cup per washing machine load. Let it soak for 30 minutes, drain, and wash as usual.

Ways to dry up

A whole industry is dedicated to blocking sweat and body odors. Dermatologists size up the options:

Deodorants: Reduce growth of odor-causing bacteria and neutralize odor with perfume. Products target men or women, but the main difference among deodorants is the fragrance.

Antiperspirants: Help to stop perspiration by plugging the pores that allow sweat to escape to the skin's surface. The body has millions of pores, so it's harmless to block just the ones under the arms. Most antiperspirants have an aluminum-based compound; possible links to health risks, such as Alzheimer's disease or breast cancer, have been debunked. "Clinical strength" antiperspirants: Contain some standard antiperspirant ingredients, but concentrated. They're a significant advance in sweat-blocking technology, are usually packaged in a box and cost twice as much as regular antiperspirants.

Alternative/natural products: Don't contain the chemicals commonly used in commercial products, such as aluminum and triclosan, which some people choose to avoid. Ingredients vary but can include green tea, baking soda, lemon, vinegar and herbs; there are also crystal deodorants made of mineral salts. Many of the ingredients can inhibit bacterial growth, thus reducing odor.

Botox: Tiny injections of botulinum toxin block nerve messages, including ones that say "sweat." Botox is approved by the Food and Drug Administration to treat excessive underarm sweating and is used on palms and feet. A treatment lasts seven to nine months.

Prescription medications: The options to treat excessive sweating include anticholinergic drugs or beta blockers, but long-term use is discouraged because of side effects. Prescription-strength antiperspirants are effective but can cause irritation if not used properly. Often, the most effective treatment is a combination of therapies.

Underarm shields: Pliable disc-shaped shields that fit into the underarm part of clothing to absorb sweat and prevent sweat and deodorant stains on clothing. They're available in reusable, washable fabric or one-day disposables.

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