With the exception of pro athletes and people who love saunas, most of us live by the motto, Never let them see you sweat

(Fun fact: That came from a 1984 ad campaign for Dry Idea antiperspirant, and yes, that’s Carol Burnett!)

Sure, it’s totally natural —’Sweat’s main function is to cool the body,’ says Dee Anna Glaser,  a professor in the department of dermatology at St. Louis University — and nothing to be ashamed of. That said, pit stains will never be aspirational, and since being anxious or nervous can stimulate sweat glands to up their output, it makes sense that you wouldn’t want to broadcast your emotional state in this particular way.
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And if you’ve got hyperhidrosis — the medical term for excessive sweating anywhere on the body — the problem is way more than aesthetic. ‘It can profoundly affect someone’s life — it may affect an adult’s choice of profession or limit opportunities,’ says Maral Skelsey, a clinical associate professor of dermatology at Georgetown, as they might need to pick jobs that do not involve speaking in front of a group or shaking hands, or in which they cannot change clothes several times a day. ‘I’ve treated teenagers who won’t raise their hand in class. One said, “I know the answers, but the teacher doesn’t know I know,”‘ Dr Glaser added.
Why do our underarms sweat?
We have millions of sweat glands all over our bodies — the greatest concentration are in our hands and feet, says Dr Glaser, but our armpits are another hotspot. Most of these are eccrine glands, which crank out clear, odourless fluid that cools us off when it evaporates. But your pits and your other hairy bits also have apocrine glands, which put out a thicker fluid, also odourless; it’s when that fluid interacts with bacteria on your skin that you don’t smell too great.

A common myth is that prolific perspirers have more body odour, but that’s actually not so. ‘People who sweat a lot don’t tend to have a smell,’ says Dr Glaser, because the bacteria gets washed away, resulting in no stinkage. ‘It’s people who don’t sweat that much that may notice more of an odour.’

Another misconception? That we sweat out toxins. ‘Sweat consists nearly entirely of water,’ says Dr Skelsey. The rest of it, according to the International Hyperhidrosis Society, is salt, urea, and a little bit of carbs and protein. Luckily, our kidneys and liver do a good job of detoxing us.
What causes excessive sweating?
First off, there are two kinds of hyperhidrosis: primary and secondary, and they have different causes.

The primary variety starts when you’re young — even toddlers can have super-sweaty hands and feet, but those whose underarms are the primary spots usually show it shortly after puberty or as young adults, says Dr Glaser. Experts aren’t sure why some people get hyperhidrosis, but suspect it is genetic, as it can run in families. Because sufferers have normal sweat glands, the theory is that the hypothalamus, a part of the brain that, among other things, tells your glands to produce sweat, is sending these glands a glitchy message.

The secondary kind shows up when there’s some change in your body, such as menopause (hello, hot flashes and night sweats!), an underlying medical reason (say, a thyroid or pulmonary condition), or you’re on a medication that messes with these same brain signals. Secondary hyperhidrosis “tends to lead to more diffuse sweating,’ i.e., not only from your underarms, and it can show up when you’re older, she says.
How do I know if I have hyperhidrosis?
The condition, which affects an estimated 15.3 million people worldwide, needs to be diagnosed by a doctor, usually a dermatologist, but if you have excessive, disruptive, visible sweating at least once a week for six months or more, those are signs that you may have it, says Dr Skelsey.

The other big factor is how much your sweating interferes with your functioning and how much you’re bothered by it. Some people may objectively sweat buckets, but if it’s no big deal to them, there’s no need to treat it, says Dr Glaser, who adds that excessive sweating can wax and wane, but doesn’t disappear entirely. Some excessive sweaters can manage it on their own most of the time with antiperspirants, but for special occasions (say, they’re a bridesmaid in a wedding and plan to be photographed dancing the night away) they’ll seek next-level treatment. ‘If they come to see me about it, it’s probably really bothering them,’ she says.
So how do I stop armpit sweating?
There are a few treatments, each of which has its own pros, cons and side effects.
Clinical strength antiperspirants
Whether or not you consider your sweating majorly excessive, this is the easiest first step. ‘I always start with clinical strength antiperspirants,’ says Dr Skelsey. ‘They are much more effective than regular ones—especially when used correctly. That means applying them at night and again in the morning. (Because you sweat less at night, the medication can better make its way into your glands.)
Botox injections
If antiperspirants don’t work or irritate your skin, you might opt to do as Chrissy Tiegen has done and get this neurotoxin (perhaps best known for smooth foreheads) injected shallowly into your pits. It works by blocking the secretion of the chemical that activates your sweat glands. Botox shots in this area tend to last around six months, says Dr Skelsky, and sometimes more.
This is the only non-surgical, FDA-cleared procedure that permanently reduces sweating by zapping your pits with thermal energy to destroy the sweat glands altogether. ‘Some patients are worried about losing these glands,’ says Karyn Grossman, MD., a dermatologist in Santa Monica, CA, who offers the treatment. “However, it’s important to note that the underarm only contains 2% of the sweat glands in your body,” and your other glands will continue to cool you down. While some people can ditch deodorants and antiperspirants entirely after a treatment or two, Dr Glaser says some hyperhidrosis patients still need to use some. ‘They say they have a normal amount of sweating after treatment,’ she says.

Source: Good Housekeeping US 
Image: spukkato/Istock
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