We all sweat during hot weather, especially if the humidity is also high. In fact, though, some of us do sweat more than others. Should you be concerned?
On average, individuals have two to four million sweat glands made up of a combination of eccrine, apocrine and apoeccrine glands depending upon the body location. Children have a higher density of sweat glands because the same number of glands are distributed across a smaller skin surface. Women have a higher density too because of their smaller skin surface while, conversely, larger individuals have fewer per unit area of skin.
Sweating plays a critical role in thermo-regulation. In hotter environments or with strenuous physical activity body temperature rises enough to trigger the sweat glands to produce sweat. Evaporation of sweat from the skin surface cools the skin and keeps body temperature within normal range which is why sweating, although unpleasant, is necessary.
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With a hot temperature of 30 C or above, working or exercising outdoors for at least one hour can mean, on average, production of 16 ounces of sweat just to keep the body cool. Dehydration can result and by the time that someone feels thirsty, they may have lost a large volume of fluid.
A good fluid intake is essential, and water is ideal. Beverages containing caffeine should be avoided because they can contribute to dehydration. There are numerous oral rehydration solutions and/or “sports” beverages available which also contain minerals that help replace lost levels; however, some people cannot tolerate some minerals or additives and need to avoid certain products. Reading the label is important.
Sometimes excessive sweating is associated with an underlying condition, for example hypoglycemia or low blood sugar, fever, infection, overactive thyroid, or some types of cancer. Ideally good control of the underlying condition or treating it will reduce sweating. For people with diabetes, being aware of the symptoms of hypoglycemia and always having 20 grams of carbohydrate (such as glucose tablets) at hand is essential.
Vasomotor symptoms or “hot flashes” experienced in menopause include excessive sweating. Non-drug approaches are usually the first recommendations followed by drug therapy such as hormonal therapies or drugs like paroxetine and venlafaxine.
Anhidrosis is lack of sweating and extra care needs to be taken to avoid dehydration. Skin damage from scars, trauma or even diseases like psoriasis can physically damage the sweat glands. Connective tissue diseases such as lupus can also damage sweat glands.
Any nerve system damage may interfere with the functioning of the sweat glands in that they are still present, but they do not receive nervous system messages to produce sweat. Some examples include nerve damage caused by alcoholism, nerve conditions like diabetic neuropathy, nervous system diseases such as Parkinson’s disease, and even spinal cord injuries. It may even be a genetic factor that results in anhidrosis.
Drug adverse events may reduce the production of sweat. Most occur through anticholinergic effects on the nervous system. Tricyclic antidepressants like amitriptyline, incontinence drugs like oxybutynin and tolterodine, seizure medications like topiramate, and even narcotic pain relievers can have these effects. Botulism toxin works through the nervous system to reduce the response of the sweat glands, and it is sometimes used to reduce excessive sweating or hyperhidrosis.
Sweating is a necessary body function, but ensuring a good fluid intake, wearing loose-fitting light clothing, and avoiding unnecessary exertion will help reduce unpleasant excessive symptoms and dehydration. Keep in mind too that applying an antiperspirant before bedtime will allow it to sink into the skin overnight and be more effective during the day.
