BODY ODOR AND SWEATING

Treatment

For some people who sweat excessively, the answer may be simple: an over-the-counter antiperspirant used on the hands and feet as well as the underarms. Antiperspirants work by blocking your sweat ducts with aluminum salts, thereby reducing the amount of perspiration that reaches your skin. Deodorants, which can eliminate odor but not perspiration, turn your skin acidic, which makes it less attractive to bacteria. Although you may have heard stories linking antiperspirants and breast cancer, there is no evidence of such a link.

Continued use of antiperspirants can cause irritation or even contact dermatitis — red, swollen, itchy skin. In fact, antiperspirants are the cosmetic product most associated with skin irritation. Deodorants, especially herbal or crystal deodorants, may be less irritating for most people.

If over-the-counter products aren't strong enough, your doctor may suggest a prescription antiperspirant such as Drysol. For more severe problems with sweating, he or she may recommend other treatments, including:

• Iontophoresis. In this procedure, a dermatologist uses a battery-powered device to deliver a low current of electricity to the affected area. Although iontophoresis is painless and quite safe, it may be no more effective than a topical antiperspirant.

• Botulinum toxin (Botox). This is the same product that helps smooth facial wrinkles by paralyzing certain muscles. Researchers have now discovered that Botox injections are also an effective way to treat severe hyperhidrosis by blocking the nerves that trigger the sweat glands. Botox isn't a cure-all, however. It may take several injections to achieve the desired results, the treatment can be painful and the results only last about 4 months. In addition, although Botox stops sweating, it doesn't prevent body odor.

• Surgery. In rare cases surgery may be an option. If excess sweating just occurs in your armpits, removing the sweat glands may help. Another procedure involves cutting the nerves that carry the messages from the sympathetic nerves to the sweat glands. At one time, this was a major operation, requiring large incisions in the chest or back to reach the spinal column were the nerves are located. You typically stayed in the hospital a week and could expect to spend a month recovering. But today the surgery can be performed laparoscopically in a procedure known as endoscopic thoracic sympathectomy. It requires just three small incisions for a video telescope and small surgical instruments. Although the operation is delicate, it typically requires only a day in the hospital and produces minimal scarring. Following the surgery, sweating on the hands permanently stops. But increased sweating can occur elsewhere on your body, such as your back or behind your legs.