I sweat so much I stain my dress shirts. Any advice?

This is a common scenario among professional women and men who must give, as part of their job function, presentations, speeches and seminars to an audience. This results in a stress response that causes nerves in the body to signal the eccrine glands (sweat glands) to pump out sweat. Men and women differ significantly in sweat function, as men produce about 30-45% more sweat and have a different pH, bacteria colonization and oil:sweat ratio than women. Dana Point Dermatology typically recommends a step-wise approach to combat excessive sweating. First, try a prescription strength anti-perspirant containing aluminum chloride (Drysol). This is composed of aluminum salts that form a physical plug in the duct that carries sweat from the sweat gland deep in the skin onto the surface. It takes about 1 week of daily use to create the plug and lasts about 14 days after stopping. It is important to note that antiperspirants are more effective when applied at night. The reason for this is that the plug is more “sticky” when there is less sweat flowing through the duct, which happens to be when your sleeping. Twice daily application to the entire armpit area results in a stronger plug yet. Common side effects are itching and irritation, which happens in about 1 in 3 people. If this doesn’t help or your skin gets too irritated, the next step is a Botox treatment. Botox, when injected in to the skin of the underarm area, temporarily reduces the nerve impulse for sweat gland secretion and is FDA approved to treat underarm sweating. It is very effective and decreases sweat production in the treated area by 80% in most cases. The results kick-in within 2 to 4 weeks and last about 6 months; men need to be re-injected to maintain the results, however. Rarely, the above methods don’t work and other options must be pursued, including iontophoresis, microwave therapy and surgery.