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TRYING TO CONTROL EXCESSIVE SWEATING

Q: My problem is that I sweat too much. Whether I'm doing a sport or just reading a book, whether it's summer or minus-40 degrees outside, I still sweat a lot (I especially have sweaty hands). Some say it's completely normal, since I'm still a teen-ager. But I don't feel this is normal at all and I'd really like to know the cause of all of this and what I can do to stop it (taking showers often doesn't seem to help). I'd appreciate your opinion on this.

-- F.R., Montreal

A: Abnormally excessive sweating is, by definition, not normal. In medical terms, excessive sweating, or hyperhidrosis, is the abnormal increase in secretion from the sweat glands in the skin.

Excessive sweating (unless under extreme conditions of overheating or overexertion) is not a serious threat to physical health. But it can be a very distressing condition that affects day-to-day life. It can also have a major effect on a person's self-esteem and social interaction.

Hyperhidrosis may affect the entire surface of the skin, but is most often localized in the hands, feet and underarms. The cause is unknown.

Overreaction to exercise as well as stress, pain, caffeine and nicotine can aggravate the sweating.

There are few effective treatments for hyperhidrosis. The most common method of control is the use of strong antiperspirants that contain aluminum chloride such as Drysol. Drysol is a prescription drug, so you'll have to see a doctor to get it.

This antiperspirant is to be applied at bedtime three or four times a week.

When the treated areas are covered by a thin plastic film during these applications, this method seems to be effective for mild to moderate sweating. Once the sweating is under control, you can reduce the number of times you apply it per week.

If the Drysol doesn't work, another approach to excessive localized sweating is a device that applies a weak electric current to the sweaty area (called iontophoresis). But this device works for some people and not for others.

Ask your doctor or a dermatologist if you can try it out at the doctor's office before spending the money for a device.

There are no oral drugs available specifically for controlling excessive sweating. There are medications, such as those found in decongestant preparations that dry your mouth and nasal lining. But they do not work well for underarms and have too many side effects to be used for very long.

If your sweating is particularly bad when you are under stress, counseling or anti-anxiety medications may help reduce your problem. Counseling may also help if you do not find a good solution to your excessive sweating.

The more drastic step of surgery, known as sympathectomy, blocks the nerves' signals to the sweat glands. But before deciding on this surgery, be sure that you understand the potential benefits and risks.

A relatively new alternative treatment to surgery may be of interest to you.

Botulinum A neurotoxin (Botox) is injected into the skin and chemically blocks the nerve signals to the sweat glands. The injections are repeated every few months as needed.

Update on ADHD: Although a lot of attention has been paid to the concerns that too many children, especially those under 6, are being diagnosed with attention-deficit hyperactivity disorder, a new formulation of the standard medication should make treating those who need it easier.

Medical research, using methylphenidate in an extended release form (Concerta), has shown that it is just as effective when Concerta is given once a day in the morning as the standard use of methylphenidate given three times a day.

Some advantages of this, such as easier administration by the child, parents and school personnel, are obvious. But it will also be of great psychological benefit to the child not to have to focus so much on the medical concern and just be a kid.

Dr. Allen Douma welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Douma in care of Tribune Media Services, 435 N. Michigan Ave., Suite 1400, Chicago, Ill. 60611. His e-mail address is DRFamily@aol.com.

This column is for informational and educational purposes only. It is not intended to provide medical advice or take the place of consultation with a doctor or other health-care provider.

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