It's something that people with the condition don't like to talk about, because it's . . . well, um . . . so embarrassing.In fact, many of the estimated 300,000 Canadians who suffer from excessive, uncontrollable sweating of the underarms, hands, feet or forehead try everything and anything to hide their problem. Many don't know there are medical treatments, including the cosmetic wrinkle treatment Botox.
Thought in a majority of cases to be genetic in origin, excessive sweating -- known as hyperhidrosis -- usually begins in the early to late teens and can cause people to produce up to four times the average volume of perspiration.
For Tanya Threatful of Vancouver, the onslaught of overactive sweat glands didn't begin until she was 27. But the constant underarm drenching caused the once-confident, outgoing saleswoman to withdraw in both social and business situations. She began wearing clothes that would hide her soaked underarms, and was afraid to get too close to people to keep them from seeing the wet patches and be offended by her body odour.
Affectionate by nature, Ms. Threatful stopped hugging family and friends, and shied away from intimacy with her boyfriend.
She kept looking for a solution. Her medicine chest shelves were lined with countless bottles of different brands of deodorant and antiperspirants, even those marketed for men, but they did nothing to stanch the constant flow. Everywhere she went, she carried a little kit that included antiperspirant and moist towelettes, so she could wipe herself down throughout the day.
"My self-esteem began to really suffer," Ms. Threatful said in an interview from Vancouver. "I thought I was a freak."
It's a common reaction among those affected by hyperhidrosis, believed to occur because of a malfunction in the sympathetic nervous system, which regulates body temperature by switching sweat glands on and off, experts say.
Some patients are so desperate to mask their problem that they devise innovative strategies, including sewing absorbent material inside their pants pockets so they can wipe their clammy palms before shaking hands with someone, said Dr. Nowell Solish, a dermatologist at Sunnybrook and Women's Health Sciences Centre in Toronto.
Others with profuse underarm sweating refuse to shake hands at all, keeping their arms rigidly by their sides, while many with severely sweaty feet are horrified at the thought of taking off their shoes in public because of the intense odour.
"Many of my patients are anxious, depressed, even suicidal because of this problem . . ." said Dr. Solish. "Often, they go undiagnosed or are misdiagnosed or untreated due to lack of awareness about solutions, even among physicians."
Patients often believe they will just have to live with the condition the rest of their lives.
"Many people who suffer from this condition are too embarrassed to consult their doctors and think they are abnormal," said Dr. Charles Lynde of the Canadian Dermatology Association. "Most of them just suffer in silence."
The association is trying to raise awareness about hyperhidrosis and to get the message out that sufferers can be helped, said Dr. Lynde, who has a practice in Markham, northeast of Toronto.
Among the most recent and successful treatments is Botox, best-known for relaxing facial muscles to reduce wrinkles. Doctors make a number of tiny injections of Botox at the site of excessive sweating, which puts the brakes on the neural chemical that signals sweat glands to produce perspiration. Treatments need to be repeated about every six to eight months. The cost, which runs upwards from about $500, is often covered by private health plans.
Studies have shown that in 95 per cent of patients with severe underarm hyperhidrosis, Botox reduced sweating by an average of more than 80 per cent within a week of treatment, said Dr. Solish.
Besides Botox, which can cause some discomfort at the injection site, prescription-strength antiperspirants containing aluminium chloride can effectively alleviate less-severe cases of hyperhidrosis, although they may cause skin irritation.
A therapy called iontophoresis, which uses a mild electrical current to temporarily shut down sweat glands, can help dry up overly moist palms or feet.
For more severe cases, an operation to cut or remove nerves that control perspiration is an option for hands, but is less effective for underarms and also carries some surgery-related risks.
For Ms. Threatful, now 33, the humiliation of being a supersweater ended when she went to work for a Vancouver skin-care clinic and discovered that help existed for people like her. Since starting Botox injections, her problem perspiration is just a bad memory.
"It was great, it was sheer joy," she said of the result. "It was like a whole new world opened up to me. I could wear whatever I wanted and not be afraid of looking and smelling sweaty.
"I feel such a sense of freedom again. I'm rediscovering myself."