This summer was among the hottest on record, yet at the humid height of August inside Bikram Yoga Norwalk it was hotter still. The room temperature was set at a balmy 110 degrees Fahrenheit, humidity was hovering around 40 percent, and people were bent over in downward dog poses with sweat pouring off them and pooling on the yoga mat.
"This is a place where you come to sweat. I sweat buckets," says Eric LaBonte, a firefighter from Norwalk who takes some pride in his ability to soak a shirt. "It's almost like the more you sweat, the more you show how hard you worked. It feels good!"
Not everyone shares his enthusiasm for perspiration. Alexa Lane, who trains yoga instructors and whose husband co-owns Bikram Yoga Norwalk, says a lot of people say they hate hot yoga because they don't like to sweat that much. As someone with a degree in exercise science, however, she says working out in a warm room makes good sense.
"You don't want to stretch a cold muscle because it makes the muscle more susceptible to injury," she says. "The heat raises the intensity of the workout. You're going to raise your heart rate and it makes the muscles easier to stretch." To get that benefit, naturally, you're going to work up a sweat.
We're Cool Because We Sweat
Sweating is the body's cooling mechanism. "It's a normal, healthy response," Lane says. "You want your body to sweat. The sweat glands allow the water to be transported to the surface where it evaporates. The sweating cools the body down."
We have anywhere from 2 million to 4 million sweat glands, but not all of them are the same. Sweat glands come in two types: eccrine glands (which are by far the most numerous and are all over the body), and apocrine (which are located around the hair follicles that develop during puberty).
Believe it or not, eccrine sweat is naturally odorless. It might take on an odor if someone eats a lot of spicy food, but it usually has no smell until bacteria start to break it down on the body (which is, if anything, an even more unpleasant thought!). Apocrine sweat contains fat, however, and that can be a bit stinky.
Though many people believe sweat flushes out toxins in the body, there's not much evidence to suggest that perspiration does this in any significant way. Sweat is mostly water, says Dr. Ivan S. Cohen, a Fairfield-based dermatologist and associate clinical professor of dermatology at the Yale University School of Medicine. It contains sodium, chloride and potassium, which is why it tastes salty, but the organ that handles detoxification is the liver, not the skin.
Sweating does deplete the body of fluid, salt and electrolytes, though, so if you're working up a sweat it's important to stay hydrated or you risk heat stroke, circulatory problems and even kidney failure.
Naturally, most of us sweat when it's hot or when we're engaged in some kind of vigorous physical activity. But some people sweat buckets while others hardly seem to sweat at all. Sometimes this can be related to how much water you drink, but there really is no explanation for why some of us sweat more than others.
And sweating isn't just a biological reaction to heat; it's an emotional response, too. The sweat glands are part of the body's sympathetic nervous system. A sudden rush of adrenalin boosts activity in the sympathetic nerve, prompting people to break out in a "cold sweat."
No One Wants to Shake a Sweaty Hand
How much someone sweats really varies from person to person, but, for some, excessive sweating can be a real issue, especially when it's a chronic condition called diaphoresis or hyperhidrosis, which
typically runs in families. People with this condition may have to change clothes several times a day and the problem is generally most noticeable around the armpits. The condition often develops around puberty, when the sympathetic nervous system kicks into high gear, but it's a lifelong problem for those who have it.
Excessive sweating that develops later in life is more often a symptom of something else. It's common for people who have hyperthyroidism or who are obese to sweat more than most. Sometimes excessive sweating is triggered by hormone imbalances that may occur during menopause. It also can be a side effect of certain medications or caffeine.
Conversely, some people don't sweat at all. As with excessive sweating, the inability to sweat also runs in families, although it, too, can also be caused by other diseases, most typically skin diseases such as Guillain-Barre syndrome that block the sweat glands.
While many people worry about sweating too much, people who can't sweat have a much more serious problem. Sweating regulates the body temperature to keep it at a normal 98.6 degrees Fahrenheit, so if you can't sweat, you run the risk of overheating.
Never Let Them See You Sweat
Chronic sweating isn't a dangerous condition but it certainly can be a socially awkward one. "It's an extremely embarrassing problem," Cohen says. "The people we see are changing their clothes frequently, their clothes get discolored, they can't shake hands with people and they have problems with their feet."
Hyperhidrosis afflicts about 3 percent of the population, according to the International Hyperhidrosis Society, and Cohen says it affects men and women in equal numbers. Most often, the profuse sweating occurs around the armpits, hands and feet.
Underarms are the easiest to treat, Cohen says, adding strong antiperspirants (see sidebar) are first on the treatment list.
"If that doesn't work, usually the next step is to think about Botox," he says. Just as Botox acts to block the transmission of a nerve signal to a muscle, it can block the transmission to the sweat gland so it doesn't get the signal to sweat. Botox can last six months to a year and the $1,000 cost to treat the underarms is sometimes covered by medical insurance.
"I've had a lot of success with Botox under the arms," says Cohen. "I see a lot of young women with that (problem) and it's made a huge difference. They don't have to worry about their clothes and it makes them feel so much better."
Cohen says most of his patients have tried every over-the-counter solution before coming to see him. By the time they've walked into his office, they've exhausted all other options.
It's more difficult to treat people whose main problem is sweaty hands or feet. Botox can weaken the muscles, which makes it less than ideal for use on hands. Iontophoresis, a process that involves passing a mild electrical current through water, is one option for treatment of hands and feet. This requires a battery operated device into which people put their hands and feet.
No one is exactly sure why this works, although the theory is that the electric current and the minerals in the water act together to thicken the skin on a microscopic level, blocking the sweat ducts. This treatment has been around since the 1940s, and the American Academy of Dermatology reports that it's about 80 percent effective.
The Food and Drug Administration approved a new microwave device called MiraDry for the treatment of hyperhidrosis late last year. It uses microwave energy to destroy sweat glands, and is effective in 80 percent of those who've tried it. It's not cheap, however, costing $3,000 for two sessions, and it isn't covered by insurance.
The last resort for hyperhidrosis is surgery to cut some of the sympathetic nerves. This is less invasive now that it can be performed with endoscopic surgery, but it's done rarely since Botox has been found to be effective.
Working Up a Sweat and Loving It
Of course, not everyone thinks sweating is a bad thing. In fact, if you're working out, it's one way to measure your success.
"We like to do things with a high intensity at CrossFit so you definitely get a sweat on," says Susan Friedman, owner of CrossFit in Norwalk. "Sweating makes you feel good, like you accomplished something and you got a good workout. When we finish our workout, people will lay down on the floor and when they get up they've left a sweat angel on the floor. I think people are proud of it. It shows that they gave it their all."
And while some women may think sweating is unattractive, LaBonte is one man who would disagree. "I see women sweat and it's a turn-on," he says. "It's just like it shows they're not afraid to do something, that they like to live out of their comfort zone a little bit."
And that's hot!
HOW ANTIPERSPIRANT WORKS
For most people, daily applications of antiperspirant under the arms are enough to stop the sweating. Although deodorants are intended only to mask body odor, antiperspirants contain aluminum compounds that actually block sweat. Aluminum ions enter the skin cells that line the eccrine-gland ducts and carry water in with them. As more water enters, it causes the cells to swell, effectively blocking the ducts.
Antiperspirants that have high concentrations of aluminum chloride, such as Certain Dri or prescription strength Drysol, work well for many people. The latter is applied at night and within a couple of nights it can significantly reduce daytime sweating.