Perspiration/Body Odour Flashcards
what are the 3 types of sweat glands?
what are their functions and locations?
Eccrine glands are responsible for cooling the body and preventing excessive electrolyte loss.
They are located on the palms, soles, face, head, and trunk.
Apocrine glands open into hair follicles. Sweat produced from them develops an odour once it reaches the skin surface.
They are located primarily in the underarm, nipple, and genital area.
Apoeccrine glands have features of both of the above
glands. They secrete 10x more sweat than eccrine glands.
They are found only in the underarm of adults (they develop in puberty).
The existence of these glands is of much debate
why do we sweat
- body temp regulated by hypothalamus, responds to change in core and skin temp
- essential for regulating body temp
- impaired sweating can lead to heat exhaustion or death
what are the 3 types of sweating
normal, physiologic
hyperhidrosis
bromhidrosis
when does normal sweating occur
Reaction to thermal or emotional stimuli
e.g., hot environments, exercise, over-dressing, embarrassment, anger, hot or
spicy foods
when does hyperhidrosis occur? what are the two types?
1º – ANS dysfunction affecting 0.5 – 4% of the population, typically affecting the axillae
Not usually associated with odour, but can significantly affect quality of life
2º – due to body changes or conditions such as menopause, obesity, malignancy, fever, anxiety, or substance withdrawal; affects the entire body
Could also be due to medications such as ASA or insulin
when does bromhidrosisoccur?
Chronic condition where sweat is malodourous, typically due to decomposition of fatty substances by bacteria
Predisposing factors include hyperhydrosis and poor hygiene
sweating/odour goals of therapy? (4)
Control socially undesirable body odour
Control underarm wetness due to physiologic sweating
Reduce quantity of sweat excreted due to hyperhydrosis
Prevent complications of hyperhydrosis
Especially of the feet: odour, blisters, infection
red flags sweating (2)
Self-management is appropriate for individuals who have wetness and odour concerns arising from normal, physiologic sweating
Consider referral for
Recent increase or onset of sweating
Sweating in an unusual or unexplainable pattern
e.g., only at night or in the absence of exercise, unusual location
if sweating is excessive and affects qlty of life, not controlled by standard antiperspirants classify as primary of secondary hydrosis
if primary, treat with stronger aluminum conc and use nonpharm measures
if secondary, treat underlying medical condition/change med
non-pharm for sweating
4 categories
General measures
Wearing breathable, natural-fibre clothing; using underarm shields; avoiding triggers; maintaining hydration
Personal hygiene
To manage odour, daily bathing or sponging with soap and water will help prevent build-up of bacteria, sweat, and dead skin cells (bar soap better)
Foot care
As above (wearing breathable footwear and washing feet daily), plus changing socks frequently and allowing feet to dry to avoid complications
like athlete’s foot
Other
Iontophoresis – use of a mild electrical current to block sweat duct
(Feet and hands only, 2-4 times a week, 30 mins each session)
secretions on hands and feet (can buy device for home use, see next slide)
Surgery – removal of glands or cutting of nerves that signal glands
Microwave energy or laser treatments (clinic)
pharm for sweating
antiperspirants
ingredient?
MOA?
strength?
Work best for axillary sweating, but can be applied anywhere.
MOA: Sweat glands are mechanically plugged, causing sweat to thicken and clump; this signals the body to stop perspiring. Over time, application of antiperspirants may destroy secretory cells, so decreased application is required.
“Regular” vs. “clinical” strength
Aluminum salts like aluminum zirconium (e.g., Speed Stick®) create more superficial blockages and should not create irritation with once or twice daily application
Aluminum chloride 6.25% – 20% (e.g., Drysol®) may provide deeper and more effective blockages, but may be more irritating
There is no evidence of any connection between use of aluminum- containing antiperspirants and Alzheimer disease (or any other dementias) or breast cancer
pharm for sweating
deodorants
ingredient?
MOA?
strength?
Do not prevent sweating
MOA: Mask odour with fragrance or by reducing bacterial population
Contain ingredients such as “alum” (a water purifier) or crystals of potassium or ammonium alum. Some contain vinegar, sodium bicarbonate, and isopropyl alcohol.
Those marketed for the feet may contain the above, or zinc salts and corn starch
e.g., Crystal Body Deoderant®, Dr. Scholl’s Foot Powders®
4 common OTC pdts for sweat/odour
regular strength antiperspirtant
clinical strength antiperspirant
deodorant
foot powder
pharm for sweating
botox – onabotulinumtoxinA
MOA?
Block the release of acetylcholine from cholinergic neurons in eccrine glands
Approved for 1º hyperhydrosis of the axillae, but could be used on other sites as well
Results possible within 2 weeks, with effect lasting 4-12 months
al salts, then electrophoresis, then botox
pharm for sweating
oxybutynin
MOA?
Commonly used for overactive bladder
Has anticholinergic effects
has side effects
monitoring
what should be monitored and timelines?
Body sweating should be monitored daily for 2-3 weeks while using products
If patient is not responding within this time, consider
trying other products or referring (based on severity of
symptoms)
Body odor should be eliminated in 1-2 weeks
Irritation should be monitored for daily or 2-3x weekly depending on product being used
If irritation persists despite correct use, consider
stopping and trialing other options or referring
