You know that perspiration is the sign that your body’s internal thermostat is working. But what happens if it works too well…and you’re faced with constant telltale sweat marks on clothes, not to mention the odor? Here are strategies you can use, depending on how bad the problem is.

Sweat Glands 101

You have two main types of sweat glands. The eccrine glands are over most of your body. This type of sweat is what gives your skin that moist glow when you exercise, but most people don’t notice the loss of moisture during low-exertion times. As your temperature goes up, these glands release fluid, mostly water, that cools you off as it evaporates. The sweat from the eccrine glands has no odor.

The apocrine glands are more problematic. They’re found mostly in areas where hair grows—underarms, scalp, groin. When you’re stressed, they release a milky fluid that’s odorless on its own, but once it mixes with the bacteria on your skin, that’s when the stink starts.

Why am I sweating so much?

You expect to sweat when you work out, start feeling nervous in social and business situations or have a fever that breaks. But there are health conditions—and it’s not just menopause—that ramp up the level of sweating. 

Heavy sweating can be traced to infections…the nervous system, heart, lung and thyroid diseases…and diabetes (often from low blood sugar), among others. Hyperthyroidism and other ­hormone-related problems that stem from the hypothalamus, the part of the brain that regulates temperature, can cause excessive sweating during sleep. Managing those conditions should get your sweating under control, so check with your doctor to rule out these causes. 

Some medications, such as anti-depressants and heart and blood pressure medications, also can cause night sweats. Ask if a change in prescription is possible. 

Being overweight can make you sweat more—you might notice it even with just a few pounds of weight fluctuation. Losing weight can help.

Important: Because changes in your perspiration pattern can be a warning of an undiagnosed medical condition, such as diabetes, leukemia or non-­Hodgkin’s lymphoma, see your doctor if…

  • You suddenly begin to sweat much more or less than usual.
  • You experience night sweats for no apparent reason.
  • You notice a change in your body odor.

There also are millions of people who experience excessive sweating with no underlying cause. Called primary ­hyperhidrosis, there’s no rhyme or reason to when the sweating happens. But there are ways to resolve it…

Simple At-Home Solutions to Sweat Less 

Slight changes to your daily routine can have a big impact…

Double up on deodorant/antiperspirant. Most people apply a combination deodorant/antiperspirant each morning to their underarms to block sweat and fight odor. 

Better: Also apply it each night before bed. This gives your sweat glands the time needed to absorb the aluminum, which is the active ingredient in antiperspirants. Choose a higher-strength product, which often will say “clinical grade” on the label.

Note: Many people have switched to deodorant-only underarm products, because of skin irritation or because they believe that the aluminum in ­antiperspirants can increase the risk for breast cancer, dementia, kidney disease and other health problems. There is no substantial scientific evidence to support these fears. And deodorant-only products do nothing to stop the sweat. 

Dry off. Before getting dressed or putting on your pajamas, carefully dry yourself—especially between your toes and under your arms—to reduce bacteria growth on skin, which is the foundation for odor. Skin also must be thoroughly dry before you apply antiperspirant for optimal absorption. 

Relax. If your emotions bring on perspiration, practice relaxation techniques such as yoga, meditation and biofeedback. These can help you learn to control the stress that triggers sweating. 

Change your pajamas and your bedding. If you sweat in your sleep, whether or not it’s related to hot ­flashes, try cooling, moisture-wicking sleepwear, underwear and sheets—it is easy to find these using an Internet search. Certain fabrics, such as cotton flannel, can make sweating worse. As comfy as they are, down blankets can trap heat, causing you to sweat more, too. 

Serious Remedies for Hyperhidrosis

If you’re sweating through your clothes during the day and the amount is bothering you, see a dermatologist to discuss treatment options, starting with prescription-strength antiperspirants. If that’s not enough, here are other medical options to try… 

Topical: Glycopyrronium (Qbrexza) is available as an underarm wipe. In clinical trials, participants who used it for one month reported that it decreased sweating severity by up to 30% and sweat production by 50%, with some improvement seen after the first week. While glycopyrronium can be used in other areas of the body, it is approved only for underarms and may not be as effective elsewhere.

Glycopyrronium is an anticholinergic, meaning that it blocks the ­neurotransmitter acetylcholine, responsible for activating the sweat process. As with other anticholinergics, it’s not for anyone with glaucoma, severe ulcerative colitis, myasthenia gravis or Sjogren’s syndrome because it can make those conditions worse. 

Injection: Botulinum toxin (Botox) is the most effective treatment we have for excessive underarm sweating. It also can be used on the palms of the hands and soles of the feet. For most people, it reduces sweating by 75% to 90%, bringing it down to a normal level. The treatment needs to be repeated every six months. Some health insurers will cover the injections because they’re for a medical reason although Botox is not covered for cosmetic purposes. Check with your dermatologist’s billing office—some may need repeated requests to do the paperwork and follow-up phone calls required for insurance approval. 

Oral: Glycopyrrolate (Robinul). For people who aren’t helped by Botox, off-label use of glycopyrrolate may help. This is another form of the active ingredient in Qbrexza but is given in pill form. It was developed to reduce other types of body secretions and a decrease in sweating is one of its side effects. It works for some people, but not everyone finds its other side effects—dizziness, drowsiness, nervousness, loss of taste and headache—worth the benefit.

Noninvasive procedure: miraDry. This noninvasive, FDA-approved procedure uses a handheld device to target thermal (heat) energy at sweat glands in the underarms while keeping skin at the surface cool. One to two treatments are all that’s needed to destroy underarm sweat glands. You will continue to sweat normally in other parts of the body.

How to Stop the Stink

Sweat by itself doesn’t cause body odor. That happens when it meets bacteria on your skin. Washing off sweat after a workout will help. So will washing workout clothes every time you wear them—something that a surprising number of people don’t do. But if you’ve ever felt that these clothes weren’t becoming truly stink-free, your nose isn’t deceiving you. High-performance fabrics tend to hold on to odors. Try specialty detergents ­developed for these fibers.

You can wash your hands or dab on sanitizer when your palms get sweaty, but it’s harder to keep your feet odor-free when they’re in shoes and unable to breathe all day. One of the best things you can do is not wear the same pair of shoes two days in a row. This gives the shoes a chance to completely dry out. Try any or all of these additional tips to conquer foot odor…

  • Wash feet nightly with an antibacterial soap, and dry them completely.
  • Use a spray underarm deodorant or antiperspirant on your feet. 
  • Place deodorizing insoles in every pair of shoes, and change them as needed.
  • Buy socks and hosiery made from breathable, moisture-wicking fabrics and shoes made from natural materials such as canvas, especially important for closed-toe shoes that limit air circulation around your feet.