Q I am a 67-year-old man. I sweat a lot across my body, especially when I am in a room with poor ventilation.

If I sleep in an air-conditioned room, my underwear would be wet in the mornings. If I sit on a chair, the cushion would be wet after a couple of hours.

Even if I clean the area around my groin before sleeping, it would be wet again when I wake up.

Fungus has developed there, making it very itchy and I tend to scratch around it during my sleep.

I wash the area three to four times a day and apply anti-itch cream, but it does not stop the itch. What should I do about the itch and excessive sweating?

A It appears that you have hyper- hidrosis.

Most people have the primary idiopathic form where, due to unknown reasons, there is an abnormal or exaggerated response to the nervous stimulation of sweat glands.

Occasionally, there are certain medical conditions such as a hyper- functioning thyroid gland disorder that causes excessive sweating.

There are also medications that can cause excessive sweating.

Fungal infections are a common complication of hyperhidrosis because these organisms thrive in moist, humid conditions.

It must be distressing for you to deal with two separate problems - excessive sweating and a persistent itch.

However, I would caution against the random use of over-the- counter anti-itch creams and excessive washing, especially if they do not improve the itch, or, in fact, make it worse.

This could be due to contact dermatitis - a skin rash caused when an irritant substance touches the skin.

In this case, it could be the anti- itch cream and an irritant dermatitis from frequent washing.

It is best to consult your doctor and let him prescribe the appropriate treatment.

The simplest way to control the excessive sweating is to apply an antiperspirant twice daily onto the affected skin area when it is completely dry.

The active ingredient - aluminium chloride hexahydrate - mixes with the perspiration to form a salt which blocks the flow of sweat.

After repeated use, you may be able to achieve similar control with less frequent applications.

This may be difficult in your case as many areas are affected.

Hence, another treatment to consider is to take an oral medication. You will need a doctor's prescription for this.

It works by blocking the nerve transmission which triggers sweat production.

Do note that this medicine will reduce sweating over the entire body, including places where sweating is not a problem.

Thus, it could put you at risk of heat exhaustion if you take part in strenuous activities.

Some people may also experience palpitations, dry mouth, blurred vision, urine retention and constipation.

Surgery would not be suitable as your sweating is rather generalised.

Dr Chris Tan

Associate consultant in the division of dermatology at the National University Hospital

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