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Certainly, having sweat stains under the armpits is uncomfortable, even embarrassing vis-à-vis the people around you. But perspiring remains a natural body reaction, when it is not excessive, recalled Wednesday Laurence Netter, dermatologist and guest of the show No appointment presented by Melanie Gomez on Europe 1. The perspiration can however become pathological and deserve a consultation.
Why do we sweat?
According to the dermatologist, sweating is essential to maintain a temperature of about 37 ° C for the body. "Man needs to have a temperature at this level to protect the brain," insists Laurence Netter. "When this temperature increases, a message will arrive at the hypothalamus, in the center of the brain.The hypothalamus will control the functioning of the sweat glands.These glands will secrete sweat, made of 99% water. to put on the surface of the skin and it is its evaporation that will reduce the temperature, "she explains.
These glands are also of two types, says the dermatologist: the "Eccrines", about four million, cover the whole body and mainly the face, palms and hands, while the "apocrines" are found rather in the genitals and armpits and are responsible for a sweat thicker, fragrant and stimulated by stress.
Problem: In some cases, sweating can be more problematic. This is called hyperhidrosis. "Hyperhidrosis is too much perspiration unrelated to the outside temperature, there are people who come to work completely soaked in the winter, there is a big role of stress, it can be generalized or a lot more often located in the armpits, hands or feet, people lose liters of water, "says Laurence Netter.
When to consult
A consultation may therefore be necessary. "It is important to consult to eliminate secondary hyperhidrosis due to certain medications, diabetes or hyperthyroidism.But these are easy diagnoses.When hyperhidrosis is generalized and especially nocturnal, we must seek a cause, "says the dermatologist who takes the example of" a patient who can never take off his jacket at work "because" halos under the arms "or" a hairdresser who always has his hands soaked " .
Consult would then break a taboo, or even escape a significant psychological impact. "These are patients who always dress in black, do not loose their arms, do not shake hands or do not go barefoot in the summer, they are in control of their image and more they are in control, the more they sweat, it comes from the apocrine glands that are essentially stimulated by the stress, the emotions, the concentration.As soon as, subconsciously, they feel the slightest humidity under the arms or the least warm microclimate, they are The vicious circle is on the way and they are soaked, "says Laurence Netter.
For her, it is necessary in this situation instead to prefer an appointment with a dermatologist, perhaps more familiar with the subject than a general practitioner.
Which treatments can be chosen?
For patients with hyperhidrosis, the use of a deodorant is often derisory. According to the dermatologist, one solution is an injection of Botox under the arms. "The effect of the product will stop the transmission of neurotransmitters and therefore we do not sweat," says Laurence Netter. "The advantage: it works with everyone and it is completely dry, whatever the temperature. [...] The disadvantage: it is expensive and [...] it must be done every six months for a cost of 400 500 euros, "she continues. She assures, no side effects can be felt for an injection under the arms. Thermoregulation would not be affected either.
Second technique: use a machine that will heat the area where you perspire excessively. "This machine is approved by the FDA (the US drug agency), it is called the Miradry.It is a machine that will use the waves that will go to heat the sweat glands that n ' do not like hot at all, "says Laurence Netter. According to the dermatologist, the result is degradation of the sweat gland, which is then eliminated by the lymphatic glands. "Today, we can only treat the armpits with this technique.The marketing authorization for the chest and chest is scheduled for 2021," she says. The cost of treatment? "Around 2,000 euros," says the dermatologist.
Finally, another technique is recommended by Laurence Netter for the hands. it is iontophoresis. This requires the purchase of a device, "which costs around 300 to 400 euros," according to her. "You dip your hands into the device, to have an efficiency of the order of 70 to 80%, it takes about ten sessions that are done at home," she concludes.