It was just minutes after being selected as a ‘traitor’ on the BBC’s hit show Celebrity Traitors that the first beads of sweat began to appear on Alan Carr’s brow.
‘I thought I wanted to be a traitor, but I have a sweating problem and I can’t keep a secret. What am I going to do?’ the comedian, 49, wailed to the camera.
The stress of it all had, it seemed, caused Alan’s body to betray him already. But he nevertheless made it to last week’s dramatic series finale where he scooped the £87,500 charity prize pot.
It is not the first time that Alan has spoken about his tendency to sweat to excess. Nor is he the first to be open about the unpleasant condition, which can affect the face, armpits, groin, palms of the hands and soles of the feet.
Medically known as hyperhidrosis, other celebrities such as BBC presenter Gethin Jones and Loose Women’s Penny Lancaster have discussed their own struggles. Penny, 54, who is married to Sir Rod Stewart, avoids social handshakes because of her sweaty hands and wore cotton gloves during exams so she could grip a pen.
While it is generally an under-discussed issue because of the embarrassment it causes, it is a prevalent one. Estimates suggest it affects around 1 per cent of the UK population – around 670,000 people. And for some, it can be a significant problem.
Dr Adil Sheraz, from the British Association of Dermatologists, says: ‘The impact on patients can be terrible. I’ve seen teenagers struggling to hold a pen or write on paper because it gets wet. I’ve had patients prevented from joining the Army because their hands were too slippery to hold weapons.
‘Patients who constantly sweat often have to change several times a day and take two or three shirts to work. It affects their mental health and means they avoid socialising or taking part in exercise. It can seem like something that isn’t taken very seriously, but people do genuinely suffer.’
However, experts say there are steps patients can take to combat excessive sweating, allowing them to live worry-free.
Alan Carr has often spoken about his tendency to sweat to excess – medically known as hyperhidrosis
‘I thought I wanted to be a traitor, but I have a sweating problem and I can’t keep a secret. What am I going to do?’ the comedian, 49, wailed to the camera
Sweating is a normal bodily function which helps regulate body temperature. Everyone is born with up to four million sweat glands – known as eccrine glands – all over the skin, and when body temperature rises, these release sweat which cools the body down as it evaporates.
Other sweat glands under the arms and groin – known as apocrine glands – only become active during puberty and produce a thicker sweat that contains fatty acids and lipids that bacteria like to feed on. This bacteria is what produces the sweat smell.
Both sets of glands can be triggered by stress, anxiety, exercise, heat, spicy foods and hormonal fluctuations. But some people do naturally sweat more than others – most likely because they are genetically programmed that way.
But Dr Sheraz says it becomes a problem if the sweating is so disruptive it interferes with daily life, or if it develops in adulthood with no obvious reason.
For these patients, there are treatments available that can help manage the condition.
But, importantly, excessive sweating can also be a symptom of an underlying medical problem – and even some types of cancer.
Doncaster-based GP Dean Eggitt says: ‘Hyperhidrosis can mean you’re just naturally one of those people who happens to sweat a bit more than others. But in some cases it’s linked to an underlying problem – we need to rule those out before we treat the symptoms.’
The most common is an overactive thyroid, in which the butterfly-shaped gland in the neck makes too much of a certain hormone. This causes the body’s metabolism to speed up, making patients feel too hot and leading to excessive sweat.
Other symptoms include unexplained weight loss, a fast or irregular heartbeat, increased blood pressure and frequent bowel movements. Treatment includes anti-thyroid medication to reduce hormone production.
Both forms of diabetes – type 1 and type 2 – can trigger sweating. This is because the blood sugar conditions can damage the nerves that control the sweat glands.
There are also hormonal causes, particularly in women over 40.
Fluctuating levels of the sex hormone oestrogen, linked to the menopause, make the hypothalamus – the gland in the brain that acts as the body’s thermostat – more sensitive, making it feel as if the body is overheating when it is not. This prompts hot flushes and night sweats. These symptoms can be effectively treated with hormone replacement therapy (HRT).
On rare occasions, sweating – particularly night sweats – can be a sign of cancer. Blood cancers lymphoma or leukaemia can cause ‘awful, drenching night sweats’, says Dr Eggitt, because they trigger changes to the immune system and also affect the hypothalamus.
Some advanced prostate, breast, liver and kidney cancers can cause this, too.
All of this means a GP will want to carry out blood tests to check your full blood count, sugar levels, and liver, kidney and thyroid functions to rule out these other conditions. But even if those tests come back normal, there are various options to help ease the problem.
Estimates suggest it affects around 1 per cent of the UK population – around 670,000 people
In the first instance, experts say, lifestyle changes can be helpful.
‘If you’re overweight, we’d advise you to lose weight as that extra adipose tissue can drive up inflammation in the body and cause more sweating,’ Dr Eggitt says.
‘Try to wear man-made fibres like cotton, or wicking fabrics [that moves moisture away from the body], and address any psychological issues that might be driving the problem such as anxiety or stress – talking therapies like CBT can help with that.’
Beyond this, medical treatments depend on the type and severity of the problem.
Dr Eggitt cautions that few are either licensed to treat hyperhidrosis, or available on the NHS – and some come with significant side effects.
Antiperspirants which contain aluminium salts such as aluminium chloride hexahydrate – brand names include Driclor or Perspirex – can be effective and can be used on feet as well as under-arms.
They should be used at night when sweat production is lower, helping it to penetrate better. The aluminium compound reacts with sweat in the ducts to form salts which create temporary plugs in the duct openings, preventing sweat from reaching the surface.
‘Don’t use a deodorant, as these only mask the smell, while antiperspirants will actually block your sweat ducts,’ says Dr Sheraz.
If this doesn’t work, or you have significant sweating in places such as the face, hands or groin, there are some medications that can be taken orally which will help stop sweating all over the body.
Antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, are one option – but some are linked with an increase in sweat in some people. This is because they increase serotonin levels, which plays a role in regulating the hypothalamus.
Any fluctuations can cause the hypothalamus to overreact and falsely believe the body is too hot – triggering sweat production.
Dr Adil Sheraz says hyperhidrosis becomes a problem if the sweating is so disruptive it interferes with daily life,or if it develops in adulthood with no obvious reason
GP Dean Eggitt says that beta blockers which slow the heart rate ‘can be helpful in a high stress situation’
Beta blockers, which slow the heart rate, anxiety and, as a result, perspiration, and some blood pressure drugs can also have an impact.
‘They can be helpful in a high stress situation and are the sorts of things Alan Carr might have benefited from,’ Dr Eggitt says.
There are also drugs known as anticholinergics which are licensed to treat incontinence but have also been shown to block the nerves that produce acetylcholine, the chemical messenger that tells sweat glands to produce.
Dr Sheraz says they can be ‘very effective’ if patients can tolerate their side effects, which include a dry mouth, dry eyes and difficulty passing urine.
One such drug, propantheline, is licensed for hyperhidrosis and some NHS bodies say GPs can prescribe it if other treatments like antiperspirants have failed.
But Dr Eggitt warns they may have significant longer-term effects. ‘Because they switch off nerve signalling across the body, not just to sweat glands, it’s thought they can damage signalling pathways in the brain,’ he points out. ‘They create mental fogginess and, if taken for prolonged periods, can increase the risk of dementia.’
Away from medication, some patients opt to have anti-wrinkle injection Botox. It contains a toxin, called botulinum, that paralyses the nerves – as well as the muscles – so they cannot send signals to the sweat glands.
But this is rarely available on the NHS, unless a GP feels a case can be made for special funding. Private clinics charge up to £1,000 to treat both under-arms. As it only lasts four to six months it will have to be regularly repeated, making it an expensive option.
One cheaper treatment, which can be done at home, is iontophoresis. This involves passing an electric current through the hands or feet when they are placed on a special pad in a tray of water.
The exact mechanisms aren’t fully understood, but it’s thought the mild current may interfere with the signals between the nerves and the sweat glands. Some clinics offer iontophoresis at around £100 a session, but the machines can also be bought online for around £450 or rented for six months for £250.
Three sessions a week, lasting 20-30 minutes, are initially recommended, followed by maintenance sessions once or twice a week. Microwave energy can also be harnessed to permanently stop underarm sweating, using a hand-held device applied to the affected area called miraDry. Again, this is not available on the NHS and costs up to £2,000 in clinics for a first session – if another is needed, this can cost a further £1,000.
‘The idea is essentially that it destroys the sweat glands, which is quite painful,’ says Dr Sheraz. ‘It isn’t very commonly used and, while the studies generally seem to show that it works, the effect will be localised to the area.’
As a last resort, surgery is available on the NHS. Known as endoscopic thoracic sympathectomy, it involves severing or clamping the sympathetic nerves in the chest cavity, which permanently interrupts the signals to sweat glands in the underarms, face and hands.
The surgery is minimally invasive, and involves inserting instruments through tiny incisions in the armpit. Fewer than 100 such surgeries are carried out on the NHS every year and Dr Eggitt says it is generally only offered to people who start to develop cysts under their arms from the bacterial build up.
It comes with significant risks. There are many important nerves and veins supplying the upper body in the armpits, and damage can lead to movement problems.
Dr Sheraz adds: ‘The main side effect I’ve seen is compensatory sweating. That’s people whose hand or under-arm sweats might have been cured by the operation, but now they sweat through their buttocks and they’re leaving wet patches wherever they sit.’
Ultimately, it’s a case of trial and error to see what works. And while the condition can be unpleasant, Alan Carr is proof that it doesn’t need to hold you back.
Despite the comedian believing that his tendency to sweat could ruin his chances of winning the BBC show, it appears this was unfounded – and the rest of the cast were left none the wiser.
For more information, the British Association of Dermatologists has a factsheet at bad.org.uk/pils/hyperhidrosis.
I WAKE UP DRENCHED EVERY DAY …DOCTORS CAN’T TELL ME WHY
Every morning, Kayy Mackenzie wakes up so drenched in sweat she has to change her bedclothes.
‘I wake up and it’s like I’ve just stepped out of the shower,’ says the 31-year-old musical theatre performer.
‘All of me is wet. My bedding is wet. Even my hair will be dripping – that’s how bad it is.’
Kayy, from Epsom, Surrey, was six when she started sweating through her clothes while playing with friends.
Every morning, Kayy Mackenzie, 31, wakes up so drenched in sweat she has to change her bedclothes
Understandably, it left her hugely self-conscious, particularly as she hit her teens, but a GP told her it was ‘normal for her age’ and routine blood tests to check for other conditions, such as an overactive thyroid or diabetes, ruled out another medical problem.
Although a GP prescribed an antiperspirant, it ‘didn’t really do anything’ and when she brought up the issue again at an appointment last year, she was told it was ‘probably’ linked to the antidepressant medication she is taking, despite the problem starting long before she began taking them.
‘I don’t know what else to do – I just live with it day-to-day and try to cope as best I can,’ she says.
‘I have to carry tissues wherever I go in my handbag so I can dab under my arms and I don’t wear anything with sleeves, even when it’s cold. It gets very frustrating and upsetting.’