Sweating

Sweat is secreted by 2 to 3 million sweat glands in the skin, unevenly distributed across the body, with the highest concentration on the palms, soles, underarms, and around the genitals.

Sweat is a colorless liquid, mostly water, containing substances unnecessary or harmful to the body, produced during metabolism: urea, acetic acid, ammonia, and fatty acids.

The salty taste of sweat comes from sodium chloride (table salt). Diet affects sweat composition; excessive salty food increases salt content in sweat.

The odor of sweat varies by body area. The distinct smell under the arms and around the genitals comes partly from specialized scent glands and partly from the unique composition of sweat. Pigment-producing bacteria or small amounts of blood can color sweat. In the past, red sweat was attributed supernatural significance.

The primary function of sweat is regulating body temperature. Sweat evaporates easily, making normal sweating barely noticeable. Evaporation cools the body when it has excess heat or is exposed to high external temperatures.

On hot days, sweating increases, reaching up to two liters per hour. Heavy physical exertion generates significant body heat, intensifying sweating.

Everyone sweats, some more than others. Obese people sweat more than thin people, adults more than children, and the elderly less than middle-aged individuals. Sweating is minimal in cold weather but common in hot summer conditions. Some sweat while eating, others when excited, some only during sleep, and it may affect the whole body or specific areas.

Sweating is involuntary. Sweat glands are controlled by specific nerves in the autonomic nervous system, operating independently of conscious control.

The main control center for this involuntary nervous system is in the hypothalamus, a brain region that regulates the intensity of sweating and whether it occurs across the body or in specific areas. If these nerves function normally, the amount of sweat produced matches the need to maintain body temperature.

This means just enough sweat is produced to evaporate immediately. Excessive sweat dripping in droplets is inefficient, leading to unnecessary fluid loss, as it does not evaporate or cool effectively.

Excessive sweating of the entire body is normal during fever, intense physical activity, or high environmental temperatures, when excess heat must be removed through increased sweat evaporation.

Prolonged excessive sweating can cause serious bodily imbalances. It may also occur on a “nervous basis,” often in women during menopause, where night sweating is a sign of disrupted nervous balance.

Excessive sweating can accompany sudden, intense emotional states like fear or anxiety, typically limited to the hands, feet, or underarms.

Severe pain, especially in episodes, is often accompanied by excessive sweating, commonly seen in attacks caused by kidney stones, urinary tract issues, or gallstones. Sweating ceases when pain subsides.

Excessive sweating accompanies severe, acute heart conditions, such as cold sweat during heart attacks or angina pectoris. It also occurs in many infectious diseases with high fever, like rheumatic fever, malaria, influenza, or sepsis. It can appear in chronic conditions like tuberculosis.

Excessive sweating accompanies life-threatening states. “Cold sweat” typically occurs after significant blood loss or in shock. Cold sweat is not related to temperature regulation and occurs when the body is suddenly in a critical, dangerous situation.

Excessive sweating of the palms and soles is most common and bothersome, prompting many to seek medical help. Most people adapt to their sweat and odor, which they no longer notice but others do.

Sweat glands on the palms and soles do not regulate body temperature but compensate for the absence of sebaceous glands, which lubricate skin elsewhere to keep it soft.

The skin on palms and soles must stay moist to grip smooth surfaces effectively. Dry hands make many tasks difficult or impossible, hence why workers spit on their hands when using shovels or picks. Sweat on palms and soles has more fatty acids than elsewhere.

The unpleasant odor of sweaty feet comes from the breakdown of these fatty acids. Excessive sweating on the soles, combined with sweat decomposition, damages the skin, causing redness, erosion, or sores. Bacteria and fungi easily proliferate on such altered skin.

Such changes are less noticeable on hands because sweat is constantly removed through work, wiping, or frequent washing, preventing decomposition.

Excessive sweating of palms and soles often occurs on a “nervous basis.” It is considered excessive only if it occurs independently of weather, physical effort, or clothing type.

Sensitive individuals may experience sweating episodes during complete rest, with sweat dripping from their hands and feet. This indicates a disrupted balance in the autonomic nervous system, a condition called neurovegetative dystonia, where excessive sweating is one symptom.

Treating excessive sweating is often challenging and prolonged. Excessive foot sweating is the biggest issue. Affected individuals must wash their feet multiple times daily, massage them with alcohol, and powder them, especially between the toes. Alternating hot and cold foot baths (three minutes in hot water, one minute in cold, repeated several times) followed by thorough drying strengthens nerves.

Such individuals should wear wool or cotton socks to allow ventilation and absorb sweat, unlike synthetic socks. Socks should be changed multiple times daily. Feet, socks, and shoes should be powdered with products containing boric acid as a mild disinfectant.