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How Compensatory Sweating works:

The current train of thought is that our own inbuilt thermometer is faulty. This is called the Hypothalamus and it’s tucked away in the brain. This is what causes us to overheat. When the body’s temperature rises by 4 degrees C, we become disorientated and confused. By the time we reach 7 degrees C, we’d be dead. Because the body is such an amazing feat of natural engineering, we have an inbuilt sprinkler system to prevent us from overheating and to keep us alive. This is where the sweating comes from. When you block off any area of sweating, that’s all you’re doing. You’re not cooling yourself down. As you’re still hot, you’ll still be sweating until you cool down, it’s just that the sweat will appear in other areas and it’ll take longer to cool down as your sweating is limited. Blocking sweat is not the best way of dealing with it, although we all need to block in the odd area or two – ie underarms etc. It’s always a far better idea to soak up and disguise sweat than to block it.

CS as a result of ETS and Generalised Hyperhidrosis:

The main places ETS people suffer is down their back, torso, groin and legs. I would suggest products like laulas undershirts and polo shirts, www.sweat-help.com and Wrapps www.coolwrapps.com. Both of these products will deal with soaking up sweat by clever use of fabrics. I use both products and they certainly make life easier for me. Wrapps are also increasingly used by sportsmen and women, musicians etc as well as HH sufferers.

Please feel free to visit the site and dive into the forum conversations – or even just keep an eye out for competitions (we get to give away lots of free products) and hints and tips on disguising and dealing with your sweating.

 AWARENESS on our disease.

When you see a Doctor or specialist most do not know the impact this has on us on the daily basics. They fob us off with yet another aluminum chloride treatment which burns your skin, sometimes leaving it so sore and takes weeks to heal.

Some of us have to educate the Doctor about Hyperhidrosis as they look at you blankly!!! I honestly don’t think much has changed in the last 5-10 years!   I am in a constant argument with my  Doctors for Botox as this is the only treatment that does give me relief.   I dry out to much on oral medications and feel worse being on them.

Do you think we will ever get the awareness on this???   We see the clinical strength out on the market and I have read them all, only one says you may have Hyperhidrosis!!!! One out of lots!!!  Adverts never tell you about it or commercials, the woman whom show there pits dry and arms up have never suffered from a days sweat or constantly worrying about it.

Who is ready to write a day in a life of a sufferer? I am and I will post them on the front page of our website for all to see. It is about time. Does not have to be long, just how it really is.

If you are interested then PM me, or drop Beverly a line betty@verysweatybetty.com please put in topic line, GUEST BLOG A DAY IN A LIFE OF A SUFFERER.  Or what you would like to be changed for the better of us, any ideas or suggestions will not be ignored.

We are the ones who can only help make the change, tell your Doctors and Medical staff how it really is, ask them to try the awful treatments they give us….

LOTS OF LITTLE VOICES CAN MAKE ONE BIG ONE XXXXX

By our very own Denise, Following her, Help Wanted….
For the Record,

If any of you have read my last post, and thought I might be implying that Hyperhidrosis does not compare to scleroderma and we have no right to complain, that was not what I was trying to say, not at all.

My point is that Michele Mayer was a highly educated woman, her husband is in fact a physician, Moreover Michele was highly respected in the medical community, could speak the lingo, knew what she had and it still took 6 years to get a proper diagnosis. In that 6 years she was aware of what medications, procedures and protocols were available to treat the early stages of her disease.

Yet, because of her inability to get a proper diagnosis, all of these avenues were closed to her. We will never know if she could still be alive today, had she been diagnosed in a timely matter. Moreover, Michele had done her research and frequently went head to head with the doctors, who repeatedly tried to prescribe outdated medications, that had been shown to be wholly ineffective, while fighting her requests for another. Albeit, the truth is there is very little to help people suffering with Scleroderma. As her skin turned into a shell like structure, her vital and unseen organs were doing the same. This disease is a killer, very little is known how to treat it, and it is a death sentence. It may be 3 years it may be 5 years, but with the passing of each year, reduced mobility is a given as ones internal organs turn to stone.

Yet, Michele worked on her own memorial, did what she could with her children, and wrote about her life, her doctors, her friends, family, as the disease slowly turned every breath into a struggle. She had to fight the medical community every step of the way, as the disease continued to turn her internal organs into stone.

How do we proceed?   Does any of us hold a Doctorate in Public Health? How do we proceed to get the attention of the medical community? How do we proceed? I continue to write letters, and be ignored.   I sent a letter to a doctor here in town, he is mentioned in one of Suzanne Somers books as a surgeon who turned away from surgeries for excessive sweating to a more natural remedy. NOTHING, no response.

What should we do to be heard?

Help us fight to be heard, fight with us to be treated for our medical disease/disorder.  We deserve this.  Write you story on living with Hyperhidrosis, we are still in the, Dark Ages and will continue to be if we don’t stand our ground and help raise awareness.  You can send your story to Anne, Beverly, Denise, kimberly in our friendly forum, we can keep it all confidential but our little voices, can make one BIG ONE.  So please help.

Denise

If you have problems with groin sweating, please visit Denise’s website www.coolwrapps.com

Hello all,

I have been asking for members help to try and get the awareness out for all to see and to encourage a guest blog on a day in their lives or a certain story you can share with us that shows what it is like.

I came up with the perfect title and many have agreed with me that it is perfect…how much has treatment really changed in the last 10 years?!  Not much.  ETS is less and being banned in certain countries around the world. 

I would love to feature your story and let people see how we suffer from this awful affliction.

Think about it and get writing

Our first guest blog is our very own Denise, she is such a talented lady and an amazing friend.  Denise also invented the Wrapps,  www.coolwrapps.com which have saved many of us from embarrassing situations.   Denise is a very talented writer also, enjoy.

The Dark Ages, Living with Hyperhidrosis

For many of us, we have discovered that most health care providers are wholly unable to understand what it is to be the patient. Largely because, they are the Doctor and have spent years of their lives learning about body parts. Sadly, that is reflected in treatment of the current ailment, sprained ankle, migrain headache, or broken bone that necessitated your visit. You are simply a body part, to be attended to. The whole person insignificant. This is the American way; to treat pregnancy as a disease; while we have managed to turn our birth rate into one that rivals any third world nation in the world. How did things come to be this way? Moreover, is there anything we do to change it? It will be an uphill battle, but having lived for as long as you have with Hyperhidrosis, can you think of any better training?

A while back, Dr. Oz did another segment on hh. The advise to those of us suffering from HH was simple: “wear a little extra deoderant and don’t worry about it.”   Though I had sent Dr. Oz an email on a previous occasion, this was too much. I wrote  Dr. Oz a letter asking him to please refrain from doing any more segments on HH.   I asked Dr. Oz how many times in a day did he advise the application of deoderant on the scalp, back, back of the knees, etc.   Explained to Dr. Oz that I understood he did not believe in HH.

I had a doctor (here where I live,) who did not believe in depression, and refused to write me a prescription for antidepressants.   I understand Dr. Oz does not believe in HH, this other doctor did not believe in depression. But it is still hurtful to those of us who suffered from either, or both.   So please stop doing segments on HH, it is only hurting us as you do not have a clue.

I sent the letter to his TV show, in New York, and it was returned to me, unopened, with a big black question mark by my name on the return address.   I immediately looked up his work adress, and enclosed an other note on top of the unopened, returned letter about how he really knew how to make his viewers feel important, and put it back in the mail. No, I have not heard from him. I do not expect to. He is an important man, a Doctor, for crying out loud.   He does not have time to listen to his viewers, he has to do a surgery, a show. He is a busy man, much to busy to learn that he does not know what he is talking about.   Why should he listen to his viewers or patients? We did not go to medical school, he did. And that appears to be the prevailing attitude of most doctors, the M.D. stands for Major Diety. It does not, and I am so tired of this attitude. The medical community can not even decide if drinking coffee is good or bad for us, for crying out loud. Why do doctors have the right to decide which disease they believe in, or treat? Why? This I do not know.   I do know, that it is difficult to find a decent doctor, one that will listen. And if it takes raising our voices to be heard, or voting with our feet, each of us must decide which course of action to take.

Denise

Denise, we feel your pain and know how frustrating this is, how about you get in touch with my good friend Dr Danial Carrasco.  He was the only one who fully knew about living with HH, his brother suffers from this disease and he was patient and understanding.  He also trains other Doctors about Hyperhidrosis.  I doubt I will ever find another Dr so understanding again.

Dr Carrasco is our Doctor on board, if you have private questions to ask him in regards to your Hyperhidrosis PM myself, Anne, Beverly, Denise or Kimberly and we will make sure he gets your questions.
The Dark Ages is open for all comments and if you want to feature your guest blog, please let me know on the forum or our Sweaty Betty FaceBook page and we can make this happen.

Lots of little voices can make one huge voice, lets get heard and lets make a difference.

Becoming Comfortable Enough to Talk About My Hyperhidrosis
By Maria Thomas Mickiewicz

FORUM LINK

Validation was the catalyst for me to start being more open with people about my condition. While my closest friends and family members already know about it, to be able to share my life with others on a larger scale like this occurred after I attended a medical event on hyperhidrosis back in April and received my Botox treatment. Like I mentioned, that entire day was complete validation for me. I didn’t feel any shame about my sweating, nor was I embarrassed or uncomfortable about standing there doing exactly what I was supposed to be doing: dripping. (I’ve since thought about referring to this as my super power. Look at me! I can make my own rain drops!) For the first time in my life, I felt like I had met my tribe. It was pure, unadulterated validation on the part of the all my fellow Hyperhidrosis sufferers and the physicians who administered the Botox. I conquered my fear of the needle injections, spoke openly with another attendee about how Hyperhidrosis affected me, and was allowed to bask in my personal sweating glory for the entire day. I was actually flattered when the physician who treated me said I definitely had THE BEST case of palmar hyperhidrosis he’d seen all day. In that room, with those people, one day my soul just opened up.

It’s hard to put into words exactly how I felt as I left that day. I felt like I could conquer the world, like there was hope for me, like I could finally stop living behind a curtain of daily activities avoided or somehow altered in an attempt to mask my sweating. I dared to believe that something inside me was superior to circumstance. Maya Angelou says, “Beauty and strength can be found in adversity.” But in order to find it, you must go through it. Yes, grace can be found amidst the pain and suffering, amidst the physical manifestation of the sweat and the emotional turmoil we experience because we were made to be a little more wet than most. Maya Angelou also says, “We are more alike than we are unalike.” I think as a sweater, I am better able to relate to people and be more conscientious of how I treat them and what I might say to them. In a strange way, this sweating problem I have makes me more of who I was created to be. For the most part, yes, it’s physically, mentally, emotionally, socially, and professionally debilitating, but it is who I am. Everyone has a story, and this is mine. Because I am who I am, I feel that I can better understand others and relate to adversities they might be experiencing and bridge the gap to validate them and their experiences. Everyone has situations in which they might feel debilitated in the ways I’ve mentioned above. As much as I hate having HH, I also wonder what I’d be like without it. And don’t get me wrong. I am still actively pursuing different treatments to treat my condition, but it is not the be-all and end-all for me if nothing ends up working.

As a result of my experience at the Hyperhidrosis event, I have launched this blog to raise awareness and now several writing opportunities have come my way. I am moving forward and embracing them even if they might take me out of my comfort zone. And people with HH definitely have a comfort zone in place! I’m doing some freelance writing for my church as well as an organization called Time Out for Women, I’ve been selected to be a book reviewer and will have my own book blog on Book Trib, and I have the absolute honor of writing an article and guest blogs for various Hyperhidrosis websites and newsletters, all on a voluntary basis. I have aligned myself with my intention, and that is authentic power.

If you have Hyperhidrosis, or know someone who does, embrace it. Yes, it affects our lives in ways we don’t like, but if we can live freely with it and realize there are treatment options and hope, we can create positive change. So be ready for a revolution. Your revolution.

1. From the book One Day My Soul Just Opened Up by Iyanla Vanzant

Maria Thomas Mickiewicz’s weblog is growing fast and well worth a visit. You can find it by clicking HERE

We think you’re an inspiration Maria, never mind Maya Angelou! She’s one of Anne’s and my favourite authors and her quotes are some of the wisest and most wonderful I’ve ever heard.

Everyone related to VSB are also volunteers, including myself and Anne and you’re so right, it does help you feel validation, as though you’re kicking the butt of this miserable disease and making other people feel happier through sharing your sweat and tears.

We thank you enormously for your fabulous guest blog and we would be honoured to host your work any time!

Beverly and Anne x

Session Two is in full swing, sign up to take part in this HH discussion.  This could be so important to how the Medical world sees how HH effects us on a daily basics.

Hello all,

There is currently a discussion going on about how Hyperhidrosis affects our everyday lives.  WE are shouting out for participants to help take part in this.  The more they are aware of how it affects us the better in the long term treatment will be and Doctors understanding about this awful affliction and skin disease.

Everything is confidential, all is text typed, you will take part with others who suffer from HH.  All the data is saved and used this will help us get one step closer to having awareness and people understanding how it is to live with this.

PLEASE HELP TOWARDS ANOTHER GOOD CAUSE.  REMEMBER OUR LITTLE VOICES CAN MAKE ONE BIG ONE!

A Novel Measure of Quality of Life in Hyperhidrosis Patients

Intro

The Welsh School of Pharmacy is developing a new patient centred instrument (measure/index) for evaluating the quality of life of HH patients.
Our goal is to create a user friendly measure that could act as a two way communication tool useful to HH patients as well physicians, enhancing the physician-patient communication in HH. On one hand the tool will allow patients to understand their condition better. On the other hand, the new measure will enable physicians to more accurately understand how their HH patients really feel and how their condition is affecting their lives.
In order to develop a tool of the highest usefulness, HH patients will be involved throughout the development process of the new measure.
As a first step in the process, a group discussion on “how HH affects the everyday life (everyday activities) and the quality of life (i.e. social life, emotional life, satisfaction) of HH patients” has been planned. We are interested in learning how the various dimensions of the participants’ lives are affected by HH.
The discussions will be convened online (text based), via a secure platform. We intend to run three sessions, each taking a period of 7 to 10 days, with different participants. Each participant will take part in one session.

Your role as a participant

Once you confirm to be a participant you will receive a link, a username and a password to ensure your secure access to the platform. Only the moderator will know your real name, to ensure anonymity in the discussions.
Your role, as a participant, will be to take time everyday, during a session, to read the posts made by the moderator (Paul Kamudoni) and the responses of other participants and to give your responses.
Everyone with HH is invited to participate! Drop me an email on KamudoniP@cardiff.ac.uk.

URL: http://everydaysweating.blogspot.com/2011/04/patient-group-discussion-on-daily-life.html

Paul Kamudoni
(Lead – Hyperhidrosis Quality of Life Research Team, CSER Welsh School of Pharmacy)

I’ve just come across this article and it made me think – it’s all very well but what if you suffer with Hyperhidrosis?  From what I can make out, we’d be better off just rinsing off the sweat occasionally.  I don’t think I could give up soap or showers to the extent I would only use it once or twice a week but I might rethink my use of soap for my night-time shower as I regularly shower up to three times a day.

Hygiene of the Skin: When Is Clean Too Clean?

Elaine LarsonColumbia University School of Nursing, New York, New York, USA

Skin hygiene, particularly of the hands, is a primary mechanism for reducing contact and fecal-oral transmission of infectious agents. Widespread use of antimicrobial products has prompted concern about emergence of resistance to antiseptics and damage to the skin barrier associated with frequent washing. This article reviews evidence for the relationship between skin hygiene and infection, the effects of washing on skin integrity, and recommendations for skin care practices.For over a century, skin hygiene, particularly of the hands, has been accepted as a primary mechanism to control the spread of infectious agents. Although the causal link between contaminated hands and infectious disease transmission is one of the best-documented phenomena in clinical science, several factors have recently prompted a reassessment of skin hygiene and its effective practice.

In industrialized countries, exposure to potential infectious risks has increased because of changing sociologic patterns (e.g., more frequent consumption of commercially prepared food and expanded child-care services). Environmental sanitation and public health services, despite room for improvement, are generally good. In addition, choices of hygienic skin care products have never been more numerous, and the public has increasing access to health- and product-related information. This paper reviews evidence for the relationship between skin hygiene and infection, the effects of washing on skin integrity, and recommendations for skin care practices for the public and health-care professionals.

Does Skin Cleansing Reduce Risk for Infection?
Personal Bathing and Washing

There is a clear temporal relationship between improvement in general levels of cleanliness in society and improved health. Greene used historical and cross-cultural evidence and causal inference to associate personal hygiene with better health. However, the role of personal cleanliness in the control of infectious diseases over the past century is difficult to measure, since other factors have changed at the same time (e.g., improved public services, waste disposal, water supply, commercial food handling, and nutrition).

Studies of personal and domestic hygiene and its relationship to diarrhea in developing countries demonstrate the effectiveness of proper waste disposal, general sanitary conditions, and handwashing. However, aside from hand cleansing, specific evidence is lacking to link bathing or general skin cleansing with preventing infections. Part of the difficulty in demonstrating a causal association between general bathing or skin care and gastrointestinal infection is that interventions to reduce diarrheal disease have been multifaceted, often including health education, improved waste disposal, decontaminating the water supply, and general improvement in household sanitation as well as personal hygiene. Risk for diarrheal disease has also been linked to the level of parental education. Multiple influences complicate definition of the impact of any single intervention.

In 11 studies reviewed by Keswick et al, use of antimicrobial soaps was associated with substantial reductions in rates of superficial cutaneous infections. Another 15 experimental studies demonstrated a reduction in bacteria on the skin with use of antimicrobial soaps, but none assessed rates of infection as an outcome.

Extensive studies of showering and bathing conducted since the 1960s demonstrated that these activities increase dispersal of skin bacteria into the air and ambient environment, probably through breaking up and spreading of microcolonies on the skin surface and resultant contamination of surrounding squamous cells. These studies prompted a change in practice among surgical personnel, who are now generally discouraged from showering immediately before entering the operating room. Other investigators have shown that the skin microflora varies between persons but is remarkably consistent for each person over time. Even without bathing for many days, the flora remain qualitatively and quantitatively stable.
For surgical or other high-risk patients, showering with antiseptic agents has been tested for its effect on postoperative wound infection rates.

Such agents, unlike plain soaps, reduce microbial counts on the skin. In some studies, antiseptic preoperative showers or baths have been associated with reduced postoperative infection rates, but in others, no differences were observed. Whole-body washing with chlorhexidine-containing detergent has been shown to reduce infections among neonates, but concerns about absorption and safety preclude this as a routine practice. Several studies have demonstrated substantial reductions in rates of acquisition of methicillin-resistant Staphylococcus aureus in surgical patients bathed with a triclosan-containing product. Hence, preoperative showering or bathing with an antiseptic may be justifiable in selected patient populations.

Hand Hygiene for the General Public

Much contemporary evidence for a causal link between handwashing and risk for infection in community settings comes from industrialized countries. Although many of these studies may be limited by confounding by other variables, evidence of an important role for handwashing in preventing infections is among the strongest available for any factor studied. Reviews of studies linking handwashing and reduced risk for infection have been recently published. The most convincing evidence of the benefits of handwashing for the general public is for prevention of infectious agents found transiently on hands or spread by the fecal-oral route or from the respiratory tract. Plain soaps are considered adequate for this purpose.

Several highly publicized, serious outbreaks from commercially prepared foods have raised questions about food safety and the hygienic practices of food handlers and others in the service professions. Despite public awareness, however, handwashing generally does not meet recommended standards–members of the public wash too infrequently and for short periods of time.

These factors have led to suggestions that antimicrobial products should be more universally used, and a myriad of antimicrobial soaps and skin care products have become commercially available. While antimicrobial drug-containing products are superior to plain soaps for reducing both transient pathogens and colonizing flora, widespread use of these agents has raised concerns about the emergence of bacterial strains resistant to antiseptic ingredients such as triclosan. Such resistance has been noted in England and Japan, and molecular mechanisms for the development of resistance have been proposed. Although in some settings exposure to antiseptics has occurred for years without the appearance of resistance, a recent study described mutants of Escherichia coli selected for resistance to one disinfectant that were also multiply-antibiotic resistant. Some evidence indicates that long-term use of topical antimicrobial agents may alter skin flora. The question remains whether antimicrobial soaps provide sufficient benefit in reducing transmission of infection without added risk or cost.

Hand Hygiene in Health-Care Settings

Issues regarding hand hygiene practices among health-care professionals have been widely discussed and may be even more complicated than those in the general public. Unless patient care involves invasive procedures or extensive contact with blood and body fluids, current guidelines recommend plain soap for handwashing; however, infection rates in adult or neonatal intensive care units or surgery may be further reduced when antiseptic products are used.

Skin Barrier Properties and Effect of Hand Hygiene Practices

The average adult has a skin area of about 1.75 m2. The superficial part of the skin, the epidermis, has five layers. The stratum corneum, the outermost layer, is composed of flattened dead cells (corneocytes or squames) attached to each other to form a tough, horny layer of keratin mixed with several lipids, which help maintain the hydration, pliability, and barrier effectiveness of the skin. This horny layer has been compared to a wall of bricks (corneocytes) and mortar (lipids) and serves as the primary protective barrier. Approximately 15 layers make up the stratum corneum, which is completely replaced every 2 weeks; a new layer is formed approximately daily. From healthy skin, approximately 107 particles are disseminated into the air each day, and 10% of these skin squames contain viable bacteria. The dispersal of organisms is greater in males than in females and varies between persons using the same hygienic regimen by as much as fivefold.

Water content, humidity, pH, intracellular lipids, and rates of shedding help retain the protective barrier properties of the skin. When the barrier is compromised (e.g., by hand hygiene practices such as scrubbing), skin dryness, irritation, cracking, and other problems may result. Although the palmar surface of the hand has twice as many cell layers and the cells are >30 times thicker than on the rest of the skin, palms are quite permeable to water.

Long-term changes in skin pH associated with handwashing may pose a concern since some of the antibacterial characteristics of skin are associated with its normally acidic pH. In one report, pH increased 0.6 to 1.8 units after handwashing with plain soap for 1 to 2 min and then gradually declined to baseline levels over a period of 45 min to 2 hr. Some soaps can be associated with long-standing changes in skin pH, reduction in fatty acids, and subsequent changes in resident flora such as propionibacter.

In an investigation of the effect on skin of repeated use of two washing agents, all skin function tests (stratum corneum capacitative resistance, lipids, transepidermal water loss, pH, laser Doppler flow, and skin reddening) were markedly changed after a single wash, and after 1 week further damage was noted. In a study of irritant skin reactions induced by three surfactants, damage lasted for several days; complete skin repair was not achieved for 17 days.

Soaps and detergents have been described as the most damaging of all substances routinely applied to skin. Anionic and cationic detergents are more harmful than nonionic detergents, and increased concentrations of surfactant result in more rapid, severe damage. Each time the skin is washed, it undergoes profound changes, most of them transient. However, among persons in occupations such as health care in which frequent handwashing is required, long-term changes in the skin can result in chronic damage, irritant contact dermatitis and eczema, and concomitant changes in flora.

Irritant contact dermatitis, which is associated with frequent handwashing, is an occupational risks for health-care professionals, with a prevalence of 10% to 45%. The prevalence of damaged skin on the hands of 410 nurses was reported to be 25.9% in one survey, with 85.6% of nurses reported to have problems at some time. Skin damage was correlated with frequency of glove use and handwashing. Washing with plain soap may actually increase the potential for microbial transmission because of a 17-fold increase in the dispersal of bacterial colonies from the skin of the hands. Skin condition clearly plays a major role in risk for transmission.

Microbiology of Hands of Health-Care Professionals

Damaged skin more often harbors increased numbers of pathogens. Moreover, washing damaged skin is less effective at reducing numbers of bacteria than washing normal skin, and numbers of organisms shed from damaged skin are often higher than from healthy skin. The microbial flora on the clean hands of nurses (samples taken immediately after handwashing) have been reported in several recent studies. Methicillin resistance among coagulase-negative staphylococcal flora on hands did not seem to increase during the 1980s to the 1990s, and tetracycline resistance decreased.

Even with use of antiseptic preparations, which substantially reduce counts of hand flora, no reductions beyond an equilibrium level are attained. The numbers of organisms spread from the hands of nurses who washed frequently with an antimicrobial soap actually increased after a period of time; this increase is associated with declining skin health. In a recent survey, nurses with damaged hands were twice as likely to be colonized with S. hominis, S. aureus, gram-negative bacteria, enterococci, and Candida spp. and had a greater number of species colonizing the hands.

The trend in both the general public and among health-care professionals toward more frequent washing with detergents, soaps, and antimicrobial ingredients needs careful reassessment in light of the damage done to skin and resultant increased risk for harboring and transmitting infectious agents. More washing and scrubbing are unlikely to be better and may, in fact, be worse. The goal should be to identify skin hygiene practices that provide adequate protection from transmission of infecting agents while minimizing the risk for changing the ecology and health of the skin and increasing resistance in the skin flora.

Recommendations for the General Public

Bathing or showering cleans the skin by mechanical removal of bacteria shed on corneocytes. Bacterial counts are at least as high or higher after bathing or showering with a regular soap than before. Frequent bathing has aesthetic and stress-relieving benefits but serves little microbiologic purpose. Mild, nonantimicrobial soap should suffice for routine bathing. Bathing with an antimicrobial product reduces rates of cutaneous infection and could be beneficial when skin infections are likely or before certain surgical procedures. With those exceptions, available data do not support a recommendation for bathing with antimicrobial products.

No single recommendation for hand hygiene practices in the general population would be adequate. The potential advantage of sustained antimicrobial activity for certain occupations (e.g., food handlers and child-care providers) must be balanced with the theoretical possibility of emergence of resistant strains and perhaps other, as yet unrecognized, safety issues.

An alternative to detergent-based antiseptic products is the use of alcohol hand rinses, which have recently become widely available over the counter. Their advantages include rapid and broad-spectrum activity, excellent microbicidal characteristics, and lack of potential for emergence of resistance. Alcohol-based products could be recommended for use among persons who need immediate protection after touching contaminated surfaces or before and after contact with someone at high risk for infection.

Since hands are a primary mode of fecal-oral and respiratory transmission, specific indications for use of antiseptic hand products by the general public are close physical contact with persons at high risk for infection (e.g., neonates, the very old, or immunosuppressed); close physical contact with infected persons; infection with an organism likely to be transmitted by direct contact (diarrhea, upper respiratory infection, skin infections); or work in a setting in which infectious disease transmission is likely (food preparation, crowded living quarters such as chronic-care residences, prisons, child-care centers, and preschools).

Recommendations for the Health-Care Professional
Detergent-Based Antiseptics or Alcohol

Because of increasingly vulnerable patient populations, the demand for hand hygiene among health-care professionals has never been greater. However, frequent handwashing is not only potentially damaging to skin, it is also time-consuming and expensive. Finnish investigators demonstrated that after frequent washing the hands of patient-care providers became damaged and posed greater risk to themselves and patients than if they had washed less often. A mild emulsion cleansing rather than handwashing with liquid soap was associated with a substantial improvement in the skin of nurses’ hands. Alcohol-based formulations are superior to antiseptic detergents for rapid microbial killing on skin and, with the addition of appropriate moisturizers, are probably milder. Since alcohols are rapid acting, are broad spectrum, and require no washing or drying, damage caused by detergents and mechanical friction from toweling is avoided.

Use of Lotions and Moisturizers

Moisturizing is beneficial for skin health and reducing microbial dispersion from skin, regardless of whether the product used contains an antibacterial ingredient. Because of differences in the content and formulations of lotions and creams, products vary greatly in their effectiveness. Lotions used with products containing chlorhexidine gluconate must be carefully selected to avoid neutralization by anionic surfactants. The role of emollients and moisturizers in improving skin health and reducing microbial spread is an area for additional research.

To improve the skin condition of health-care professionals and reduce their chances of harboring and shedding microorganisms from the skin, the following measures are recommended: 1) For damaged skin, mild, nonantimicrobial skin cleansing products may be used to remove dirt and debris. If antimicrobial action is needed (e.g., before invasive procedures or handling of highly susceptible patients) a waterless, alcohol-based product may be used. 2) In clinical areas such as the operating room and neonatal and transplant units, shorter, less traumatic washing regimens may be used instead of lengthy scrub protocols with brushes or other harsh mechanical action. 3) Effective skin emollients or barrier creams may be used in skin-care regimens and procedures for staff (and possibly patients as well). 4) Skin moisturizing products should be carefully assessed for compatibility with any topical antimicrobial products being used and for physiologic effects on the skin.

Conclusions

From the public health perspective, more frequent use of current hygiene practices may not necessarily be better (i.e., perhaps sometimes clean is “too clean”), and the same recommendations cannot be applied to all users or situations. Future investigation is likely to improve understanding of the interaction between skin physiology, microbiology, and ecology and the role of the skin in the transmission of infectious diseases.

Dr. Larson is professor of pharmaceutical and therapeutic research, The School of Nursing, and professor of epidemiology, Mailman School of Public Health, Columbia University. She is editor of the American Journal of Infection Control and former chair of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and member of CDC’s National Center for Infectious Diseases Board of Scientific Counselors.
Address for correspondence: Elaine Larson, Columbia University School of Nursing, 630 W. 168th St., New York, NY 10032, USA; fax: 212-305-0722; e-mail: ell23@columbia.edu
_____________________________________________________

http://www.cdc.gov/ncidod/eid/vol7no2/larson.htm

This could be excellent news for people within the catchment area, I do hope Nicola Roxon comes through for you guys!

BOTOX could be added to the Pharmaceutical Benefits Scheme to help people with excessively sweaty underarms and palms.

Health Minister Nicola Roxon confirmed she was considering subsidising Botox, a move dermatologists fear could result in rogue doctors exploiting the system to treat patients for cosmetic purposes.

The most common use for Botox, or botulinum toxin type A, is to minimise wrinkles and lines by paralysing muscles in the face.

The drug is already listed on the PBS for the treatment of severe spasms and spasticity in elderly patients or for certain medical conditions.

Ms Roxon said her Government had deferred a decision to list Botox, alongside five other medications.

A spokesman for Ms Roxon said the listing was deferred due to “difficult fiscal circumstances” but would be reconsidered when the financial situation allowed.

David Francis from the Australasian College of Dermatologists agreed the PBS listing should be extended to cover patients with excessive sweating, or hyperhidrosis.

“This is a debilitating condition, you-can’t-go-out-of-the-house type suffering,” Dr Francis said.

He said patients struggled with the cost of Botox at $500 or more an ampoule, requiring one ampoule per treatment every six to 12 months.

The only other option for patients is to have an operation to sever a nerve in the neck that causes the sweating, although this carries the risks of any surgical procedure.

Dr Francis admitted there was room for exploitation. “There may be the unscrupulous people who may say they’re treating underarms and using the rest on wrinkles,” he said. “It would be simple to catch doctors who took advantage of the subsidy. Most dermatologists would see no more than one or two patients a year with the condition.”

The Government last week listed seven new medicines and vaccines that would be available on the PBS from April 1 and announced the deferral of listings for the first time.

Ms Roxon said that while there were alternatives for the other five medications deferred, there was no alternative treatment for hyperhidrosis.

The chair of the Australian Medical Association’s Therapeutics Committee, John Gullotta, said the Government should say when it would make a decision about Botox.

A golden opportunity has just landed in our laps!  It took me two minutes to complete this online form and I hope everyone who reads this can do the same – male or female, young or old, wherever you are.  The louder we shout the better – we desperately need to raise awareness of Hyperhidrosis and there’s no better medium than television.

http://www.thedoctorstv.com/main/tell_us_form/1159

We’ve just been sent this link by Denise (http://www.coolwrapps.com)

ask our doctors

* Women: Do You Suffer With A Sweaty Crotch?

Do you have a sweat problem?

Are you embarrassed by sweating in your groin area?

Does your crotch sweat?

If you or someone you know has a sweat problem in the groin area, we want to help. Tell us your story!

If we all do this then it will be more likely they’ll actually do something about bringing this into the open. Please mention you found the link through www.verysweatybetty.com, we really want them to know we exist as we’d really like the odd bit of expert advice from them to pass on to all of you.

I know it’s a US website but all of us who are not in the US should reply too, if we all shout at the same time they’re more likely to hear about what a huge problem this can be for us. Men too, please. This is a huge opportunity for us to be heard!

Hyperhidrosis, or excessive sweating, is a skin disease which produces a lot of unhappiness.  It is estimated by the medical profession that 2-3% of people all around the world suffer from excessive sweating.  Non-medically speaking, the figure could easily be far, far higher.  In our experience, many people only find out they have Hyperhidrosis because they stumble across the name of it by accident.  Many people don’t want to bother their doctor because they think it’s ‘just them’.  There are many reasons why people can go throughout life and never mention it to anybody. Read the rest of this entry »