Preventing Heat-Related Illness

Hyperhidrosis, as you know, is extreme, uncontrollable sweating that can happen unpredictably and regardless of the ambient temperature. It’s excessive sweating occurring beyond what’s expected or needed for the human body to cool itself and maintain a normal internal temperature.

But, when temperatures soar and humidity gets smothering, hyperhidrosis sufferers can sweat even more. Sweating is, after all, the body’s air conditioning. And in recent years, all over the world, sweat glands have had A LOT of work to do.

With heat waves becoming more common and more severe, it’s important for all of us to know how to stay cool and to recognize the warning signs of heat illness. This is especially crucial for hyperhidrosis sufferers who use oral anticholinergic medications to help control their sweating, because along with limiting unwanted sweating (like from hands, feet, and face), anticholinergics also inhibit all sweating.

Oral anticholinergics for managing excessive sweating include glycopyrrolate, oxybutynin, benztropine, propantheline, and others. They work by blocking the chemical messenger acetylcholine as it travels to receptors on the sweat glands that are responsible for triggering sweating. Because anticholinergic medications cannot target just one body area, they decrease sweating over the entire body, even in those locations where sweating is not a problem. This overall decrease in sweating can put the patient at risk for overheating and heat illness.

Dee Anna Glaser, MD, president and a founding board member of the International Hyperhidrosis Society, treats hundreds of hyperhidrosis patients a year and is well versed in anticholinergic use, either alone or in combination with other hyperhidrosis treatments. She cautions her patients thinking about anticholinergics saying, “When taking anticholinergics, the body may have more difficulty keeping itself cool with the sweat mechanism ‘turned off.’ Therefore, athletes, people who participate in sports, people who work outdoors, and anyone who may potentially cause themselves injury by becoming overheated must use extra care when considering these treatments.” In fact, experts suggest active patients, especially in hot climates, should likely NOT consider anticholinergics. For those who do use them, or parents of children taking the medications, it’s important to be aware of temperature, water intake, exertion, and any symptoms of overheating such as pale skin, dizziness, muscle cramping, weakness, headache, and nausea.

Tips for Keeping Cool

When the weather heats up, remember the following tips for keeping cool:

• Stay out of the sun during the hottest hours of the day. If you’re outside, find shade.
• Wear a hat wide enough to protect your face. This is advised for preventing skin cancer, too.
• Wear loose, lightweight, light-colored clothing.
• Spritz or mist your skin with cool or room temperature water.
• Wipe your forehead with a cool cloth.
• Soak your feet in basins of cool or cold water.
• Drink ice water and stay hydrated. If you’ve been sweating a lot (like if you have hyperhidrosis) make sure you are also getting enough electrolytes.
• If you need to exert yourself outdoors, drink something very cold (like a slushie) first or wet your head with cold water before you head out.
• After exercising or working in high heat, take a cool or cold shower to help bring your body temperature down.
• Avoid alcohol and caffeine as they can cause you to lose more water.

If you don’t have air conditioning in your home, school or office:

• Use fans as much as possible. Consider investing in battery-operated fans, with extra batteries, for power outages.
• Make a homemade "air conditioning" system by directing a fan so that it blows over an open cooler or pan filled with ice and sit (or sleep) in this airway.
• Use blankets or other materials to help block hot sun from coming through windows.
• Avoid using appliances or even light bulbs in the home that generate more heat.
• Open and close windows and doors and direct fans strategically to bring cooler nighttime air in and keep hotter daytime air out.
• Identify places in your community where you can go to get cool such as libraries and malls or contact your local health department to find a cooling center in your area. The human body needs periodic breaks from high heat and humidity.

Recognize & Treat the Three Heat Illnesses

Scientists expect that we’ll have more and more days with temperatures hotter than 90°F in the future. And, extremely hot weather can even occur in places that have traditionally had cooler summers and in places where air conditioning has not been needed in the past (such as in the Pacific Northwestern U.S.) This means that around the world, we need to be more aware and proactive in preventing and caring for the three main heat illnesses including heat cramps, heat exhaustion, and heat stroke, which can be serious, and life-threatening.

1. Heat Cramps

Signs: 

Muscle pains or spasms in the stomach, arms or legs. Usually occurring during heavy exercise in hot environments.

Treatment:

• Resting and cooling down.
• Drinking clear juice or an electrolyte-containing sports drink.
• Practicing gentle, range-of-motion stretching and gentle massage of the affected muscle group.
• Avoiding any additional strenuous activity for several hours (or longer) even after heat cramps go away.
• Calling your doctor if cramps don’t dissipate within one hour or so.

2. Heat Exhaustion

Signs: 

Heavy sweating, cold, pale and clammy skin, muscle cramps, tiredness, weakness, fast or weak pulse, dizziness, headache, fainting, nausea, vomiting. 

A less serious condition than heat stroke, heat exhaustion can progress to heat stroke without proper interventions.

Treatment:

• Moving to a cooler place, out of the sun.
• Removing or loosening clothing.
• Cooling by applying cold, wet cloths or bathing in cool water.
• Taking sips of water.
• Seeking immediate medical help if there’s vomiting, if symptoms get worse, or if symptoms don’t improve in one hour.

3. Heat Stroke

Signs: 
            
Extremely high body temperature (above 103°F when taken by mouth); red, hot and dry skin with NO sweat; rapid, strong pulse; dizziness, confusion or unconsciousness.

Treatment:

Heat stroke is a medical emergency requiring immediate medical help. Call 911 (or the equivalent in your country) or get the affected person to a hospital as soon as possible. While you wait for professional assistance, take care of heat stroke by:

• Moving to a cooler place, out of the sun.
• Cooling down with whatever methods are available such as by applying cold, wet cloths or by placing the person in a cool bath.
• Avoiding giving the person anything to drink.

The American Public Health Association has declared climate change a health emergency and it's also a hyperhidrosis issue, a dermatology issue, a public health issue, a local issue, an everyday issue, and a planetary issue.

By learning how to care for your skin, your body temperature, your psyche, and your community as we face climate change, you can be prepared to adapt AND continue to fight for a better tomorrow.