Rx for Readers: Sweat it out

My 11-year-old son asked me to buy deodorant and antiperspirant for his daily use. He says he wants to smell good and thinks he has a sweat/odor problem. Is it safe for him to use deodorant on a daily basis at his age? Is antiperspirant okay – for him and for adults? I heard that antiperspirant clogs up the pores with aluminum and is not healthy. Can either of these products cause skin allergies? And what about occasional stories on the Internet that antiperspirants can cause cancer?
T.R., Shoham

Veteran Jerusalem dermatologist Dr. Julian Schamroth replies:

There are two types of sweat glands in the skin – eccrine glands, which produce a liquidy form of sweat composed mainly of salt water, and apocrine glands, which produce an oily form of sweat composed mainly of organic compounds. Although both types of glands are found all over the body, the eccrine glands tend to be concentrated on the palms and soles, and the apocrine glands are concentrated in the armpits.

When considering sweating, we need to deal with three different conditions: normal sweat, excessive sweating and malodorous sweat.

Normal sweating occurs in everyone, even when sleeping. It is usually insignificant in young children, and it tends to increase at puberty. Normal sweat is usually clear and odorless and is produced mainly by the eccrine glands.

Excessive sweating – known as hyperhidrosis – is a condition resulting from overstimulation of the eccrine glands. It usually occurs in the late childhood and teen years. It, too, is odorless. It presents with very wet palms and soles, but may affect all areas of the body.

Malodorous sweat is believed to be caused by bacteria on the skin that break down the organic compounds produced by apocrine glands in the armpits.

And it is this decomposing sweat that gives off a strong, offensive odor. If there is a slight odor, then it may be due to ingesting food with strong spices such as onion or garlic.

Normal sweating can be controlled with antiperspirants.

These products usually contain aluminum chloride or other aluminum salts. Their mode of action is not clear – they may work by blocking the sweat duct or by causing the eccrine glands to atrophy (shrink). These compounds are not dangerous, and do not cause cancer, although excessive use may cause some irritation. They certainly may be used in pubescent or pre-pubescent children. Hyperhidrosis can be treated with topical applications, oral therapy, botox injections, electrical therapy or by surgery on the nerves connected to the sweat glands.

Malodorous sweat is best treated with deodorants.

These usually contain antimicrobial agents, such as triclosan, as well as fragrance to mask the odor. An antimicrobial soap may also be of help. In severe cases – especially malodorous feet – a topical antibiotic cream may be helpful. Most commercial products contain a combination of antiperspirants and anti-odorants.

Deodorants too are not carcinogenic.

Dr. Eli Sprecher, chief of dermatology at Tel Aviv’s Sourasky Medical Center, adds:

Antiperspirants and deodorants are generally safe, but antiperspirant can clog pores and consequently cause inflammation in some cases. In addition, some of the compounds present in commercially available deodorants can indeed (as well as in many cosmetics, soaps, shampoos and the like) cause allergic reactions known as contact dermatitis.

My 18-year old son insists on discarding all food after the expiration date has passed – be it refrigerated food or dry food from the pantry. I say that under most circumstances, the food is safe to eat for quite some time after the expiration date. I myself eat things unless they have changed color, have anything growing on the surface or smell. Maybe I’m wrong. Is there a general rule on whether food is safe to eat or whether it should be tossed?
S.T., Efrat

Dr. Olga Raz, chief clinical dietitian of Tel Aviv’s Sourasky Medical Center, replies:

Your son is right. He follows the instructions of food products as they appear on the package, and if the date for consumption has expired, he is not willing to eat it.

At the same time, there is usually no problem with eating food in the refrigerator or pantry even after the date has expired if you examine it and it looks and smells like the fresh product. It is likely to cause no harm – although you cannot always be sure. It depends on many factors.

What I advise is that you let your son follow his rules without arguing with him, and you do what you like – hopefully without any arguments from him.

Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.

Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.