DEAR DR. DONOHUE: My husband has a terrible sweating problem. I cannot remove the stains that soak his shirts under the arms, and his hands are so wet that it’s disgusting when he touches me. He sprays antiperspirants under his arms and on his hands, but they have no effect. Can anything be done for this? He is becoming very self-conscious about it. – R.K.

ANSWER: Excessive sweating is not an uncommon problem, and only rarely is a solution found in nonprescription remedies.

A 20 percent solution of aluminum chloride, available only with a prescription, can often provide relief. It is applied under the arms at night before going to bed. The skin must be completely dry before putting the aluminum chloride on, and a blow-dryer is a good way to achieve the necessary dryness.

The solution is left on overnight and washed off in the morning. After three to seven nightly applications, there should be a diminution in sweating. If there is, applications can be cut down to once or twice a week as needed. Aluminum chloride can also be applied to the palms.

Battery-powered devices that deliver electric current to the skin can cut down on sweating on the palms, soles and under the arms. These devices plug up the sweat glands there. One such device is Drionic, made by the General Medical Co. of Los Angeles.

Botox, a panacea for practically everything these days, comes from the bacterium that causes the most serious form of food poisoning. Diluted many times over, it can be injected under the arms to stop sweating. It can also be injected for palm sweating.

When I mentioned the palm injection in the past, Cathy, a reader and Botox patient, let me know that I was a sadist for not warning people that palm injections are painful. Under-the-arm injections are not so formidable.

At the top rung of treatments are surgical procedures. One, for under-the-arm sweating, entails excising the skin most heavily populated with sweat glands. For palm sweating, removing nerves in the chest that control sweating in the palms can be effective. The operation can be done with a scope and through small incisions. Postoperatively, some people develop sweating in other areas – the trunk, for example.

DEAR DR. DONOHUE: I have had trouble recently getting my eyes to focus with one another. One eye drifts toward my nose, and it gives me a double image that’s hard to cope with. The eye doctor says I have sixth nerve palsy. Just what is that? I am not taking any medicine because the doctor says there is none. Can’t something be done? – W.P.

ANSWER: “Sixth” refers to the sixth cranial nerve, one of the 12 nerves that sprout directly from the brain. The sixth nerve innervates the eye muscle that moves the eye to the side. Palsy is weakness of that muscle due to nerve malfunction. The palsy causes the eye to turn toward the nose. The two eyes, therefore, are sending two different images to the brain, and that causes double vision.

Causes of sixth nerve palsy include diabetes, blood-vessel bulges (aneurysms) that impinge on the nerve, and viral infections. Eye doctors are experts at discovering the causes for this nerve malfunction, and your doctor must not have found one that lends itself to treatment.

Even in such cases, recovery is possible, but it can take time. Ask your eye doctor if the use of a prism lens would help you see a single, focused image.

If the nerve never recovers, then eye-muscle surgery might alleviate the problem.

DEAR DR. DONOHUE: My nurse practitioner wants me to see a gynecologist because I have a crusted nipple. She says it might be Paget’s disease. Is that cancer? – P.G.

ANSWER: Paget’s disease of the nipple is an unusual kind of breast cancer and accounts for only 1 percent of all breast cancer. It begins as a redness of the nipple that drains fluid and forms a crust. Women often mistake it for eczema.

Scrapings of the involved skin or a biopsy furnishes evidence for a definitive diagnosis.

DEAR DR. DONOHUE: What is fifth disease? I know two people who have it. One is very ill. A few years ago a friend had it, and its effects lasted a year. – C.D.

ANSWER: Fifth disease’s official name is erythema infectiosum. It’s a pretty common viral infection and most often a childhood infection. The virus is a parvovirus.

In children, the infection first brings a bright red flush to the cheeks, so they look like they have been slapped. Then the rash spreads to the chest, back, arms and legs and looks a bit like measles. Next the rash begins to clear up and leaves a lacy configuration. The rash leaves within one to three weeks, but it can recur. During the illness, children are often not very sick. They are usually up and about and doing the things they normally do.

With adults, fifth disease is a different story. Adults are less likely to have a rash and more likely to have swollen, painful joints. Treatment with anti-inflammatory drugs such as Advil, Motrin and Indocin eases joint pain.

Permanent joint damage is not the rule. Usually symptoms clear up within three weeks. For some, however, they persist for months, and for a very few, they can continue for years. Infections with fifth disease during pregnancy can be passed to the fetus. In a small number of cases – less than 1 in 20 – the fetus dies.

In the early part of the 20th century, illnesses that produced similar childhood rashes were given numbers. Erythema infectiosum happened to fall fifth on the list, and that’s where the name came from.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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