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As odd as it may seem, there's actually a medical condition that causes excessive perspiration at your derriere. It's gluteal hyperhidrosis, also known as inguinal of Hexsel's hyperhidrosis. This disorder is focal. Hexsel's hyperhidrosis causes profuse sweating in the general area of the crotch. It is sometimes associated with excessive perspiration at other areas of the body, but sometimes the massive sweating only occurs at the crotch. There can be so much sweating that it looks like someone wet their pants, but the dampness is caused by perspiration, not by urine.

Hexsel's hyperhidrosis usually starts in adolescence, before the age of 25. It doesn't go away on its own. It often gets worse throughout life. Sometimes the sweating only occurs at the gluteal fold (the butt crack), and sometimes it also includes the area between the anus and the genitals. This sweat is "watery" rather than stinky. In medical terms, the intense sweating characteristic of this condition is generated by eccrine glands, the kind of sweat glands over most of the body, rather than apocrine glands, the kind of glands at the armpits and near the external reproductive organs. It tends not to grow as many bacteria as underarm sweat, although wearing tight fitting clothes or failing to accomplish personal hygiene after using the toilet may result in a highly odorous condition.

Scientists don't really know what causes this condition. The sweating reflex is normal. It is triggered by heat, emotional distress, or embarrassment, just like other kinds of sweating. Sexual activity, wearing tight clothes or clothes made of synthetic fabrics, drinking lots of liquids, gaining weight, or, in women, premenstrual tension can increase sweating in general. In Hexsel's hyperhidrosis, however, the sweat glands in and around the crotch in these and other conditions produce sweat 10 times faster than other sweat glands, resulting in wet undergarments, slacks, and trousers.

The social problem caused by Hexsel's hyperhidrosis is that the stains from sweat look like stains from urine. People who have the condition find it intensely embarrassing. There are professions in which it is simply impossible to do work if one has the condition. People who have Hexsel's hyperhidrosis may even lose their jobs as the condition gets worse. They may withdraw from contact with families and friends and become more and more isolated and stressed, which only causes the condition to become still worse.

People who have excessive sweating around the groin can get the adult equivalent of diaper rash. Folliculitis and staph infections can become intensely painful. There can be bromhidrosis, what one might call "underpants odor," but deodorants to keep it under control can cause skin irritation. There can even be chromhidrosis, changes in the color of the skin of the buttocks and groin as sweat accumulates.

What can be done about this "sweating ass" disease?

  • Simply changing clothes two or three times a day can make concealing the problem easier, as can wearing adult diapers. 
  • Dark clothing doesn't show sweat stains as obviously as light clothing.
  • If you have to go out in the heat, wear loose fitting clothes that allow your skin to dry "down there."
  • Cold baths are preferable to hot showers.
  • You may need an "industrial strength" antiperspirant. Most products for this kind of hyperhidrosis contain aluminum chlorohydroxide, glutaraldehyde, or formol. All of these are chemicals that can irritate the skin. They may also stain the skin yellow. The antiperspirants that are strong enough to stop sweating typically are only available with a doctor's prescription. They have to be applied as directed to work; usually that means after a cold bath and just before going to bed.

Excessive sweating can also be treated with Botox. This the same Botox used for wrinkle care. Don't get Botox for your butt from a "Botox party" or a doctor who does not have extensive practice in treating hyperhidrosis. Get Botox from a a dermatologist. You don't want certain structures to be paralyzed by the injections, which take about six months to wear off.

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