Beating the Heat: Managing Sweat for Prosthetic Users

The heat is here—and with it, sweat!
For many prosthetic users, residual limb perspiration is a year-round challenge, but it becomes especially problematic during the hot, humid Lowcountry summers where temperatures often climb into the 90s. When the sweat starts flowing, so do issues with socket fit and suspension.

Let’s break it down.

The Problem with Sweat

Excessive perspiration, or hyperhidrosis, can cause a cascade of complications for prosthetic users. Most people with limb loss wear roll-on liners, which are similar to a snug rubber boot against the skin. These liners are great for suspension and protection—but they trap heat and moisture. Think of wrapping your leg in a warm, form-fitting thermos.

Here are some common issues caused by excess sweat inside the liner:

• Partial loss of suspension
• “Burping” noises from trapped air
• Sweat pooling at the bottom of the liner, requiring you to doff the prosthesis to drain it
• Complete loss of suspension, increasing fall risk
• Odor and hygiene challenges

So how can we fight back against sweat—the arch-nemesis of secure socket suspension?

1. Sweat Sock or Sheath

These ultra-thin socks are worn on the residual limb before applying the liner. They help absorb and wick away sweat, keeping the limb/liner interface drier. You can purchase them online, or ask your prosthetist to order them—most insurance plans will reimburse for them.

2. Sweat-Combating Liners

Sometimes thinner equals cooler. Some prosthetic liners are designed to reduce heat and moisture:

• WillowWood’s SmartTemp liners have temperature-regulating properties backed by research.
• Blatchford and Uniprox offer perforated liners with tiny holes that allow moisture to escape.
• At Jameson Prosthetics, we’ve even used a simple, in-house perforation technique to modify standard liners with success.

Talk to your prosthetist about whether one of these liner options is right for you.

3. Socket Design Considerations

There’s not a ton that can be done to modify the socket itself—but a few things are worth discussing:

• Fenestrated (vented) sockets can allow some airflow and lower temperatures, but they may compromise the structural integrity of the socket.
• Adjustable socket technologies, like Martin Bionics’ Socketless Socket or Jay Martin’s Slingshot Socket, are more open by design and may help reduce heat buildup—though more research is needed.

As always, consult your prosthetist before making changes to your socket system.

4. Antiperspirants: Certain Dri

Topical antiperspirants like Certain Dri use aluminum-based compounds to block sweat ducts. Some patients have had success with this, although skin irritation can occur. Apply it at night to dry skin, and then wear your prosthesis as usual the next day. It’s available at most pharmacies alongside regular deodorants.

5. Botox Injections

Botox isn’t just for wrinkles—it’s also FDA-approved to treat excessive sweating in areas like the palms and underarms. Injections in the residual limb have shown promise in reducing sweat for prosthetic users. The effects are temporary, so this may be best used seasonally during the hottest months.

6. miraDry Treatment

This FDA-approved treatment permanently reduces sweat by destroying sweat glands—but it’s currently only approved for underarms. While some have considered it for limb use, research is still limited. At the time of writing, the closest provider is in Augusta, GA. Consider this a last-resort option.

Final Thoughts

Excessive sweating isn’t just uncomfortable—it can be dangerous, increasing your risk of falls and skin breakdown. If you’re struggling with sweat-related socket issues, talk to your prosthetist about these solutions. Everyone’s needs are different, but together, we can find the right strategy for you.

Stay cool out there!

Ben Jameson, CP