Hyperhidrosis and Excessive Sweating: Tips for Teens

Tips for Minimizing This Distressing Symptom

Woman wiping sweat with a towel
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Sweating can sometimes seem annoying, but it is important to remember that it is through sweating that the body is able to cool itself when it gets too hot.

Without the ability to sweat, a medical condition called anhidrosis, the body can overheat and even develop heat stroke, a life-threatening condition.

Understanding the Process of Sweating

Sweat is produced by eccrine and apocrine glands in the skin.

Eccrine sweat glands are found over most of the body and produce sweat without any odor. On the other hand, apocrine sweat glands are not as widespread, and are typically just found in the underarms and groin area.

Unlike the odorless sweat that is produced by eccrine glands, apocrine glands produce sweat that, once it has contact with bacteria, has a distinct body odor.

When Do Children and Teenagers Sweat?

Children, especially teens, normally sweat when:

  • it is hot
  • eating spicy foods
  • exercising
  • they are angry, anxious, or nervous
  • they have a fever

Causes of Excessive Sweating 

There are a number of medical conditions that can cause excessive sweating, including:

  • hyperthyroidism (overactive thyroid gland)
  • diabetes mellitus
  • cancer
  • infections
  • heart failure
  • medication side effects
  • drug withdrawal

Most teens with excessive sweating and no other symptoms though have a condition called primary focal hyperhidrosis. In this condition, the excessive sweating is limited to just one or more areas of their bodies, and the sweating is bilateral and symmetric (for example, both hands or both armpits).

The sweating stops while they are sleeping.

Unlike the generalized excessive sweating that someone with an overactive thyroid gland might have, a teen with primary focal hyperhidrosis will probably just have sweaty palms, sweaty feet, sweaty armpits, and/or excessive facial sweating.

Primary focal hyperhydrosis is common, affecting about 3 percent of people, and many experts think that it usually starts by teen years.

It's also thought to usually be genetic, although the precise underlying cause is unknown. That being said, it's important to understand that people with primary focal hyperhidrosis have a normal number of sweat glands, and they work normally -- they just produce more sweat for some reason.

How to Control Excessive Sweating 

Since just about everyone sweats, how do you know when or if your teen has a problem with excessive sweating? One easy way is to simply compare his sweating to other teens in similar situations. For example, your teen will likely be sweating while playing volleyball, but it shouldn't be so severe that sweaty palms interfere with her holding the ball.

If a teen's excessive sweating frequently interferes with his daily activities, has become barely tolerable, or especially if it is intolerable and always interferes with his daily activities, then he should seek help.

Treatments that may help control excessive sweating include:

  • a regular over-the-counter antiperspirant -- use it both in the morning and the evening for best results
  • a newer over-the-counter antiperspirant, such as Secret Clinical Strength (Aluminum Zirconium Trichlorohydrex) or Hydrosal Professional (Aluminum Chloride Hexahydrate 15%)
  • an over-the-counter antiperspirant, such as Certain Dri, with Aluminum Chloride 12%
  • a prescription strength antiperspirant, such as DrySol, with Aluminum Chloride 20%, or Xerac AC, with Aluminum Chloride 6.25%
  • anticholinergic medications -- although because of their side effects, such as dry mouth, constipation, and drowsiness, they are more helpful for generalized hyperhidrosis, and not teens who just have sweaty palms or excessive armpit sweating

Other treatments for excessive sweating that are more commonly used in adults include surgical treatments like local sweat gland excision or endoscopic thoracic sympathectomy. Iontophoresis, in which low-level electrical current is applied to the skin's surface to reduce sweat production, is another option, as are Botox injections. Although the effect is only temporarily, Botox works to block a neurotransmitter that stimulates sweat glands, leading to a decrease in sweat production for 6 to 7 months.

What You Need To Know About Excessive Sweating

Other things to know about hyperhidrosis and excessive sweating control:

  • follow the directions closely when using antiperspirants with Aluminum Chloride, as they can be very irritating to your teen's skin. To decrease any chances of irritation, apply the antiperspirant to dry skin at night, and then wash it off 6 to 8 hours later. Remember that you will only need to use it every 1 to 3 weeks once the excessive sweating is under good control.
  • don't apply an antiperspirant right after shaving
  • use a cool blow drier (don't use a warm or hot setting) to help dry your skin if necessary before applying an antiperspirant
  • applying hydrocortisone cream or topical baking soda after you wash away the antiperspirant may help to decrease the chances of skin irritation.
  • antiperspirants are sometimes used on sweaty palms and sweaty feet, but talk to your pediatrician first, because there is a risk for skin irritation
  • a dermatologist can help you further manage your teen's excessive sweating

Sources:

Habif: Clinical Dermatology, 5th ed.

Haider A. (2005). Focal hyperhidrosis: diagnosis and management. CMAJ, 172(1): 69-75

International Hyperhidrosis Society. Hyperhidrosis Treatments. Antiperspirants. 

Kliegman: Nelson Textbook of Pediatrics, 18th ed.

Lowe, N.J. et al. (2007). Botulinum toxin type A in the treatment of primary axillary hyperhidrosis: A 52-week multicenter double-blind, randomized, placebo-controlled study of efficacy and safety. Journal of the American Academy of Dermatology Apr;56(4):604-11.

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