Hyperhidrosis: Tips for Teens With Excessive Sweating

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 heatstroke, a life-threatening condition.

That being said, in some individuals, excessive sweating—also known as hyperhidrosis—can be an issue. While it is not harmful, it can be embarrassing and frustrating to deal with, especially as a teen in school.

Normal vs. Excessive Sweating

Sweaty underarms, foreheads, faces, palms, and feet are on the common side in teens and preteens. Sweating is normal in obvious situations—high heat and humidity, when eating spicy foods, exercising, in cases of fever, and when your teen is angry, panicking, anxious, or nervous.

If you notice anything out of the ordinary, particularly sweating when there's no obvious reason or if your child is soaking through his or her clothing, there may be something else at play.

Primary and Secondary Hyperhidrosis

Hyperhidrosis—excessive sweating—can be a condition in and of itself (primary hyperhidrosis) or a symptom of an underlying cause (secondary hyperhidrosis).

Primary Hyperhidrosis

Primary hyperhidrosis often begins in childhood. The cause is unknown, and most teens with excessive sweating and no other symptoms are thought to have it. 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). Sweaty palms, feet, underarms, and faces are most common. The sweating doesn't usually occur when sleeping.

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. They produce sweat that, once it has contact with bacteria, has a distinct body odor.

Secondary Hyperhidrosis

Secondary hyperhidrosis is usually generalized and caused by an underlying medical condition. These conditions can include:

• Hyperthyroidism (overactive thyroid gland), which may be accompanied by other symptoms like weight loss and changes in heartbeat
• Various types of infections
• Diabetes, often accompanied by other symptoms like increased thirst, urination, and weight loss
• Other metabolic and hormonal disorders
• High blood pressure in children

Know that the risk of secondary hyperhidrosis is small in younger individuals. Risk increases with age and is often accompanied by other symptoms outside of sweating. Whether or not your teen complains about any additional symptoms, or if you notice something out of the ordinary yourself, it's important to go see a doctor to double check what's going on, especially if your teen's excessive sweating frequently interferes with daily activities or has become intolerable.

A physical examination, bloodwork, and other lab tests such as a sweat test, which tests how the body reacts to changes in temperature and air flow, can confirm a diagnosis.

If it turns out that your teen has primary hyperhidrosis, know that the condition isn't particularly harmful—just often times embarrassing and frustrating to deal with. Luckily, there are treatment options available for coping with the excess sweat.

Treatments

Treatments that may help control excessive sweating in teens include:

• A regular over-the-counter antiperspirant—use it both in the morning and the evening for best results. There are also over-the-counter antiperspirants, such as Certain Dri, with 12 percent aluminum chloride, and prescription strength antiperspirants, such as DrySol, with 20 or 6.25 percent aluminum chloride.
• Anticholinergic medications—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
• Prescription medication such as Qbrexza (glycopyrronium) cloth, which is an anticholinergic drug infused in a pre-moistened disposable towelette. It is to be used on the underarms only and is approved for the treatment of excessive underarm sweating by the U.S. Food and Drug Administration (FDA) for adults and children 9 years of age and older.

When it comes to the antiperspirants, help your teen 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. Use a cool blow dryer (don't use a warm or hot setting) to help dry your skin if necessary before applying antiperspirant. Applying hydrocortisone cream or topical baking soda after you wash away the antiperspirant may also help to decrease the chances of skin irritation.

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.

A dermatologist can help you further manage your teen's excessive sweating and explore the prescription medication options available.