Excessive sweating in children, which is not related to physical activity or climatic conditions, can be concerning. It is also called hyperhidrosis. Sweating is a physiological reaction for regulating body temperature when higher than normal. Although sweating can be present anywhere in the body, it’s common in the palms, hands, axillae, and soles of the feet. Socked clothes or wet palms can interfere with a child’s regular activities. Hyperhidrosis can occur in preteens and teens or early ages, such as developmental years (1). This may trigger issues such as social anxiety in some children. Therefore, it is recommended to seek medical care to identify underlying causes and help prevent complications such as dehydration and skin diseases. Read on to know the causes, risk factors, types, signs, diagnosis, and treatment of excessive sweating in children and ways to prevent it.
Types Of Hyperhidrosis In Children
Hyperhidrosis can be classified into three types, namely (2):
Primary focal hyperhidrosis: This type of excessive sweating affects certain parts of the body, such as the palms, armpits, feet, etc. without an apparent cause. Primary hyperhidrosis may affect one or more parts of the body and often begin during childhood or teenage. Image: iStock
Secondary generalized hyperhidrosis: This type of excessive sweating is due to underlying causes, such as certain medical conditions or drugs.
Emotionally induced hyperhidrosis: It affects the arms, soles of feet and the axillae.
What Causes Excessive Sweating In A Child?
The exact cause for primary focal hyperhidrosis is not yet known. Excessive sweating can be due to overactivity of the sweat glands. Some children may not have hyperhidrosis beyond adolescence, while others may have excessive sweating in adulthood. Hyperhidrosis may affect both girls and boys equally. Secondary general hyperhidrosis can be due to various medical conditions, such as (3):
Imbalances in thyroid function Impaired function of the pituitary gland Infectious diseases Diabetes mellitus Image: Shutterstock Gout Tumors Certain medications, such as aspirin, antidepressants, etc. Anxiety Febrile illness
The severity of secondary hyperhidrosis may vary depending on the cause. You may consult a pediatrician for a detailed analysis of your child’s health.
Symptoms Of Excessive Sweating In Children
The following signs and symptoms can be seen in hyperhidrosis (4).
Constant sweating in affected areas, if it is primary hyperhidrosis
Increased sweating in hot environments and stressful situations; however, they may experience excess sweating regardless of the weather or situation
Underarms (axillary hyperhidrosis), hands (palmar hyperhidrosis), and feet (plantar hyperhidrosis) are usually affected.
Your child may experience the following difficulties due to excessive palm sweating (4).
Interference with the ability to write
Can’t hold papers, as they could soak in sweat
Challenging to use touch screens and other objects
Interfere with other regular activities
Excessive sweating can lead to clothes getting soaked and often interfere with a child’s social interactions. Children may require treatment to manage this condition since it may negatively impact their daily activities and psychiatric wellbeing. You may also notice additional signs and symptoms of underlying diseases in generalized hyperhidrosis (secondary).
Is It Normal For A Child To Sweat While Sleeping?
Sweating may stop during sleep in primary hyperhidrosis. However, night sweats can be seen in secondary hyperhidrosis due to the underlying conditions. Possible causes of nighttime sweating can be (5):
High levels of thyroid hormone
Infectious diseases, such as tuberculosis (TB), HIV, and heart valve infections
Cancers such as Hodgkin lymphoma and leukemia
Night sweats can also be due to warm ambient temperature, use of blankets, or other clothing. You may notice sweat-soaked clothing and bedding in such cases.
Risks And Complications Of Excessive Sweating In Children
Any child who has hormonal imbalances and other medical conditions may have a higher risk of developing generalized hyperhidrosis. The complications of hyperhidrosis can be:
Skin infections due to profuse sweating Image: Shutterstock
Dehydration from fluid and electrolyte loss
Social and emotional problems due to wet hands and clothes
You may seek medical care if your child has night sweats to identify the exact cause and begin early treatment.
Diagnosis Of Excessive Sweating In Children
Pediatricians may ask about the symptoms and medical history of your child. They may also perform some necessary tests and physical examinations to assess excessive sweating in children. These tests may include the following (3) (6) (7).
Blood and urine tests: These tests are useful to analyze the thyroid hormone levels, blood sugar levels, uric acid for gout and other markers of infections. They can also evaluate fluid and electrolyte loss. Urinary catecholamines for a tumor of the adrenal glands.
Paper sweat tests: This method uses special papers that absorb sweat, and are then weighed to identify the amount of sweat.
Purified protein derivative (PPD) to screen for tuberculosis.
Starch iodine test or minors test: Sweaty areas of the body will have dark blue color if starch is sprinkled over the iodine solution applied on the skin.
Thermoregulatory sweat test: This test is done in a lab with controlled airflow, humidity, and temperature.
Skin conductance response (electrodermal response or galvanic skin response): This method of testing uses two electrodes to measure the conductance of skin in the areas where more eccrine glands (sweat glands) are seen. It is mostly used to assess conductance in palms and soles.
Biopsy of the sweat gland: Useful to rule out structural abnormalities of the eccrine gland
Your child’s health care provider may order other tests to exclude or confirm the possible diagnosis of underlying diseases, depending on the symptoms and signs. This may include imaging examinations such as chest X-ray, CT scan, echocardiography, etc.
Treatment Of Excessive Sweating In A Child
Primary focal hyperhidrosis is managed with sweat-controlling measures. Some children may require a combination of treatments to manage excessive sweating. A few children may not have excessive sweating after treatment, whereas some may continue to have it, or experience it in later life. Secondary hyperhidrosis can be controlled by treating the underlying causes. Most children may not require additional interventions to control excessive secondary sweating. The available treatments for excessive sweating in children are mentioned next.
1. Medications
Pharmacological treatments for hyperhidrosis may include (3):
Antiperspirants with aluminum chloride, available as Xerac AC and Drysol, which may block sweat ducts and prevent excessive sweating. Hydrocortisone creams can be applied if this prescription antiperspirant causes skin irritation.
Glycopyrrolate creams are available on prescription to manage facial and head sweating.
Oral medications to block the autonomic nervous system stimulation (anticholinergic medications) may help to reduce sweating. Dry mouth and blurred vision can be side effects of nerve-blocking medications.
Botulinum toxin injections such as Botox or Myobloc can block the nerves that cause sweating. Several injections are given to the affected area, and the effect may last six months to one year. Pain and temporary muscle weakness can be seen after the injections in some cases.
2. Surgical and other procedures
Surgeries and other interventions to treat hyperhidrosis are required if medication fails to control sweating. Surgeries are most commonly used in primary localized hyperhidrosis. This may include (8) (9) (10)::
Sweat gland removal surgery helps reduce sweating in many cases. This can be done through various methods, such as suction curettage technique, excision, or through laser.
Sympathectomy is the nerve surgery involving the disconnection of nerves controlling the sweating from the sweat glands. This may often cause compensatory sweating in other areas of the body and cannot be used for head and neck sweating.
Sympathotomy is a procedure that blocks nerve impulses without the removal of sympathetic nerves in the affected areas.
Microwave therapy uses microwave energy to destroy sweat glands. Microwaves may cause temporary skin irritation and swelling. This procedure is mostly used for axillary hyperhidrosis (excess sweating in underarms).
Iontophoresis or no-sweat machine is a device used for treating sweaty palms and soles. It uses low-voltage electricity to turn off the sweat glands temporarily. It is a non-painful treatment method.
You may talk to a pediatric dermatologist regarding the appropriate treatment for your child, depending on their age, location of the affected area, types, and severity of hyperhidrosis.
Prevention Of Hyperhidrosis In Children
Primary hyperhidrosis cannot be prevented (11). The prevention of secondary hyperhidrosis is possible in some situations, such as by treating hormonal imbalances or by changing medications if it is the cause. However, some reasons, such as cancer, may not always be modifiable. The following lifestyle changes and home remedies may help your child reduce body odor from sweating.
Daily bathing helps reduce bacterial growth in sweaty areas that may cause a bad smell. Image: Shutterstock
Non-prescription topical antiperspirants may help reduce minor hyperhidrosis.
Use socks that are moisture-wicking or made of natural materials, such as cotton. Wear shoes made from breathable materials or those that allow ventilation.
Change socks and air dry the feet before wearing a fresh pair of socks.
Wear sweat-absorbing or breathable clothes.
