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Excessive Sweating (Hyperhidrosis) In Child: Causes And Treatment

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Sweating is a normal physiological condition required to maintain a normal body temperature. Excessive sweating is called hyperhidrosis and is not related to heat or physical activity. Any site on the body may be affected, but the most frequently affected sites are the palms of the hand, soles and the axillae. The condition may interfere with your child’s daily activities due to the soaking of clothes and wet palms. Heavy sweating may also result in social anxiety in many children.

Hyperhidrosis may occur at any age. However, it commonly affects preteen and teens, with the onset of the condition being high during the developmental years (1). You may seek medical care since excess sweating can be due to some medical conditions, which may lead to complications, like skin diseases and dehydration.

Read this post to know more about the types, causes, signs, symptoms, diagnosis, treatments, and prevention of hyperhidrosis in children.

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.
  • 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
  • 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) (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
  • 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 cathecholamines 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) (11):

  • 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 (12). 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.
  • 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.

You may also encourage your kid to participate in activities that may calm them. Avoiding stress and anxiety can be beneficial. Excessive sweating can be distressing for many children if it is interfering with their activities.

Wet hands, feet, body odor, and sweat stains on clothes can often be concerning since children may become anxious about it and could isolate themselves from the peer groups. You may seek a doctor’s advice to manage the condition and also create awareness among peer groups to avoid bullying. Hyperhidrosis is a manageable physical condition that will not affect your child’s talents and intellectual abilities if well in time.

References:

1. Hyperhidrosis (Excessive Sweating); Aboutkidshealth; The Hospital For Sick Children
2. Two Types of Hyperhidrosis; Sweathelp; International Hyperhidrosis Society
3. Hyperhidrosis; MedlinePlus; The United States National Library of Medicine
4. Hyperhidrosis; The Children’s Hospital of Philadelphia
5. Night sweats; C.S. Mott Children’s Hospital; University of Michigan
6. Thermoregulatory Sweat Test; Stanford Healthcare
7. Hugo F. Posada-Quintero and Ki H. Chon, Innovations in Electrodermal Activity Data Collection and Signal Processing: A Systematic Review; University of Connecticut
8. Hyperhidrosis: Diagnosis And Treatment; The American Academy Of Dermatology
9. Sympathotomy; John Hopkins Medicine
10. Microwave Thermolysis for Excessive Sweating; John Hopkins Medicine
11. Tzu-Herng Hsu et al., A systematic review of microwave-based therapy for axillary hyperhidrosis; Journal of Cosmetic and Laser Therapy
12. Hyperhidrosis; Familydoctor; The American Academy of Family Physicians

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