Thursday, August 31, 2006

Sweaty Teenager

Dear Lisa,

My 15 year old daughter sweats a lot and it embarrasses her terribly. Now that school’s around the corner it just makes matters worse. She sweats so much that it stains the underarm area of her shirts which makes her very self conscious. She has to change her shirt a couple of times a day because she sweats so much. I wanted to ask her Doctor about it, but she is too embarrassed about it to tell anyone. I have tried many over the counter antiperspirants, but nothing seems to help. Is there anything that I can do to help her?

“Sweating too much”

Dear “Sweating too much”,

Excess sweating or “Hyperhidrosis” affects 2.8 % of the U.S. population or 7.8 million people. (1) So you can reassure your daughter that she is not alone. Hyperhidrosis is a medical condition where the sufferer produces four to five times the amount of sweat than a person without the condition. People with the condition can experience excess sweating on their face, hands, feet or underarms. Usually the amount of sweat is too difficult to conceal which can cause a lot of distress, especially for a teenager. Teenagers typically are self conscious about their bodies and tend to want to fit in with the group. It is at this time of life that Hyperhidrosis typically begins, with the average onset between 14 and 15 years old. (1)

It is common for teenagers to refuse to talk about the problem because of their fear of being ridiculed. (1) So, it is not surprising that your daughter did not want you to bring it up with the Doctor. It can be a very sensitive issue and the emotional and social aspects of having Hyperhidrosis can affect a teenager’s life in many ways. The sweating can be very embarrassing many times to the point where some teenagers won’t participate in sports, dances, clubs, social gatherings or other activities. (1) Some students won’t participate in class because they are afraid to raise their hand and expose the sweat stains on their shirt. Teenagers with Hyperhidrosis commonly experience social anxiety, negative self-esteem, paranoia and depression. (1) Therefore it is important for parents like yourself to take the condition seriously and seek out professional help.

There are some measures that you can take that will help your daughter. Drysol is a highly potent topical antiperspirant that is very successful in treating teenagers with excess sweating. (2) It can be obtained by prescription from your daughter’s Doctor. Perhaps if you told your daughter that there is a treatment that will help her, she would be more willing to see the Doctor about it. I found that the teenagers that I treated were very happy with the results and reported that it was better than any over the counter product that they used.

A teenager can use antiperspirants on their underarms and also spray it on the soles of their feet and between their toes. Antiperspirants are the first line treatment for excess sweating and work by plugging the sweat ducts, which reduces the amount of sweat that reaches the skin. A side effect of antiperspirants can include skin irritation, if this occurs contact your daughter’s Doctor for further treatment.

The choice of clothes that your daughter wears is also important. Pick fabrics that breathe, such as cotton, preferably in layers. (1) A lot of teenagers prefer layers of cotton shirts, wearing a sleeveless shirt under another shirt with sleeves. This way they can remove the top shirt when it gets stained. Your daughter can use absorbent insoles in her shoes and leave the shoes out to dry for a day rather than wearing the same shoes everyday. This way the shoes get a chance to dry out before wearing them again. (1) It is a good idea to avoid shoes or sandals made from plastic, rubber or fake leather because they tend to cause more sweating. (2) Also, certain foods people eat cause them to sweat. Your daughter can keep a record of those foods that cause her to sweat more and avoid eating them in public.

Adolescents with excess sweating of the feet are at risk for developing “Athlete’s Foot”. “Athlete’s Foot” is a fungal skin infection found between the toes. The symptoms include redness, itching and scaling in the toe web spaces. (3) A secondary bacterial infection may occur because of the warm moist area of shoes. (3) If your daughter develops any of these symptoms it would be important to have her evaluated by her Doctor.

If your daughter’s excess sweating causes her psychological stress or can not be controlled with the above measures, it is important to discuss this with her Doctor. She may need to be screened for physiological complications such as depression. Or a Dermatologist may be consulted in order to help select a treatment plan that can help treat her problem. (1) Some patients may be candidates for one of the latest treatments for excess sweating; Botox.

Botox injections have been used for various medical conditions including cerebral palsy, stroke and for cosmetic purposes to treat facial lines. In 2004, the FDA approved Botox or botulinum toxin type A to treat Hyperhidrosis. This treatment has been found to block the nerves that stimulate the sweat glands. A patient is injected with the botulinum toxin at the site where there is excess sweating and the medication works by freezing the nerve that normally stimulates the sweat gland. The treatments can be administered in the doctor’s office and typically last for 6 to 9 months. I have never had a patient that needed this treatment because most of them responded well to Drysol. Although, the Dermatologists that I dealt with did recommend and use this treatment successfully.

More information can be found about Hyperhidrosis on the Hyperhidrosis Society’s Web site at http://www.sweathelp.org/. There’s a section on the site for teens called “Teen Sweat 101”. Your daughter may find comfort in knowing that there are other teens that are experiencing the same symptoms.

(1) Grassia T. Hyperhidrosis is not a “no sweat” issue when it comes to teenagers. Infectious Diseases in Children. 2006. May: 50.
(2)Hyperhidrosis Society’s Web site. Available at: http://www.sweathelp.org/. Accessed August 2006.
(3)Treadwell P. Spot the Rash. Infectious Diseases in Children. 2006. June:66.

Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Pediatric Advice for your Teenager

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