Sweating with Exercise

Hi Lisa,

My son will be 4 this October. He is very, very fair, (I am 100% Irish and he takes after me). I notice that he gets very red in the face and ears and sweats a lot quickly during activities some not so strenuous. I know from my family genes its common for us to become red in the face like that we often get wind burn. But sometimes it concerns me, could it be a sign of something more serious? Thank you.

“Very, Very Fair Skinned Son”

Dear “Very, Very Fair Skinned Son”,

When a child has very fair skin, changes in the color seem more dramatic and are more noticeable. The symptoms that you notice when your son exercises most likely reflect his body’s response to over heating. It is probably more noticeable in your son because he has such light skin. When a person exercises the body’s metabolism increases which results in an elevation of body temperature. When this occurs, the body responds by expelling excess heat in order to regulate the temperature. The body’s regulatory mechanism shunts blood to the skin and releases heat through sweating.(1) This normal response of expelling excess heat is not as well regulated in infants and young children as it is in adults because the control mechanisms have not yet matured. (2)

Sweating many times is a normal response and can be found in children during exercise, crying or in a very warm environment. (3) Sweating in and of itself is not alarming. In conjunction with other symptoms, sweating may represent a more serious condition. Hyperthyroidism is an example of one of the conditions that results in sweating. Sweating is only one of a multitude of possible symptoms of Hyperthyroidism.

Children with Hyperthyroidism suffer from the increase metabolism of all body tissues caused by the increased production of thyroid hormones. The Symptoms include; sweating, nervousness, exophthalmos (bulging eyeballs) increased appetite, emotional liability, weight loss, school problems, sleep disturbances, heat intolerance, fast heart rate, and poor endurance with physical activity.(4) Hyperthyroidism is rare in infants and in young children. The majority of cases of Hyperthyroidism occur in adolescence.(4) The incidence is increased in children with Down’s Syndrome, Rubella Syndrome or a family history of autoimmune diseases.(4)

Sweating may also be one of the many signs of Congenital Heart Disease and Congestive Heart Failure. Signs of Congestive Heart Failure include fatigue, weakness, irritability, difficulty breathing, weak cry, cough, poor feeding, pale color, duskiness, cyanosis (blue color), increased heart rate and sweating during exercise. (3) Childhood syndromes such as Down’s Syndrome, Turner Syndrome, Noonan Syndrome and Fetal Alcohol Syndrome are commonly associated with Congenital Heart Defects.(4,5)

If your child develops other symptoms along with his sweating during exercise you should bring it to your Doctor’s attention. If there is a family history of autoimmune disease, thyroid problems, cardiac defects, or early heart attack or if your child has a childhood syndrome that is commonly associated with cardiac disorders it would be prudent to discuss your concerns with your son’s Doctor.

(1)Gray N.Unusual Case of heat stroke in a young boy. The Clinical Advisor. 2006;Mar50-58.
(2) Bellack J, Bamford P. Nursing Assessment, A multidimensional approach. Belmont, CA:Wadsworth Inc.1984:284-285.
(3)Chow M, Durand B, Feldman M, Mills M. Handbook of Pediatric Primary Care. Albany, New York:Delmar Publishers Inc. 1984:275,734.
(4)Betz C, Hunsberger M, Wright S. Family-Centered Nursing Care of Children. 2nd ed. Philadelphia, PA:W.B.Saunders Company. 1994:1969,1276-1277.
(5)Schwartz M, Charney E, Curry T, Ludwig S. Pediatric Primary Care. A Problem Oriented Approach. 2nd Ed. Littleton, Mass:Year Book Medical Publishers, Inc 1990:799.


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

Pediatric Advice Website