Q. My 15-year-old daughter seems to sweat excessively. Sometimes she will start sweating for no reason and soak her clothes. She has tried several types of deodorant but nothing seems to help. Is there anything else she can do?
A. She could have a condition called hyperhidrosis, or excessive sweating. Hyperhidrosis is common, affecting about 2.8 percent of the population, and typically occurs between ages 14 and 25.
There are two main categories of hyperhidrosis: primary and secondary. Primary hyperhidrosis is usually localized to one area such as the palms, soles, face or armpits. There is no known cause, although there’s some thought it could be linked to an underlying medical condition or medication (i.e. secondary hyperhidrosis).
The first line of treatment for primary hyperhidrosis is an antiperspirant that contains aluminum chloride. These are available over the counter (Certain Dri and Secret Clinical Strength) or by prescription (Dri-sol). For best results, the product should be applied to dry skin at bedtime.
In most cases, primary hyperhidrosis can be managed with topical antiperspirants; however, when this doesn’t work, there are other options.
Iontophoresis is a procedure that uses water to conduct a mild electrical current through the skin’s surface. Although this is an approved treatment, it’s unclear how it works. Iontophoresis can be expensive and requires long-term use to maintain its effect.
In some cases, psychotherapy focused on biofeedback techniques may be helpful, particularly when sweating is triggered by anxiety.
If results are still not positive, more invasive methods may be considered. Botulinum toxin is a neurotoxin that has been shown in studies to decrease sweating when injected at the affected site. The effects typically last four to six months. There are also more invasive permanent surgical treatments. Obviously, such treatments are associated with more risks, so they should only be considered in very select cases.
Rhonda Patt is a pediatrician with Charlotte Pediatric Clinic. Email firstname.lastname@example.org; put “pediatrician” in the subject line.