Dr Phil Kieran: What can my teen do about his excessive sweating?

Rear view of man looking away

My 16-year-old son sweats profusely when exercising. Sometimes, a brisk walk can leave him drenched. Antiperspirants don’t help. He manages by always having a change of clothes in his bag, but is embarrassed by the condition. Is there anything he can do?

Excessive sweating is a common and frequently distressing problem. A number of patients have attended my surgery in the past and, in some cases, continue to attend with this issue. 

Hyperhidrosis is defined as the secretion of sweat in amounts greater than those required for regulating body temperature, and this sounds like an accurate description of what your son is experiencing.

Thankfully, there is rarely a serious underlying medical issue, and if excessive sweating is present in adolescence, it will become less problematic as the hormonal system starts to settle down.

One significant change during puberty that often gets overlooked is the change in our sweat glands. A subset of glands, called the apocrine sweat glands, becomes active in response to puberty hormones, changing the quantity and composition of our sweat. 

Interestingly, body ‘odour’ is primarily caused by normal skin bacteria digesting the oils in the sweat produced by these glands, rather than the sweat itself.

While the body is going through these changes, it is not uncommon for people to sweat more and to be more self-conscious about it. Antiperspirants usually control sweating, but sometimes, they are not sufficient. In your son’s case, talking to your pharmacist about stronger antiperspirants would be a helpful first step.

Although this is usually a normal part of development, it would be worth going to your GP for a check-up to rule out other common conditions that can cause excessive sweating, such as an overactive thyroid gland. Certain medications, such as the most commonly used antidepressants, can also exacerbate sweating.

If prescription-strength antiperspirants are not controlling the symptoms, your GP can advise on a number of other treatments.

These can range from other topical medications to treatment with botulinum toxin (Botox), oral medications, and, in some cases, a procedure called iontophoresis, where a mild electrical current is applied to the area of skin with the most sweating.

Aside from the medical interventions, you could help your son understand that this is often a temporary and normal part of growing up. It is important to help him feel supported and not isolated.

I would encourage him to continue to exercise, as people with a lower exercise tolerance will sweat more with less effort. So, staying fit may help prevent his symptoms from getting worse. 

Cool showers and lighter, more ventilated clothing may also help, as some people will sweat abruptly if they become too hot. Reducing caffeine intake may also help, as stimulants can cause sweating.

When he is a bit older, if sweating is still an issue, I would advise him to limit his alcohol consumption, as this can increase sweating.

See the international support organisation www.sweathelp.org for more information and advice.

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