Few things can be harder for a teen than being different, especially when that difference is due to an embarrassing and isolating condition like hyperhidrosis, or excessive sweating. This condition can affect everything from the clothes one wears to the activities one can enjoy, and it often takes a psychological toll on teens who have it.

Speaking today at the 64th Annual Meeting of the American Academy of Dermatology, dermatologist Dee Anna Glaser, M.D., vice chairman of the department of dermatology at Saint Louis University School of Medicine in St. Louis, Mo., discussed the impact of hyperhidrosis on teens and how the condition can be effectively treated.

“Teens are already concerned about fitting in with their peers,” Dr. Glaser said. “Having a condition like hyperhidrosis during this time can have a negative impact on self-esteem, which can lead to more serious issues like social isolation, anxiety, paranoia and depression,” Dr. Glaser said.

Hyperhidrosis is a chronic medical disorder that results in the production of excessive sweat. Once thought to be rare, a recent study determined that the condition actually affects approximately 2.8 percent of the U.S. population, or 7.8 million people. The condition can cause heavy sweating on the palms of the hands, underarms and soles of the feet.

“Patients may find that their heavy sweating causes constant embarrassment,” Dr. Glaser said. “Because sweat has a negative connotation in our society, they may start to avoid social situations where someone may notice that they have a sweating problem. Their school work also may be affected because they don’t want to raise their hands. For teens, this can impact their emotional well-being.”

A recent study conducted by Dr. Glaser showed that 83 percent of her patients with hyperhidrosis reported that their condition started at or before they turned 19, with the average age of onset between 14 and 15 years of age. Unfortunately, this is not a condition that you can “outgrow,” so it is essential that a person who develops it get appropriate treatment from a dermatologist.

The first line of treatment is an anti-perspirant product. Anti-perspirants work by plugging the sweat ducts, which reduces the amount of sweat that reaches the skin. Strong, prescription anti-perspirants also may be combined with other treatments such as iontophoresis, surgery and botulinum toxin injections to help manage the condition.

Iontophoresis is a procedure in which water conducts an electrical current from an electronic device through the skin’s surface, thus inhibiting sweat production. The technique has been used successfully since the 1950s, and studies indicate that 83 percent of people treated with tap water iontophoresis respond well. After a series of treatments, patients may need one maintenance treatment every one to four weeks to keep hyperhidrosis under control.

Endoscopic thoracic sympathectomy, or ETS surgery, aims to interrupt the nerve signals from the spinal column to the sweat glands, thereby preventing the sweat glands from working. It has been shown to be successful in treating hyperhidrosis of the palms, but has a high risk of side effects.

Botulinum toxin type A was approved to treat hyperhidrosis by the U.S. Food and Drug Administration (FDA) in 2004 and works by blocking the nerves that stimulate sweat glands. Treatments can be performed in the doctor’s office and results may last up to seven months.

“A dermatologist can select the appropriate treatment for the teen and work with him or her to help understand the condition and its treatment,” Dr. Glaser said.

Dr. Glaser recommends the following tips for patients to help manage their condition:

• Choose clothing that will keep you cool. Natural fibers like cotton are cool, but they absorb sweat and can stay damp once they get wet. While synthetic fibers can be warm, they draw sweat away from the body and feel dry. You may find it more comfortable to have a change of clothing available during the day.
• If your feet are affected, try using absorbent insoles and leaving shoes to dry out rather than wearing the same pair on consecutive days.
• Avoid foods and drinks that seem to trigger your sweating. These are different for everyone and you will probably know what causes problems for you.
• Stress, tension and anxiety are common for everyone, although people with hyperhidrosis have extra difficulties coping with sweating. Think about how you can reduce stress during the day, plan your activities carefully and try to make time to relax.

Teens with hyperhidrosis may find it difficult to explain how the condition affects their lives to their family or friends. “I encourage my teen patients to talk about how hyperhidrosis is affecting them because that’s an important part of the treatment process,” Dr. Glaser said. “In addition to providing treatment to alleviate the physical symptoms of the condition, a dermatologist can refer a patient to a support group or other resource to get help for the psychological symptoms.”