My 9-year-old never seems to sweat, even

Book a paediatric appointment for your son before his next training session, and from now on treat any sign of overheating during sport as a stop sign, not something to push through.

I can't diagnose why he doesn't sweat — that's exactly what the appointment is for. What I can do is make tonight safe, tell you the moment home care is over, and give you words you can screenshot.

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Why this deserves a check (short version)

A 9-year-old who never seems to sweat, even in sport, is unusual enough that a doctor should look at it rather than the family guessing. Two things make it worth doing before the next practice instead of after a bad episode:

• Not sweating means less of the body's own cooling system is working. In hot conditions or hard exercise, that raises the risk of overheating faster than for a child who sweats normally.
• Red face and dizziness after sport are already heat-warning signs. Being able to "push through" them once does not mean it's safe next time — and this is the part the doctor needs to see, not just sweat itself.

Also worth telling the doctor: he has had dizziness/"going black" after exercise and, separately, a bad headache episode at age 9 with nausea and light sensitivity. Those belong in the same story.

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1) What you've tried vs. what helps more

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2) Tonight and today: the practical actions

Today

1. Call or use the app of your paediatrician / health centre and ask for an appointment before the next training session, saying: *"9 years old, he barely sweats even during sport, and has had a red face and dizziness after exercise."* Say those words early — they get the right slot.
2. Write down the last two episodes: date, sport and how long, how hot it was, whether he was in sun, what he drank and ate before, how long until he felt normal again.
3. Check the room: is there shade or air conditioning where he trains and where he sleeps?

Tonight / any day he feels hot after activity

1. Stop the activity and move him somewhere cool. Remove extra clothing.
2. Cool him with cool (not icy) water on the skin plus fanning; a cool cloth on neck and forehead. No alcohol rubs on the skin.
3. If he is fully awake and alert, let him sip water slowly. If he is confused, drowsy, or not fully awake, give nothing by mouth.
4. Note the time of exposure and the time he improved — the doctor wants these.
5. If he seems fine afterwards, let him rest; no extra salt powders, energy drinks or vitamins "for sweating" without asking the doctor.

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3) Decision tree

GREEN — normal home care
Sweating (even a little), pink cheeks that cool down within a few minutes, alert, drinking normally, back to normal within ~30 minutes of cooling.
→ Continue as normal, keep the log, keep the appointment.

YELLOW — stop activity, cool down, and tell the doctor this week (before the next practice)
Red face or flushed skin that stays hot, dizziness or "going black" when standing, headache, nausea, unusual tiredness, cramps, thirst that isn't relieved by water, skin clammy or pale.
→ Stop sport. Cool the room and his skin. Small sips of water if fully alert. Log it. Do not let him train again until the doctor has seen him.

RED — call 112 (Spain's emergency number) or your local emergency number now
Confusion or strange behaviour, stumbling or unsteady walking, a fit/seizure, reduced consciousness or fainting, a very hot body, fast breathing, or not waking properly after being cooled.
→ Call 112 now. Move him out of the heat, remove outer clothing, cool with cool water and fanning, note how long he was in the heat, and give him nothing by mouth while he is confused or drowsy. Follow the dispatcher. Do not wait to see if it improves — and do not wait because he is still sweating; a child who is confused after heat exposure needs help even if sweat is present.

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4) Please don't

• Don't let him "push through" a red face, dizziness or headache to finish a session.
• Don't use sweat as the safety signal — his lack of sweating is the thing being checked.
• Don't use ice straight on skin, alcohol rubs, or alcohol rubs/medicinal rubs of any kind.
• Don't give anything by mouth if he is confused, drowsy or not fully awake.
• Don't change, stop or add any medicine yourself, and don't add "sweat" supplements or powders — including ones bought online.
• Don't compare him to other kids; the doctor needs this child's own pattern.

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5) What to bring to the appointment

• Age, and the full timeline: when you first noticed he doesn't sweat; sport, duration, indoor/outdoor, temperature.
• The episode log (episode #1, episode #2 with times and how long each took to settle).
• Whether he sweats anywhere at all — face, palms, soles, armpits, at night — and whether it's "less than other kids" or "never".
• Any temperature you took with a thermometer, with the time and the method.
• Associated symptoms: dizziness, headache, nausea, palpitations, tiredness, cramps, thirst, pale/clammy skin.
• Every medicine he takes (prescribed or over-the-counter), plus any the adults in the house take.
• The 9-year-old's headache consultation sheet you already have, and the post-exercise dizziness record — bring the dizziness record only if it describes him rather than an adult.

Questions worth asking the doctor

• "He doesn't sweat even in sport — does that need its own assessment?"
• "Given the red face and dizziness after exercise, what should we do at the next practice — stop, shorten, or pause entirely?"
• "Which checks would be useful (thyroid function, blood sugar, medicines review, sweat-gland assessment)?"
• "Is there anything in his medicines that reduces sweating?"
• "What would make you want to see him the same day?"

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6) Scripts you can screenshot

To the clinic (Spanish):
> "Buenos días. Tengo un niño de 9 años que casi no suda, ni siquiera durante el deporte. Recently le ha fluxionado la cara y ha tenido mareos después del esfuerzo. ¿Me pueden dar cita antes de su próximo entrenamiento? En una hoja tengo anotados los episodios."

To the school / coach (Spanish):
> "Hola, soy la madre/padre de [nombre]. Mientras esperamos la revisión médica, no debería seguir con la actividad hasta que lo 值 el niño y su sports. Si se le pone la cara roja, tiene mareos o dolor de cabeza, se para y me avisan enseguida. Gracias."

To the practice nurse (English):
> "He's 9. He doesn't sweat, even during sport. Last time his face went red and he felt dizzy after training. I'd like him seen before the next session, and I'd like to know what to do if those signs appear again."

If a red sign appears (say this to whoever is with him):
> "Call 112 now and say: child, 9 years old, suspected overheating after exercise, [confusion / unsteady / very hot / drowsy]. We're cooling him in a cool place. He has been in the heat since [time]."

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7) What "good" looks like in the next 24 hours

• The appointment is requested or booked (not just intended), dated before the next practice.
• The log has the last two episodes written down, with times.
• No episode of red face + dizziness gets pushed through; one full session is logged with what happened.
• Everyone who supervises his sport knows the stop signs and the script above.
• A cooling plan at home: which room, what you'll do first, water where he can reach it.

If any red sign appears before the appointment, the appointment stops being the plan — 112 first, then tell the doctor.

*(Note: I could not confirm a public clinic phone number for Madrid this turn, so please use your own centre's line and the official Spanish health portals — www.sanidad.gob.es — to reach your local primary-care service. The emergency number 112 is the one verified for Madrid/Spain in this session.)*