Palmar Hyperhidrosis

Sweating is one of the fundamental ways the body regulates it’s internal temperature, but many people suffer from excessive sweating, a condition known as hyperhidrosis, and this means that they sweat even when they are not hot, or exercising.

Sweating is controlled by the sympathetic nervous system and is involuntary, and it is the over activity of these nerves that triggers excessive sweating.

There are two main types of excessive sweating, primary hyperhidrosis that causes excessive sweating in focal areas such as the armpits, hands and feet, and secondary hyperhidrosis, which causes all over sweating and is generally linked to underlying medical conditions such as infections, autoimmune disorders and diabetes. Secondary hyperhidrosis can also be caused by some psychiatric disorders.

Sweat glands are concentrated most densely on the hands and feet and these tend to be the areas most commonly affected by hyperhidrosis. Excessive sweating of the hands is called palmar hyperhidrosis and this can be an embarrassing and inconvenient condition. People who suffer from palmar hyperhidrosis tend to have cold, clammy hands that can literally drip with sweat at times. This can be triggered by anxiety, nervousness and fear, but can also occur randomly with no obvious stimulus. Symptoms usually start in the early teens and continue throughout life.

Palmar hyperhidrosis can have a very serious impact on every day life, and sufferers can also experience significant psychological symptoms, such as social phobias and depression. Having excessively sweaty hands can make it difficult to perform even the most simplest of tasks such as typing, writing or even putting on clothing, and this can be very distressing to the individual. Sufferers may also find it difficult to initiate intimate relationships because they perceive themselves to have an unpleasant, clammy touch. This additional emotional distress can aggravated the problem, and so it is important for suffers to attend to both the psychological and physical symptoms of this condition in order to find an effective cure.

There are various treatments for excessive sweating, and Iontophoresis is usually the first treatment recommended for palmar hyperhidrosis. This involves immersing the hands in a water bath, through which a small electrical charge is passed. This treatment can be uncomfortable, producing a tingling, buzzing sensation and sessions usually last for around 30 mins. Treatments are usually repeated 2-3 times a week at the outset, and then reduced as the improvements begin to show. You may need to continue treatments on and off for the rest of your life, but generally it has been found that primary hyperhidrosis symptoms can lessen with age.

Botulinum Toxin injection can be successful for treating palmar hyperhidrosis, and this involves a number of small injections into the palm area. The Botulinum Toxin numbs the nerves that trigger the sweating, but can also in some cases numb some of the smaller muscles in the surrounding area, causing minor hand weakness. Botulinum injections are not a permanent solution and will have to be repeated every 4-6 months to maintain their effectiveness, and this can be an expensive treatment as you may need over 35 injections during each session.

Endoscopic Thoracic Sympathectomy is a surgical procedure that is very successful at treating palmar hyperhidrosis, and can offer a permanent solution to the problem. This involves a small keyhole incision, through which the nerves that trigger sweating in the hands are permanently severed. Some drawbacks to this method are that it can cause compensatory sweating in other parts of the body such as the trunk or legs, and sometimes people may experience a slight weakening in their hand motor skills.