Author: Dott.ssa Basile M. Gaetana (Tania)

Date: 22/04/2020

Palmar hyperhidrosis: sweaty hands

Excessive hand sweating, also called palmar hyperhidrosis, is an annoying, embarrassing, and self-esteem-destroying problem.

Sweaty hands can negatively affect your social life during your education and career.

Learn more about palmar hyperhidrosis

There are two types of hyperhidrosis: primary and secondary.

  • Primary hyperhidrosis refers to excessive sweating without any known cause. This type of sweating occurs on specific areas of the body and in a "symmetrical" way. The affected areas are the hands, feet, underarms, head or face. Primary hyperhidrosis often begins during childhood or adolescence, particularly as hyperhidrosis of the hands and feet. People with primary hyperhidrosis do not have excessive sweating during sleep. Primary hyperhidrosis has also been shown to be hereditary.
  • Secondary hyperhidrosis. This type of excessive sweating is caused by a disease or a side effect of a medication. Unlike primary hyperhidrosis, secondary hyperhidrosis occurs over larger areas of the body. Another fundamental difference between the 2 types of hyperhidrosis is that people with secondary hyperhidrosis can often have excessive sweating during sleep. With secondary hyperhidrosis, excessive sweating usually begins in adulthood, whereas, as mentioned above, primary hyperhidrosis begins in childhood or adolescence.

To determine the best treatment for palmar hyperhidrosis, it is necessary to know the cause.

The first line of treatment for excessive hand sweating are antiperspirants. Antiperspirants are not invasive. Most doctors recommend starting with mild formulations, and if they do not relieve the symptoms, they move you on to stronger formulations. How to use antiperspirants is also important. In general, antiperspirants are applied at night before sleep and on completely dry skin to avoid irritation.

If the antiperspirants are not effective then iontophoresis may be considered, ifused correctly.

Another treatment option for excessive hand sweating is botulinum toxin. An experienced physician can inject botulinum toxin into the palm area of the hands to drastically reduce sweating. The effects are long-lasting (about 6 months), but the injections can be painful. One should be aware that discomfort during injections is a potential disadvantage for the treatment of palmar hyperhidrosis.

The use of botulinum toxin for the treatment of palmar hyperhidrosis is most effective if it is performed by a physician who has experience with this type of treatment.

Although for most people, the use of antiperspirants, iontophoresis, botulinum toxin injections, or a combination of the 3 are enough to manage excessive palm sweating, there are others who want to put a definitive end to the problem.

If less invasive treatments have been shown to be insufficient, endoscopic thoracic sympathectomy (ETS) can be considered the last resort.

ETS presents considerable associated risks, in particular a side effect called compensatory sweating (an irreversible form of excessive sweating over large areas of the body) could occur and should only be used in extreme cases after trying other treatments.

Early treatment is essential to improve quality of life because untreated palmar hyperhidrosis could cause physical, social and psychological impairments (mockery, decreased self-esteem, etc.).
Palmar hyperhidrosis should be managed for a normal social life and relationships.

Dott.ssa Basile M. Gaetana (Tania)


Dott.ssa Basile M. Gaetana (Tania)

Medico Chirurgo - N. Iscrizione all' ordine: 8309 - Cosenza

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