Definition & Overview

Sweaty palms, as the name suggests, is a condition characterised by profuse sweating in the palms of the hands. Medically known as palmar hyperhidrosis, sweat literally drips from the hands of people afflicted with this condition.

Sweating is one of the processes of releasing liquid through the 2 to 4 million sweat glands that the human body has. A large number of these glands are normally found under the arms and in the extremities such as the hands and feet. Sweating or perspiring serves to cool the body down and regulates body temperature. A person cannot control the amount of sweat being released, as this process is controlled by the autonomic nervous system. Conditions that induce sweating include exercise, hot weather, and strong emotions such as anger or embarrassment.

However, individuals diagnosed with hyperhidrosis releases a large amount of sweat even with no apparent cause or stimuli. Such is the case of those suffering from palmar hyperhidrosis, or sweaty palms. This condition has a significant impact on patients’ daily lives, with sufferers struggling to do even the easiest tasks. Sweaty hands could even affect their personal lives, causing emotional stress and trauma.

Causes of Condition

Sweaty palms are caused by the hyperactivity of the autonomic nervous system, particularly its sympathetic chain located inside the chest cavity. This hyperactivity can be triggered by several events, such as emotional distress or elevated hormonal level as well as certain illnesses and infections.

In the majority of cases, patients share the condition with other family members leading to the assumption that palmar hyperhidrosis is caused, to some extent, by hereditary factors.

Key Symptoms

People suffering from sweaty palms or palmar hyperhidrosis have noticeable wet or clammy palms. Some may even experience sweat literally dripping from their palms. They also experience excessive sweating in other parts of the body like under the arms and feet. The sweat can also lead to stained clothing.

Who to See & Types of Treatments Available

Most patients suffering from sweaty palms approach a general practitioner who is typically well equipped to properly diagnose the condition and prescribe the appropriate treatment.

Since this condition typically involves the skin of the body, patients may be referred to a dermatologist in some cases for specialised care.

However, since this condition is identified to be closely associated with the autonomic nervous system, a consultation with a neurologist might also prove beneficial for some patients.

As for the treatment, patients' options include:

• Antiperspirant solutions - Some physicians recommend the application of topical antiperspirant directly onto the palms of each hand to control heavy sweating. Some studies report the enhanced efficacy of aluminium chloride antiperspirants in reducing the release of liquid in the palms.

  • Medicines containing anticholinergic substances - These medicines are taken orally and are found to be effective against this condition. However, some patients report several side effects such as dry mouth, constipation, and dilation of the pupils.

  • Botox injections – A single injection of Botox is proven to alleviate symptoms for up to three months.

  • Iontophoresis – This treatment uses a repulsive electromotive force to drive medication through the skin.

  • Surgical options - Those seeking a more permanent solution may consider undergoing surgery to completely remove some of their sweat glands. Options include:

1. Retrodermal curettage
2. Ablation using laser
3. Sweat gland suction
4. Endoscopic thoracic sympathectomy or ETS - This procedure cuts the messaging system from the sympathetic chain in the chest and prevents stimuli from reaching the targeted body parts. This procedure involves clamping, burning, and even cutting the thoracic ganglion located along the spine. ETS has been known to be quite effective and safe in treating palmar hyperhidrosis even among young children.
   References:

• James, William; Berger, Timothy; Elston, Dirk (2006). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Saunders. pp. 777–8.

• Freedberg, Irwin M.; Eisen, Arthur Z.; Wolff, Klaus; Austen, K. Frank; Goldsmith, Lowell A.; Katz, Stephen I., eds. (2003).Fitzpatrick's Dermatology in General Medicine (6th ed.). McGraw-Hill. p. 700.