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Excessive sweating, medically known as hyperhidrosis, occurs due to an overactive sympathetic nervous system. The increased activity of the sympathetic nervous system causes the arteries to shrink, limiting blood flow to the extremities. It also triggers the sweat glands to produce excessive sweat.
As a result, your palms may turn cold and sweaty, an excess of which is symptomatic of palmar hyperhidrosis. (1) The sweating is generally intermittent and worsens in high temperatures or under stress, but continuous sweating may also happen.
Hyperhidrosis affects about 3% of Americans. While it can cause discomfort, people often fail to get treatment due to unwarranted feelings of embarrassment and self-consciousness about the visible sweating. (2)
There are several medical treatments that you can try to control the sweating, which will be discussed in this article.
Types of Hyperhidrosis
Hyperhidrosis can be categorized into the following two types:
- Primary hyperhidrosis: It is the more common form of excessive sweating and can occur without any underlying cause. It is suggested that primary hyperhidrosis may have a genetic component, since it generally starts post-puberty or during childhood. (3) The excessive sweating associated with primary hyperhidrosis is largely localized in areas such as the hands, feet, armpits, and head.
- Secondary hyperhidrosis: It is also known as generalized hyperhidrosis, and the cause of the excessive sweating is known, such as an underlying medical condition or medication use. Secondary hyperhidrosis most commonly begins in adulthood, as opposed to primary hyperhidrosis. (2)
Causes of Sweating
The causes and triggers of both primary and secondary hyperhidroses can vary greatly.
Primary hyperhidrosis
The common factors leading to primary hyperhidrosis include:
- Odors or foods such as coffee, chocolate, citric acid, spices, and peanut butter
- Excessive heat
- Injury in the spinal cord
- Excessive emotional stress or anxiety
Secondary hyperhidrosis
Secondary hyperhidrosis may occur due to the following reasons:
- Nervous system disorders
- Spinal cord injury
- High anxiety
- Certain types of cancer
- Menopause (3)
- Severe stress
- Heart problems
- Respiratory disorders
- Acromegaly (3)
- Infections such as malaria, tuberculosis, and HIV (2)
- Metabolic conditions such as diabetes, (3) gout, hyperthyroidism, hypoglycemia, and pituitary disease
- Medications such as anticholinesterases, propranolol, antidepressants, and pilocarpine
- Substance abuse
Symptoms of Hyperhidrosis
Hyperhidrosis can be differentiated from sweating by the following signs and symptoms:
- Sudden night sweats without any medical cause
- Recurrent bacterial and fungal infections
- Wet, clammy palms, with visible excessive sweat dripping
- Macerated skin
Treatment for Sweaty Hands
A number of medical interventions can address hyperhidrosis of the palms. You may consult your doctor on the use of the following treatments:
1. Antiperspirants
Antiperspirants are the first line of treatment for excessive sweating. You may try over-the-counter antiperspirants that contain aluminum chloride (Drysol) to control the sweating. (4)
If OTC antiperspirants don’t work, the doctor may suggest prescription-strength antiperspirants containing aluminum chloride hexahydrate. (4) These antiperspirants are to be applied every night until the sweating is improved, after which you may continue the use of Drysol 1–2 times a week. (2)
2. Prescription cloth wipes
People above 9 years of age can use FDA-approved prescription cloth wipes to help control sweating. These special wipes contain glycopyrronium tosylate that helps reduce sweating.
However, it may have side effects such as redness, burning, or stinging sensation in the affected area, along with some dryness in the mouth.
3. Anticholinergics
Anticholinergics work by blocking the signals sent out by the parasympathetic nervous system, (5) thereby deactivating the sweat glands and controlling sweating. These medications may be prescribed as topical creams or oral pills for around 2 weeks. (2)
Anticholinergics may also have some side effects such as blurry vision, dryness in the eyes or mouth, and heart palpations.
4. Botox (Botulinum toxin) injections
Botox injections are popularly used for hyperhidrosis of the underarms and palms. The treatment involves the administration of multiple Botox injections in one sitting to block the signals that stimulate the sweat glands to release sweat. (2)(6)
A single session of Botox treatment can be effective for 3–6 months. However, it may cause some short-term muscle weakness and pain at the injection site.
5. Iontophoresis (the no-sweat machine)
This treatment employs low-voltage direct current to gradually decrease the activity of sweat glands, (7) shutting them down in 6–10 treatments. It involves the use of a device to supply electric current to the sweat glands 2–3 times a week.
Iontophoresis, while effective, may cause discomfort during the session, which may be up to 40 minutes long. You may also notice skin dryness and irritation in the treated area. (2)(6)
6. Microwave destruction
Microwave destruction is a non-invasive treatment method that uses electromagnetic energy. It destroys the sweat glands, therefore blocking sweat production, without damaging the surrounding tissue. (8)
7. Surgery: ETS (endoscopic thoracic sympathectomy)
If you have severe hyperhidrosis that doesn’t improve with any other treatment, you may have to undergo surgery. ETS surgery involves cutting off the nerves that signal the sweat glands, causing a complete halt on sweat production in the area. (3)(6)(9)
Diagnosing Palmar Hyperhidrosis
The diagnosis of palmar hyperhidrosis involves a close physical examination of the palms and other sweat-producing parts of the body, which are identified through a sweat test.
In addition, your doctor may order blood and urine tests to check for underlying conditions such as high blood sugar levels or an overactive thyroid.
If no underlying cause is detected, you may need to undergo a starch-iodine test (10) and a paper test to confirm the diagnosis.
Complications Associated With Hyperhidrosis
Excessive, continuous sweating in any part of the body can affect skin health and increase the risk of conditions such as:
- Vesicular eczema (pompholyx)
- Allergy to footwear constituents
- Skin infections, both bacterial and fungal
- Nail infections
- Warts, in the case of human papillomavirus infections
- Self-consciousness or embarrassment, interfering with daily activities
When to See a Doctor
If you are sweating profusely or more than normal, it is best to consult your doctor for a proper diagnosis. You must seek emergency medical attention in the following instances:
- Chest pain, light-headedness, or nausea along with sweating
- Sudden onset of increased sweating, especially in the palms
- Night sweats
- No effect of OTC or at-home treatment on sweaty palms
Final Word
While it is normal to sweat after heavy exercise or in hot weather conditions, frequent excessive sweating is not and can indicate an underlying problem. However, it is nothing to be embarrassed about.
There are various treatments, such as antiperspirants and wipes, that can control the sweating and therefore prevent hyperhidrosis from disrupting your daily activities. Along with getting medical treatment, observing some self-care measures and avoiding factors that trigger the sweating will greatly help in managing the condition.
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