What is Palmar Hyperhidrosis?

Palmar Hyperhidrosis is a condition characterized by excessive sweating of the palms, beyond what is needed for body temperature regulation. It can be socially, emotionally, and functionally distressing, affecting daily tasks like writing, shaking hands, or using touch-based devices. This condition often begins in childhood or adolescence and may persist into adulthood.

What Causes Palmar Hyperhidrosis?

Palmar hyperhidrosis can be classified as either primary or secondary, depending on the cause.

Primary (Idiopathic) Palmar Hyperhidrosis:

• Most common form
• No underlying medical cause
• Likely due to overactivity of the sympathetic nervous system
• Often runs in families (genetic link)

Secondary Palmar Hyperhidrosis:

• Caused by another medical condition or medication
• Possible causes include:
  • Thyroid disorders (especially hyperthyroidism)
  • Diabetes
  • Infections
  • Neurological disorders
  • Medications such as antidepressants or antipyretics

What Are the Symptoms?

Key symptoms of palmar hyperhidrosis include:

• Excessive sweating of the palms, even in cool temperatures
• Moist or dripping wet hands
• Symmetrical sweating (affects both hands equally)
• Clammy feeling in the hands
• Difficulty with gripping objects, writing, or handling paper
• Emotional and social embarrassment

Sweating typically worsens during stressful or anxious situations.

How Is It Diagnosed?

Diagnosis is usually based on medical history and physical examination. Important steps may include:

• Medical history review – Including family history and symptom patterns
• Physical examination – Checking the extent and pattern of sweating
• Starch-iodine test – To map the areas of sweating
• Blood tests – To rule out secondary causes such as thyroid problems or diabetes

What Treatments Are Available?

Treatment aims to reduce sweating and improve quality of life. Options include:

• Topical antiperspirants – Aluminum chloride-based solutions (e.g., Drysol)
• Iontophoresis – A treatment using mild electrical currents in water to block sweat glands
• Botox injections – Temporarily block nerve signals to sweat glands
• Oral medications – Anticholinergics (e.g., glycopyrrolate) to reduce overall sweating
• Surgery – Endoscopic thoracic sympathectomy (ETS) may be considered in severe cases, though it carries risks
• Lifestyle adjustments – Using absorbent hand powders or sweat-proof gloves during tasks

What Is the Outlook (Prognosis)?

Palmar hyperhidrosis is not dangerous but can have a significant emotional and social impact. With proper treatment, many individuals experience substantial relief. Some treatments offer temporary results, while others can be long-lasting. Early diagnosis and treatment improve quality of life.

How Can People Cope or Get Support?

Managing palmar hyperhidrosis involves both medical and emotional strategies. Tips include:

• Seek medical advice early – Early treatment can prevent long-term distress
• Use hand wipes or handkerchiefs – To manage moisture discreetly
• Practice stress-reduction techniques – Stress and anxiety can worsen sweating
• Join support groups or online communities – To connect with others who understand
• Be open with trusted friends or coworkers – Reduces the emotional burden