An Overview of Sweaty Palms (Palmar Hyperhidrosis)

It can cause excessive sweating in the hands.

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sweaty palms

 

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Sweaty palms, also known as palmar hyperhidrosis, is a condition that causes excessive sweating in the palms of the hands. Though it’s called sweaty palms, often times a person will experience both sweating in the palms of the hands and soles of the feet together (sweating in the feet is called plantar hyperhidrosis). Sweaty palms is an offset of primary hyperhidrosis—a condition that causes excessive sweating in the extremities, underarms, and face. Hyperhidrosis, including sweaty palms affects between 2 to 3 percent of the population, but less than 40 percent of those affected seek medical treatment.

Symptoms

The symptoms of sweaty palms is exactly that—overactive sweat glands that result in excessive, uncontrolled sweating in the palms of the hands. Sweating will happen instantaneously and not as a cause of an external factor like exercising or an increase in body temperature. Those who have sweaty palms will experience sweating in any season, not just the spring or summer.

Your palms may feel clammy or wet, making you feel uncomfortable shaking hands with someone, handing out papers at a meeting, or typing on a keyboard. These symptoms often increase in times of stress or anxiety. You may notice the symptoms of sweaty palms early on as a child, with increased symptoms as you hit puberty. As a patient grows older into their 40s and 50s, symptoms of sweaty palms will often decrease as long as it’s not caused by a secondary cause like disease.

Causes

There may be a genetic inheritance to sweaty palms that makes the condition run in families. Certain conditions can also cause sweaty palms, or another form of hyperhidrosis, including anxiety, certain cancers, substance abuse, heart disease, hyperthyroidism, lung disease, acromegaly (when the pituitary gland produces too much growth hormone), menopause, Parkinson’s disease, glucose disorders, tuberculosis, stroke, or a pheochromocytoma (a tumor in the adrenal gland) or carcinoid syndrome (disease that occurs because of the presence of a carcinoid tumor found in the small intestines, pancreas, liver, or stomach). Certain infections can also cause sweaty palms as well as some prescription medications.

The condition was once thought to affect women more than men, but later discovered that it affects both sexes equally as women were just more likely to seek treatment for sweaty palms. 

Diagnosis

In order to rule out secondary sweaty palms caused by one of the above conditions doctors will make note of the location of sweating, pattern, timing, and other symptoms such as weight loss, fever, appetite, and hormone levels.

If there are no secondary causes to sweaty palms, doctors typically perform two types of tests to diagnose sweaty palms. The first is called a starch-iodine test. Here, an iodine solution is applied to the palm and, once dried, sprinkled with starch. In areas of excess sweat, the iodine and starch solution will turn the palms a dark blue color. Another test is the paper test, where a doctor places a special type of paper on the palms to absorb the sweat. The paper is then weighed to see how much sweat has accumulated on the palms.

In order to diagnose someone with sweaty palms, the sweat must be excessive and lasting six months or longer without a known cause. Other factors that contribute to the diagnosis include the frequency of sweating (having at least one episode of sweating a week), age (as it is most prominent in patients under the age of 25), family history, having sweat occur on both palms, and not experiencing any sweating during sleep (which could be a different condition all together called sleep hyperhidrosis).

Treatment

When not caused by a separate disease or infection, having sweaty palms doesn't harm your physical health, but it can certainly affect your quality of life and emotional health. There are a number of treatment options depending on the severity of symptoms from sweaty palms. This includes using antiperspirants on the palms to help block the sweat glands. Botulinum toxin (Botox) has also been used to treat sweaty palms by releasing acetylcholine, a chemical compound that acts as a neurotransmitter to reduce the amount of sweat the glands in your palms produce. A similar outcome can be done with a prescription of anticholinergic drugs, as they help block neurotransmitters responsible for producing sweat.

Two medical procedures that can help treat sweaty palms are iontophoresis and an endoscopic thoracic sympathectomy (ETS). With iontophoresis, a medical device uses water and an electric current to pass an ionized substance through the skin in order to stop the palms from sweating. In severe cases of sweaty palms where other treatments prove unsuccessful, ETS can be performed. It’s a minimally invasive procedure that gets rid of the pathway from the nervous system to the palms of the hands, eliminating the ability for the palms to sweat.

Coping

Dealing with sweaty palms can cause a patient’s emotional health to greatly suffer. Feeling anxious in everyday situations such as holding or shaking hands, filing papers, and even writing can be tasks that cause social distress and embarrassment. Stress and anxiety can cause you to sweat, which may only exacerbate sweaty palms.

It’s often recommended that in addition to the standard medical treatments above patients also consider psychotherapy to help learn techniques and tools to cope with anxiety and insecurities living with sweaty palms. Psychotherapy can help you learn how to successfully reduce the release of cortisol to the body (which frequently happens in times of stress). It can also provide social skills to help you cope in day to day life as you continue to get treatment for sweaty palms, reducing embarrassment or stress. 

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