An Overview of Sweaty Palms (Palmar Hyperhidrosis)

Sweaty palms, also known as palmar hyperhidrosis, is a condition characterized by excessive sweating in the palms of the hands. Though it’s called sweaty palms, it can be associated with sweating in the soles of the feet (sweating in the feet is called plantar hyperhidrosis). Sweaty palms is a subset of primary hyperhidrosis—a condition that causes excessive sweating in the extremities, underarms, and face. Hyperhidrosis, including sweaty palms, affects between 2 to 3% of the population, but less than 40% of those affected seek medical treatment.

Symptoms

The main symptom of sweaty palms is exactly that—uncontrolled sweating in the palms of the hands. 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.

Sweating will happen without a trigger, not due to any external factor like exercising or an increase in body temperature. And it can happen at any temperature or during any season. The symptoms can 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 you reach your 40s and 50s, symptoms of sweaty palms will often decrease as long as it’s not caused by another medical condition.

Causes

Sweaty palms occurs due to overactive sweat glands, and there are many reasons for this to occur.

It can run in families, and it can be associated with other forms of hyperhidrosis or with certain medical conditions.

Associated conditions include:

• Anxiety
• Infections
• Prescription medications
• Substance abuse
• Heart disease,
• Hyperthyroidism
• Lung disease
• Acromegaly (a condition in which the pituitary gland produces too much growth hormone)
• Menopause
• Parkinson’s disease
• Glucose disorders
• Tuberculosis
• Stroke
• Pheochromocytoma (a tumor in the adrenal gland)
• Carcinoid syndrome (a disease that can occur when a carcinoid tumor found in the small intestines, pancreas, liver, or stomach)

The condition affects both sexes equally, but females may be more likely to seek treatment for sweaty palms.

Diagnosis

Your doctor will ask you where you experience sweating on your body, the pattern, timing, and whether you have other symptoms such as weight loss, fever, appetite, and hormone levels.

If you don't have a medical condition as the cause of your sweaty palms, your doctor may do a diagnostic test for you.

Tests may include:

• A starch-iodine test: 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.
• A paper test: 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.

A diagnosis of primary sweaty palms requires that 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 (it is most prominent 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

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. You and your doctor can discuss which of the treatments is the right option for you, depending on the severity of your symptoms and how much they are bothering you.

Treatments can include:

• Using antiperspirants on the palms to help block the sweat glands
  
• Anticholinergic drugs, which help block neurotransmitters responsible for producing sweat

Medical procedures that can help treat sweaty palms:

• Botulinum toxin (Botox): This is an injection that has been used to treat sweaty palms by releasing acetylcholine, a neurotransmitter, to reduce the amount of sweat the glands in your palms produce.
• 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.
• Endoscopic thoracic sympathectomy (ETS): This is 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 be stressful for some people. If you're feeling anxious in everyday situations—such as holding or shaking hands, filing papers, or writing, it can cause social distress and embarrassment. Stress and anxiety can cause you to sweat, which may exacerbate the problem.

In addition to medical treatments, it’s often recommended to consider psychotherapy to help learn techniques and tools to cope. Psychotherapy and cognitive behavioral therapy may help you learn how to successfully reduce the release of cortisol in your body (a hormone that often increases in times of stress). You may also adopt social skills to help you cope in your day-to-day life as you continue to get treatment for sweaty palms.