Palmar hyperhidrosis

 

Palmar hyperhidrosis (excess sweating of the palms) is common and may occur is association with excess sweating from the axilla, the feet and elsewhere. There are a variety of treatment including surgery. You might also want to read our information leaflet on axillary hyperhidrosis which explains some other aspects of the condition.

Sweat is a solution of water and salts produced by glands immediately under the skin and cools the body by evaporation during exercise and in warm surroundings. The activity of these glands is normally controlled by the nervous system. In a small number of people (less than 1.0% of the population), this control mechanism fails to function normally causing excessive sweating, even when body temperature is normal. This condition is known as hyperhidrosis.

Occasionally, hyperhidrosis occurs as a result of abnormal hormone levels and these will be measured as part of the assessment of people with this condition. In most cases, no reason for the excessive sweating will be identified by these tests. 

Excess sweating may occur anywhere but usually affects the hands, armpits, scalp, face, and/or feet. Although some people may find this excess sweating embarrassing, it is not a dangerous or life threatening condition. 

Treatment 

The principle means of treating this condition are the use of potent antiperspirants, surgery and Iontophoresis

Antiperspirants 

The most effective antiperspirant is Aluminum Chloride which may be prescribed for you. This is applied in the evening 2-3 times per week. In some cases, it causes skin irritation. The treatment must be repeated regularly for life. This agent cannot be used on the face or scalp. 

Surgery (Endoscopic sympathectomy) 

The nerves that supply the sweat glands in the hands and axilla (armpit) can be permanently divided within the chest cavity by a surgical procedure. This procedure is performed as a Day case.  The nerves are divided using a keyhole surgery technique\r\nunder General anaesthesia. Two or three small incisions (5-10mm) are made in the skin under each arm. In order to see the nerves, the lung is collapsed. The nerves are divided and then sealed using cautery to prevent them regrowing. This is particularly effective if the excess sweating affects the hands. 

Although this is a safe procedure, complications can occur in a small number of people. Some people notice an increase in sweating from other parts of the body (compensatory hyperhidrosis) which may be quite troublesome. If the branches of the nerves that supply the face are damaged during the operation, this may cause visible drooping of the eyelid (Horner’s syndrome). Occasionally, the lung may fail to reinflate and it may be necessary to place a small drainage tube into the chest for a short time after the surgery. As with any surgery, bleeding or infection may occur but this is not common. 

The heart and major vessels are close by and if these are injured, which occurs rarely, your life may be at risk.

Postoperative instructions 

After the procedure, you may have some mild discomfort. Dissolving stitches are used to close the wounds so there are no stitches to be removed. You may need to take some simple pain killers following the procedure which will be prescribed for you before you leave. 

Iontophoresis

This treatment is suitable for people who find that the excess sweating mainly occurs from the palms or soles of the feet. An electrical machine is used which uses electrical current to drive ions from tap water into the skin. You can buy this machine and use it at home.  The treatment is used every day initially (for an hour or so) and then a few times per week. It is effective is some people in dealing with the problem but not in everyone. It has little risk of side effects. 

 

You can read more about iontophoresis and purchase a idrostar(TM) iontophoresis machine on the Morehampton Clinic website. They can be contacted by telephone  on 01 269 3921 or via their website sweating.ie.

Click here for a YouTube video showing how to use the idrostar.

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