The medical term for a sweaty palm is palmar hyperhidrosis. It is a condition where you will sweat beyond physiological need. There are two types of palmar hyperhidrosis which are primary and secondary. Primary hyperhidrosis usually affects anatomical areas caused by the unknown. It can occur in both adults and children but commonly starting at puberty. Secondary palmar hyperhidrosis is due to other causes such as endocrine, infectious or neurological disorder.
The easiest way to get rid of sweaty palms is by removing the factor that can trigger it such as heat and emotion. You need to manage your stress by considering yoga and meditation. You can go to psychotherapy and practice relaxation techniques when you start to feel your anxiety kicks in. However, these preventive measures are usually ineffective and patients who suffer from this disease will continue sweating regardless of their mood or weather.
You need to seek medical experts to treat primary hyperhidrosis. There are two options including medical and surgical treatments. The first line for medical treatment for palmar hyperhidrosis is usually topical aluminium chloride and it is very effective but ineffective to the other type of hyperhidrosis. The other choices are oral anticholinergic agents, botox injection (botulinum type A) and iontophoresis with tap water.
Iontophoresis uses a device that produces electric current to introduce ions into cutaneous tissue. The ionic current will temporarily block the sweat duct and reduce sweating. This treatment is usually combined with anticholinergic or botox injection for better efficacy. However, the side effect of this treatment is skin irritation from the currents and it is contraindicated in patients who are pregnant, or with metal implants or pacemakers.
Oral anticholinergic is usually used in those patients with sweating exacerbated in known anxiety-provoking situations. Examples of anticholinergic are glycopyrronium bromide and propantheline, which need to be taken as required and advisable to combine with any of the other therapies. It is because single therapy of anticholinergic will produce some side effects and may limit its usefulness.
For botulinum toxin Type A injection, it may be painful but it will be reduced by topical anaesthetic. The side effect of this treatment is temporary muscle paralysis of the intrinsic muscles of the palms. However, the FDA has not approved Botox for sweating of the palmar and plantar hyperhidrosis because palm injection will cause more pain and require nerve blocks to numb the hands. Otherwise, a skilled practitioner is needed to administer it as an off label use.
Surgical treatment can be considered for patients with severe sweating and failed other treatments such as endoscopic thoracoscopic sympathectomy (ETS). This procedure will interrupt the sympathetic nerve responsible for sweating. It usually destroys part of the nerve supply to sweat glands in the skin at the level of second (T2) or third (T3) thoracic ganglia on both sides and under general anesthesia. The surgeon will insert a special endoscopic instrument into the chest between two ribs just below the armpit, hence the operative wound would be too small and easily healed.
The complication of this surgery is postoperative compensatory sweating but the success rate is high with more than 95% of cases consistently yielding curative results with transection of the sympathetic chain at the level of T2 on both sides. This sympathectomy procedure is both effective and risky including lung problems, hence, it is used in younger patients or in early teenage years. Otherwise, for other patients, this surgery will use sympathectomy as a last resort.
Some surgeons will opt for ramicotomy to limit the severity of compensatory sweating but recurrent sweating is higher with this procedure. Another alternative is a laser which can focus heat a narrow beam of heat to destroy sweat glands at the palm. Patients will have faster recovery with laser technique.
