Table of content

• Sweaty palms or palmar hyperhidrosis

• Classification of hyperhidrosis

• Prevalence of different types of hyperhidrosis in the population as per a survey

• Signs and symptoms of hyperhidrosis (sweaty palms)

• Diagnosis of hyperhidrosis

• 4 Main reasons for sweaty palms

• Problems or complications of hyperhidrosis

• Home remedies for excessive sweating

• Prevention methods to reduce hyperhidrosis

• Treatment of hyperhidrosis

• Take-home points

• FAQ on Sweaty palms symptoms, causes, home remedies and treatment

Introduction

Have you ever wondered ‘why are my palms sweaty?’. Well, the reason for hand sweating can be temporary stress or a permanent medical condition with a family history. 

Before all of this, you need to know that “skin breathes”. Yes, you heard me right! Your skin needs to breathe in and out to regulate the body temperature, to remove toxins, to maintain moisture and exfoliate the skin surface. And the process is called Perspiration, skin breathing in short. 

Sweaty palms or palmar hyperhidrosis

• Hyperhidrosis, generally called heavy sweating, is a medical condition where your hands (sweaty palms), feet, face, head and body become sweaty without any external heat or internal body temperature raise. 

• Sweaty palms (palmar hyperhidrosis) can be frustrating and cause anxiety if you need to extend your hand even for a simple handshake. It becomes difficult to even fill a document, type, and hand out papers. So, researchers refer to it as a ‘silent handicap’. It’s relatable isn’t it?

• Naturally, your body produces sweat to regulate the body temperature to cool down the skin’s surface when the air temperature rises - during fever, while exercising, while you are anxious, nervous, or under stress. The overactive sweat glands cause heavy sweating which is increased to extreme levels in hyperhidrosis conditions. 

• You will find any of the following excess sweat conditions or all of them - excessive hand sweating or excessive underarm sweating or excessive armpit sweating.  You may experience heavy sweating in other places that include the face, neck, back, groin, and feet. 

• To differentiate between the areas and causes of hyperhidrosis, scientists have divided them into various types and named them accordingly.

Classification of hyperhidrosis

Hyperhidrosis is classified into generalized or localized to specific parts of the body. The hands (sweaty palms), feet, armpits, groin, and facial area are the common active regions of perspiration due to the presence of a high number of sweat glands (eccrine glands in particular).

Excessive sweating is harmless in 1% - 2% of the population with hyperhidrosis, but in some cases, you need to be aware of overactive sweat glands that can lead to potential side effects.

Types of hyperhidrosis

There are two types of hyperhidrosis based on the cause of hyperhidrosis- 

Primary hyperhidrosis

Primary hyperhidrosis is also called focal hyperhidrosis or essential hyperhidrosis. Primary hyperhidrosis causes excess sweat leading to excessive underarm sweating or excessive armpit sweating or excessive hand sweating. This heavy sweating of hands (sweaty palms), face, underarm, and feet lead to bad body odor. 

Secondary hyperhidrosis

• Secondary hyperhidrosis is also called generalized hyperhidrosis. Secondary hyperhidrosis causes heavy sweating all over the body or covers a larger area. The increased body temperature and overactive sweat glands can lead to medical conditions like generalized hyperhidrosis.

• Hyperhidrosis or excess sweat can also be classified based on congenital [onset from birth] or acquired [begins later in life] heavy sweating.

• Usually, primary hyperhidrosis or focal hyperhidrosis begins at the stage of adolescence or earlier. Focal hyperhidrosis is believed to be inherited as an autosomal dominant genetic trait. 

Hyperhidrosis is also classified based on the possible causes and amount of skin affected. 

Hyperhidrosis is also divided into other types based on the affected area which include

Craniofacial hyperhidrosis

Cranial hyperhidrosis is a condition where the body temperature causes heavy sweating from the overactive sweat glands at the site of the head, face, and scalp. 

Axillary hyperhidrosis

Axillary hyperhidrosis is the condition where you may experience excessive underarm sweating or excessive armpit sweating. 

Palmar hyperhidrosis

Excessive hand sweating or sweaty palms (palmar hyperhidrosis) is a symptom of palmar hyperhidrosis. The reason for hand sweating (sweaty palms) can be a dermatological issue or due to temporary stress or excessive workout. 

Plantar hyperhidrosis

• Plantar hyperhidrosis is characterized by heavy sweating in the feet. It is usually associated with palmar hyperhidrosis; sweaty palms. 

• The potential side effects of plantar hyperhidrosis can have a serious impact on the quality of your life and can make you feel discomfort due to dripping feet. 

Compensatory hyperhidrosis

• Compensatory hyperhidrosis is a post-operative condition that occurs in patients with primary hyperhidrosis who had incomplete control or complicated surgery. Compensatory hyperhidrosis occurs after endoscopic thoracic sympathectomy or any surgical procedures to regulate the body temperature. The sweat glands of one area become overactive to compensate for hypo or anhidrosis in another area.

• Compensatory hyperhidrosis is one of the most common and disagreeable complications of thoracic sympathectomy. Compensatory hyperhidrosis usually produces subjective and objective measurable increased sweating in body segments, usually just below the dry areas caused by sympathectomy.

Prevalence of different types of hyperhidrosis in the population as per a survey

You’re now aware of different types of hyperhidrosis but how do you differentiate the excess sweat caused by increased body temperature from the hyperhidrosis condition? So here are some tips and signs to identify the hyperhidrosis condition.

Signs and symptoms of hyperhidrosis (sweaty palms)

You may experience any of the following discomforts if you have hyperhidrosis-

• You will notice your hands with clammy or sweaty palms

• You may feel clammy or wet soles on the feet

• Frequent and heavy sweating all over the body

• Unpleasant body odor with increased body temperature

• Overactive sweat glands lead to excessive underarm sweating and excessive armpit sweating

• Noticeable excess sweat that soaks your clothing

• You experience night sweats and hand sweating for no reason

To diagnose your condition medically, your doctor will conduct the following tests.

Diagnosis of hyperhidrosis

The diagnosis of hyperhidrosis involves the following procedures- 

• On your consultation, your doctor may ask for your family history to know the reason for hand sweating or excess sweat secretion. Family history plays a huge role in most of the disorders as diseases are genetically transmitted. 

• If the doctor found no family history relation, you will be asked for health checkups and symptoms. A physical exam or test is conducted to understand the cause of your condition. For further information, a lab test and a sweat test are carried out. 

Lab test

Your blood or urine sample is collected or other lab tests are conducted to see if your heavy sweating is associated with another disease like overactive sweat glands caused by thoracic sympathectomy or hyperactive thyroid (hyperthyroidism) or lower blood sugar (hypoglycemia). 

Sweat test

Sweat tests are conducted to identify the areas of excess sweat and pinpoint the overactive sweat glands that cause heavy sweating leading to sweaty palms (palmar hyperhidrosis)or sweaty feet (plantar hyperhidrosis). The severity of your condition is estimated using the following sweat test-

• Iodine-starch test 

• Skin conductance

• Thermoregulatory sweat test

After the test you may wonder ‘what would be the cause for hyperhidrosis?’ The reason for hand sweating (sweaty palms) and hyperhidrosis can be a genetic condition or associated diseases or skin disorders. 

4 Main reasons for sweaty palms

• Generally, sweating is the body’s way of cooling down the increased body temperature by perspiration (skin breathing) process. The nervous system of your body triggers the eccrine sweat glands to produce sweat to reduce the increased body temperature. Sweaty palms become the reason for stress or anxiety during social gatherings.

• In primary hyperhidrosis, the sweat glands become overactive producing heavy sweating despite physical activity or a rise in body temperature that causes sweaty palms and feet. This type of sweating usually affects palms (Palmar hyperhidrosis) and soles (Plantar hyperhidrosis) and rarely to the face (Craniofacial hyperhidrosis). 

• Focal hyperhidrosis has no specific cause but is hereditary as it runs in the family history. Focal hyperhidrosis can be caused due to other factors like foods, drinks, nicotine, caffeine and smells that you are intolerable.

• Secondary hyperhidrosis occurs due to excess sweat caused due to an underlying medical condition. Secondary hyperhidrosis is very rare compared to primary hyperhidrosis. In secondary hyperhidrosis heavy sweating occurs all over your body. 

1.Generalized hyperhidrosis is caused by

• Idiopathic unilateral circumscribed hyperhidrosis

• Reported association with:

  • Blue rubber bleb nevus

  • Glomus tumor

  • POEMS syndrome

  • Burning feet syndrome (Gopalan's)

  • Trench foot

  • Causalgia

  • Pachydermoperiostosis

  • Pretibial myxedema

• Gustatory sweating associated with:

  • Encephalitis

  • Syringomyelia

  • Diabetic neuropathies

  • Herpes zoster (shingles)

  • Parotitis

  • Parotid abscesses

  • Thoracic sympathectomy

  • Auriculotemporal or Frey's syndrome

• Others

  • Lacrimal sweating (due to postganglionic sympathetic deficit, often seen in Raeder's syndrome)

  • Harlequin syndrome

  • Emotional hyperhidrosis

2. Cancer

Cancers like lymphoma, pheochromocytoma, carcinoid tumors (results in carcinoid syndrome), and tumors within the thoracic cavity are associated with the generalized hyperhidrosis.

3. Endocrine

Various forms of endocrine diseases like thyroid diseases, diabetes mellitus, acromegaly, hyperpituitarism and pheochromocytoma are the reason for hand sweating among 71% of people. 

4. Medications

Medications such as selective serotonin reuptake inhibitors like sertraline can cause medication induced generalized hyperhidrosis. Other medications like tricyclic antidepressants, stimulants, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), glyburide, insulin, anxiolytic agents, adrenergic agonists, and cholinergic agonists are responsible for secondary hyperhidrosis.

Others

• Can be seen in people with spinal cord injuries previously

  • Autonomic dysreflexia

  • Orthostatic hypotension

  • Posttraumatic syringomyelia

• Associated with peripheral neuropathies

  • Familial dysautonomia (Riley-Day syndrome)

  • Congenital autonomic dysfunction with universal pain loss

  • Exposure to cold, especially associated with cold-induced sweating syndrome

• Associated with probable brain lesions

  • Episodic with hypothermia (Hines and Bannick syndrome)

  • Episodic without hypothermia

  • Olfactory

• Associated with systemic medical problems

  • Parkinson's disease

  • Fibromyalgia

  • Congestive heart failure

  • Anxiety

  • Obesity

  • Menopausal state

  • Night sweats

  • Compensatory

  • Infantile acrodynia caused by chronic low-dose mercury exposure, leading to increased catecholamine accumulation and results in clinical status similar to pheochromocytoma.

• Febrile diseases

• Forceful exercise

• A hot, humid surroundings

What would be the problems that are caused due to excess sweat?

The problems or complications you face with heavy sweating or sweaty palms (palmar hyperhidrosis) are discussed below-

Problems or complications of hyperhidrosis 

Without treatment of hyperhidrosis, you will face many complications from unpleasant body odor to dripping clothes. Heavy sweating can lead you to physical, psychological and social damage. Overactive sweat glands will lead to excess sweat and increased body temperature that can cause the following problems or complications-

Infections

infections or the first and foremost concern of sweaty palms, because people with overactive sweat glands are more prone to skin infections.

The infections like bacterial viral and fungal will be a higher risk when you have excess sweat.

Social and emotional trauma-

Excessive hand sweating will cause you clammy or dripping hands which can be embarrassing to shake hands, fill a document, or hand over a paper.

You may try to avoid social engagement [hand shaking] due to sweaty palms.

Psychological effects

sweaty palms and soaked clothes will affect your pursuit of work and educational goals by decreasing your confidence. 

Hyperhidrosis can cause you greater stress and frequent depression. 

Occupational disability

• Excess sweat can cause occupational stress like handling knife can become difficult with sweaty palms (palmar hyperhidrosis), uncomfortable to play music instruments with sweaty palms, you may not be able to work under hot climate due to excessive underarm sweating, unable to move your hands at presentations due to excessive armpit sweating.

• These are the complications or problems caused due to heavy sweating or excessive hand sweating but how to get rid of sweaty palms or how to cure sweaty hands? 

• To avoid all these complications or problems, there are effective home remedies for excessive sweating and you can also try a treatment of hyperhidrosis.

• We all hate doctor consultations due to long visiting queues. And sometimes we don’t have time for an appointment, so knowledge of effective home remedies will always come in handy.

Here below are the home remedies for hyperhidrosis:

Home remedies for excessive sweating

The natural home remedies for sweaty hands and feet that will work effectively to get rid of sweaty palms (palmar hyperhidrosis) are-

Antiperspirants

Use of aluminum-based products will block your sweat pores temporarily reducing excess sweat. These antiperspirants are available for you without prescription. The heavy sweating of the skin is decreased. If you have a less hyperhidrosis situation you can go for it. These types of antiperspirants can be used for plantar hyperhidrosis and palmar hyperhidrosis.

Astringents

You can buy the nonprescription (over the counter) medication products that contain tannic acid. Zilactin contains tannic acid and you can apply it on the affected area like your sweaty palms.

Ice cubes

Eating ice cubes or having crushed ice water has found to be relieving for peripheral hyperhidrosis. Ice water helps you to cool the body temperature in blood vessels that cause excess sweat. You can feel the effect within 10 to 30 min.

It is always better to be one step ahead of everything and prevention is one such thing to practice.

Prevention methods to reduce hyperhidrosis

Prevention helps to avoid progression of the disease and practicing the following tips will improve your condition-

Daily bath

Bathing regularly will prevent you from getting 90% of skin infections and bad body odor. Pat dry yourself, specifically between the skin foldings and curves to avoid moisture. 

Use shoes and socks of natural products

Only use shoes and socks made of natural products like leather. Pure leather will prevent you from sweaty feet (plantar hyperhidrosis) by allowing your feet and sole to breathe. 

For active exercise or sport using moisture-wicking athletic socks is one of the best options for you.

Change socks regularly

Regular change of socks and replacing your used socks with fresh or clean socks will save you from many fungal and bacterial infections. Clean and dry socks always make your skin comfortable and free to breathe. You can also use foot powders that are available at general stores to help absorb the sweat.

Air your feet

Try walking barefoot as much as you can and remember to remove the foot wear whenever possible.

Try natural fabrics to wear

Natural fabrics like cotton, wool, silk will allow your skin to breathe. Clothing for exercise should always include something that wicks the moisture off the skin surface.

Practice relaxation techniques

If you participate in yoga or meditation or biofeedback, it will help you reduce your stress and anxiety levels that means reduced sweaty palms and heavy sweating. Preventing the cause is one of the best ways to avoid the disease.

Let’s find out how to get rid of sweaty palms and feet with treatment of hyperhidrosis.

Treatment of hyperhidrosis

• Treatment for heavy sweating can be done in two ways- If the excess sweat problem you are facing is due to some underlying disease, then the treatment will help you to cure that disease. If the doctor is not clear about your condition, then the treatment focuses on controlling the overactive sweat glands. 

• The treatment for hyperhidrosis is not a permanent cure as the reoccurrence of the sweaty palms is normal. You may think, ‘then why does this treatment even matter?

• It matters because you need to prevent the worsening of the condition and manage the daily activities with less sweat. The sweaty palms (palmar hyperhidrosis) treatment will actually make you feel confident with less sweat and body odor.

So, what would be the medications and how to get rid of sweaty palms with these medications is discussed below.

Medication for treatment of hyperhidrosis

Drugs that can be used to reduce hyperhidrosis are-

Prescription antiperspirant 

Your doctor may advise you to use an antiperspirant with aluminum chloride (Drysol, Xerac Ac). You need to be cautious about using it as it may cause skin and eye irritation. You have to apply the product to the affected skin before going to bed. Take proper care to not get the product into your eyes while you wash the product off when you wake up. If your skin becomes irritated, use hydrocortisone cream for a soothing effect.

Prescription creams

A prescription cream that contains glycopyrrolate will help your hyperhidrosis that affects the (craniofacial hyperhidrosis) face and head.

You can use glycopyrronium bromide containing disposable cloth for the treatment of primary axillary hyperhidrosis.

Nerve-blocking medications 

The use of some oral medications blocks the chemicals that permit certain nerves to communicate with each other. The use of such medications can reduce heavy sweating in some people. Potential side effects may include dry mouth, blurred vision and bladder problems.

Antidepressants 

Certain medications used for depression can also be used to decrease your sweaty palms (palmar hyperhidrosis). In addition, antidepressants may help you decrease the anxiety that worsens your hyperhidrosis.

The anticholinergic drugs will have potential side effects like drowsiness, visual symptoms and dryness of mouth and mucous membranes.

Botulinum toxin injections

Treatment of palmar hyperhidrosis with botulinum toxin (Botox, Myobloc, others) will temporarily block the nerves that cause palmar hyperhidrosis (sweaty palms). At first your skin will be iced or anesthetized. Each affected part of your body will require several injections. The effects of injection last six to 12 months, and then the treatment for sweaty palms needs to be repeated. This treatment can be painful, and you may experience temporary muscle weakness in the treated area.

Surgical treatment of hyperhidrosis

Surgical treatment of hyperhidrosis involves the following techniques-

Sweat gland removal 

If you have excessive armpit sweating (axillary hyperhidrosis), removing the overactive sweat glands from there will help you. If you aren't responding well to other treatments, use of suction curettage, a minimally invasive technique may be an option.

Nerve surgery (sympathectomy)

• During thoracic sympathectomy, the surgeon cuts, burns or clamps your spinal nerves that cause sweaty palms (palmar hyperhidrosis). In some cases, thoracic sympathectomy may trigger heavy sweating in other areas of your body (compensatory sweating). Surgery is generally not an option for isolated head and neck sweating (craniofacial hyperhidrosis). Thoracic sympathectomy is useful in axillary hyperhidrosis but is a failure in craniofacial hyperhidrosis.

• One of the potential side effects of endoscopic thoracic sympathectomy is compensatory sweating. 20-80% of patients suffer from compensatory sweating after the surgery. Compensatory sweating can affect the quality of your life making body odor and excess sweat intolerable.

• Other potential side effects of thoracic sympathectomy consist of Horner’s syndrome, gustatory sweating, and excessive dryness of the palms (sandpaper hands).

Percutaneous sympathectomy 

It is minimally invasive procedure similar to botulinum method, where your nerves are blocked by an injection of phenol. Physicians advise this procedure as it is more conservative than the thoracic sympathectomy which is irreversible. In most of the cases the percutaneous sympathectomy provides temporary relief. 

Take-home points

• Among all the hyperhidrosis, palmar hyperhidrosis is more relatable and frustrating as it affects your social life.

• Try using antiperspirants on the affected areas where you feel excess sweat production over your body. 

• Try using pleasant perfumes that last long, at least when you have to work under hot sun to avoid bad body odor. 

• Family history can be the reason for hand sweating in some cases or underlying diseases in other cases.

• Consult a dermatologist for treatment of sweaty palms (palmar hyperhidrosis) or feet (plantar hyperhidrosis).

• Use natural materials for clothing and footwear including socks to avoid potential side effects associated with increased body temperature.

• Cure the sweaty palms (palmar hyperhidrosis) with a variety of prevention techniques and treatments available for hyperhidrosis.

References

• NCBI

• NCBI

• NCBI

• NCBI