What is Palmar Hyperhidrosis?
Palmar Hyperhidrosis (Primary Palmar Hyperhidrosis) is a condition where the sweat glands overwork abnormally, unrelated to exercise, temperature, or environment. It usually occurs from childhood or adolescence and may have a family history. The cause is due to an abnormality in the autonomic nervous system that stimulates excessive sweating unnecessarily.
Symptoms of Palmar Hyperhidrosis
- Sweat seeps from the palms causing discomfort
- Excessive sweating causing hands to be wet all the time
- Affects daily activities such as holding a pen, typing, or shaking hands
- Skin may easily get infected due to moisture
- Some cases may also have sweating on feet and armpits
Diagnostic Criteria
Doctors will take history and perform a physical exam, considering if symptoms have lasted more than 6 months and have at least 2 of the following criteria:
- Occurs on both sides simultaneously
- Symptoms occur at least 1 time per week
- Affects daily routine
- Symptoms start before age 25 years
- Family history of the same condition
- No sweating during sleep
Distinguishing Palmar Hyperhidrosis from Other Causes
Although most cases of palmar hyperhidrosis have no clear cause (Primary Hyperhidrosis), in some cases, excessive sweating may be due to underlying diseases, known as Secondary Hyperhidrosis or symptomatic hyperhidrosis which should be differentiated before planning treatment.
Examples of diseases or conditions that may cause abnormal excessive sweating include:
- Endocrine diseases such as
– Hyperthyroidism
– Diabetes
– Hormonal changes such as during pregnancy or menopause
- Neurological diseases such as
– Parkinson’s disease
– Reflex Sympathetic Dystrophy (RSD)
- Side effects from medications such as
– Antidepressants such as fluoxetine, venlafaxine, doxepin
If you suspect that excessive sweating may be due to an underlying disease, you should consult a doctor for further evaluation before choosing the most appropriate treatment.
Treatment for Palmar Hyperhidrosis
- Topical medications (Topical Antiperspirants) usually use Aluminum Chloride at concentrations of 20-30% suitable for mild cases
- Oral medications (Anticholinergic Drugs) inhibit the nervous system that stimulates sweat glands. Side effects may include dry mouth, constipation, nausea
- Botulinum toxin injections (Botulinum Toxin) are injected locally in the hands, lasting about 6 months and require repeat injections
- Thoracoscopic Sympathectomy is the most effective treatment method. It involves cutting the nerves around ribs 4-5 using small incisions of only 5 millimeters on both sides. The surgery takes about 1 hour with only 1 day of recovery. Sweating stops immediately after surgery.
Advantages of Surgery for Palmar Hyperhidrosis
- Immediate clear results after surgery
Sweating on the hands significantly decreases after surgery, with most patients feeling the effect immediately upon waking from surgery, achieving a cure without lifelong medication dependence. - Comprehensive and long-lasting treatment helps reduce symptoms in the long term without the need for regular medication, topical applications, or injections.
- Small incision, less pain, quick recovery uses only about 5 millimeter incisions on both sides, takes about 1 hour for surgery, and requires only 1 day of hospital recovery.
- Improves quality of life and confidence When excessive sweating is resolved, patients can return to daily activities, work, writing, or social interactions with greater confidence.
- Reduces risk of skin infections Reducing sweat helps prevent moisture buildup, lowering the chance of rashes or secondary infections on the palms.
- Suitable for patients with severe symptoms who do not respond to other treatments
Specialist Consultation Available at Phyathai 2 Hospital
Phyathai 2 Hospital offers care and consultation services for palmar hyperhidrosis by a team of specialists, providing personalized treatment plans including the option of minimally invasive thoracoscopic surgery, which is an effective method to alleviate symptoms.
If you have problems with excessive hand sweating that interfere with daily life, you can receive advice from our specialist team at Phyathai 2 Hospital. We are ready to provide appropriate, safe, and standard treatment to help you regain confidence in your life.
Assoc. Prof. Dr. Sira Laothai
Thoracic surgeon specializing in thoracoscopic lung and thymus surgery
