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How to Treat Sweaty Palms and Soles

Management of Palmoplantar Hyperhidrosis

Jan 12, 2009 Hanish Babu

Treatment of sweaty palms and soles or palmoplantar hyperhidrosis involves patient education, topical applications, use of galvanic current, injections and surgery.

Sweaty palms and soles interfere with normal functioning of an individual, and can be a very disturbing and inconvenient disease for students and skilled workers. The disease affects 1-2 % of individuals and has many treatment options all of which have positive as well as negative features.

The management of palmoplantar hyperhidrosis is similar to treatment of axillary hyperhidrosis with a few notable differences.

How to Treat Sweaty Palms and Soles?

Management of palmoplantar hyperhidrosis involves the following:

Patient Education: Patients should be educated in the pros and cons of treatment modalities available so that they can make an informed decision on the choice of the most appropriate treatment options.
Tap water Iontophoresis using galvanic current is the first line of treatment in palmoplantar hyperhidrosis. Usually 3-4 treatments of 20-30 minutes each is required every week. Sweating reduces after 8-10 treatments. Maintenance therapy is indicated once every 1 to 4 weeks, depending upon the individual responses. The equipment can be purchased online. There are two main devices in the market now. The most commonly used is the Drionic (General Medical Co., Los Angeles, California). Another device is made by The Fischer MD-1a (R.A. Fischer Co., Northridge, California). These devices have an axillary pad also for the treatment of axillary hyperhidrosis. Skin dryness and irritation is the most frequent side effect.
Treatment with aluminum chloride hexahydrate 10-25% solution is the standard topical treatment for sweaty palms and soles. The solution is applied to dry palms and soles at bed time and washed off after 6-8 hours. This is continued daily till the sweating becomes normal or controlled. Then an application of once in 1-3 weeks will suffice to maintain the control.
If irritation occurs after iontophoresis or aluminum chloride hexahydrate solution, betamethasone valerate cream can be used twice daily for a few days.
In case the treatment with iontophoresis topical application fails, intradermal injection of botulinum toxin is the next choice of treatment. This provides relief for 6 to 12 months. The injection can be quite painful and requires proper anesthesia.
Systemic anticholinergic medications can reduce sweating, but also cause side effects like dry eyes, dry mouth, urine retention etc.
If the conservative treatment fails, then surgery is a permanent solution for palmoplantar hyperhidrosis. Endoscopic thoracic sympathectomy cures sweaty palms. Though some centers promote lumbar sympathectomy for plantar hyperhidrosis, it is not advisable in males because of associated risk of sexual dysfunction. The commonest side effect of surgery is that the patients may get compensatory sweating in other body areas.
Bio feedback techniques, yoga, meditation, acupuncture, hypnotherapy, herbal medications etc. also have been reported by some to be useful in sweaty palms and soles, but have no proven value amongst treatment options as of now.

Readers who found this article may also find the article What is Palmoplantar Hyperhidrosis?:Sweaty Palms and Soles: Causes and Effects also useful.

Reference

J Hornberger et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol 2004; 51:274-86
Hyperhidrosis Surgery

Disclaimer

The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.

The copyright of the article How to Treat Sweaty Palms and Soles in General Medicine is owned by Hanish Babu. Permission to republish How to Treat Sweaty Palms and Soles in print or online must be granted by the author in writing.

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