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Sweaty Palms

Q: I have an embarrassing problem. My palms sweat so much they get slick, even when I'm not feeling hot or nervous. It's so bad I won't shake hands when I meet someone new. I know I seem rude, but I'm too mortified to touch anyone. Is there anything that can help me?

Dr. Donnica:
Take heart! There is help for palmar hyperhidrosis (the medical term for palms that sweat profusely), a condition that occurs when misfiring sympathetic nerves overstimulate sweat glands in the hands. Hyperhidrosis affects approximately 1% of the population, anywhere (or everywhere) in the body, and it may be episodic or continuous.

The first step is to identify and treat any possible underlying causes, such as stress, or underlying medical conditions, such as infections, thyroid problems, malignancies, obesity, or menopausal hot flashes. For true hyperhidrosis, treatment options include over-the-counter (e.g. Odaban, Certain-Dri, or Maxum) or prescription antiperspirants (e.g. Drysol), oral medication (anticholinergics), botulinum toxin (Botox™) injections, and iontophoresis (applying low intensity electric current to the hands or feet immersed in an electrolyte solution).

While OTC and prescription antiperspirant lotions are not highly successful in patients with palmar hyperhidrosis, they should be tried before moving on to other, more invasive and expensive therapies. Note that when using these products, their instructions say "for underarm use only," but they can be applied directly to the hands. I recommend using them just before bedtime, as the lotion itself will make your hands wetter. Outpatient surgery (endoscopic thoracoscopic sympathectomy) is a last resort, but at established medical centers it can be up to 98% successful. Ask your doctor to recommend a treatment course that's best for you.

Created: 2/7/2006  -  Donnica Moore, M.D.

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