Sweaty hands (palmar hyperhidrosis)
The sweaty hands condition, also known as Palmar Hyperhidrosis, tends to begin in childhood and early adolescence1.
Around a quarter of people who suffer from focal hyperhidrosis have significant palmar hyperhidrosis1. Although not as common as underarm (axillary) hyperhidrosis many people seek treatment for palmar hyperhidrosis given how debilitating it can be. Several studies using validate QOL (quality of life) criteria suggest that palmar hyperhidrosis is comparable to severe psoriasis or eczema requiring hospitalisation2.
Palmar hyperhidrosis poses many problems. Shaking hands with a new acquaintance or a future boss during a job interview; going on a first date and holding their hand or initiating intimate contact; writing on paper or signing a document; opening a jar or turning a knob; wearing gloves; even driving a car can be difficult3.
Treatments for sweaty hands
1st line: Antiperspirant with high aluminium content
It is good to start with a clinical strength antiperspirant eg Driclor or Rexona Clinical Protection (contain around 20% aluminium). These can be bought from a supermarket or over the counter at a pharmacy. It is best to apply them at night prior to bed since you tend to sweat less overnight and it is more efficacious. It can result in localised irritation of the skin which might limit its use.
2nd line: PBS listed anti-hyperhidrosis treatment
You will need to be assessed at a clinic that specialises in Hyperhidrosis prior to treatment with PBS listed anti-hyperhidrosis treatment. If indicated it is conducted on the same day as your clinical assessment. With injections, efficacy is around 80-90% in studies and usually lasts 6 months for the hands (4 to 12 months)4. Patients usually notice a difference 4 days post-treatment however the full effect usually takes one to two weeks. 40% of patients who are treated for palmar hyperhidrosis alone have reported improvement in their plantar hyperhidrosis4. Given the surface of the hand is very sensitive, a hand block is conducted prior to the procedure which numbs the surface of the hand for a few hours so that the procedure is painless. A very small proportion of patients get a transient weakness of the big muscle at the base of the thumb (thenar eminence) that lasts for up to 14 days post treatment. This is limited by technique and as a result is very uncommon.
2nd line: Iontophoresis
Another treatment option that will be discussed following your clinical assessment is Iontophoresis. Iontophoresis uses electrical current to enhance percutaneous absorption of ions. This leads to either blockage of the sweat ducts or disruption of eccrine sweat glands. The cost of the machines vary from $400-$1000. Treatment requires daily treatment for around 20 minutes initially for up to a month (until symptom relief) then maintenance treatment a couple of times a week.
Please note: these are only guidelines and your treating doctor will discuss the treatment(s) most appropriate for you.
References:
- Lear W, Kessler E, Solish N, et al. (2007). An epidemiological study of hyperhidrosis. Dermatol Surg; 33: S69-75.
- Hamm H, Naumann M, Kowalski J, et al. (2006). Primary focal hyperhidrosis: disease characteristics and functional impairment. Dermatology; 212: 343-353.
- Keller S, Bello R, Vibert B, Swergold G and Burk R. (2009). Diagnosis of palmar hyperhidrosis via questionnaire without physical examination. Clin. Auton Res; 1-7.
- Grunfeld A, Murray C and Solish N (2009). ..Hyperhidrosis. Am J Clin. Dermatol; 10(2): 87-102.
Still sweating? What to do next
If you have tried using a clinical strength anti-perspirant and are still suffering sweat problems then we can help. Contact us now to book an appointment for treatment at one of our clinics (or if you have any questions) using the form on the right-hand side of this page.
