Sweaty palms

Hyperhidrosis is excess sweating via the eccrine glands beyond what is required for thermal regulation. There are various guidelines for how much sweat produced over a certain body area is normal, but clinically no one uses these. The guidelines are used more for research than for actually diagnosing the condition. The loose definition for hyperhidrosis is excess sweating that interferes with daily activities.

Today I was just going to discuss different causes of excess sweating and the quality of life implications. Over the next couple days I'll discuss two of the treatments.

Emedicine has a great article if you are interested in details. I thought hyperhidrosis would have more information on the internet, but most of what I found were ads for various treatments.

Localized essential hyperhidrosis usually presents in childhood or adolescence as localized excess eccrine sweat production of the palms, soles, and/or axillae. The exact cause is unknown, but it is believed to be triggered by overactive sympathetic innervation causing excessive stimulation of the glands. Palms and soles sweating is not associated with heat, but more so with anxiety, so the excess sweating should stop when the patient is asleep or sedated. Generalized excess sweating may be caused by systemic disease and should be further investigated. The Emedicine article has a list of disorders under the "Causes" subheading that can present with localized or generalized excessive sweating.

I helped treat a patient with hyperhidrosis of the palms and soles, and it was interesting to hear her perspective on how this has affected her life. She doesn't like to shake hands and can't wear shoes without socks. The thing she was most looking forward to after her treatment was to wear dress shoes! Although her disorder is completely benign, the quality of life implications can be socially debilitating. A friend of mine has trouble with yoga because of her sweaty soles, and people with axillary hyperhidrosis suffer from embarrassing sweat stains. Depending on a person's age and occupation, the effects of hyperhidrosis can vary in severity.

First line treatment is topical aluminum salts (used in anti-perspirants), which are drying to the skin.

Aamir Haider and Nowell Solish. Focal hyperhidrosis: diagnosis and management.
Can. Med. Assoc. J. 2005 172: 9.