Question of the Week

Question

Question :

Posted On : 08 Mar 2026

What is the best investigation and treatment for palm hyperhidrosis?

Expert Answer :

Answer Discussion :

S

Sangeeta Bundiwal

0

aluminum hydroxide gel rubbing on palm

3 Days ago

V

Victoria Mohasin

1

Depending on symptoms, treatment options range from oral and topical medications, injection of Botulinum Toxin and surgery, known as thoracoscopic sympathectomy. During the surgery, the surgeon will make a 1-cm incision each through the patient’s chest around both underarms in order to cut and seal a portion of the sympathetic nerve chain that runs down the back inside the chest. It takes only 1-night stay at the hospital before the patient can quickly return home.
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3 Days ago

K

kalodi nabeela

0

Thyroid function

4 Days ago

M

Mary Healthline Suganthi

0

thyroid function test . absorbable gloves

5 Days ago

M

Maria Laura Perez

0

if its too itchy you can use hydrocortisone 1% , at night. I suggest dry tissues and also patient.

5 Days ago

Answer 1

Primary palmar hyperhidrosis is caused by overactivity of the sympathetic nervous system, primarily triggered by emotional causes including anxiety, nervousness, anger and fear. In secondary palmar hyperhidrosis, hands sweat due to an obvious underlying disorder like Infections, including local infections, tuberculosis and tinea ugunium. Neurological disorders like peripheral autonomic neuropathy, Frostbite, and arteriovenous fistulas
Acromegaly, Acrodynia, Complex Regional Pain Syndromes, Pachyonychia Congenita, Primary Hypertrophic osteoarthropathy, Dyskeratosis Congenita, Blue rubber-bleb nevus
Glomus tumor. generalised hyperhydrosis can occur due to hormonal causes {diabetes, hyperthyroidism, thyrotoxicosis, menstruation, menopause}, metabolic disorders, malignant disease {lymphoma, pheochromocitoma}, autoimmune disorders {rheumatoid arthritis, systemic lupus erythrematosus}, drugs like hypertensive drugs.

Investigations include CBC, thyroid function tests, blood sugar and specific investigations as needed.

Treatment should be directed at contributing factors. Anticholinergic drugs have a direct effect on the sympathetic nervous system although there are numerous side effects. Ionophoresis involves the use of electrotherapeutic measures to reduce the activity of sweat glands. Botulinum injections at the affected area may be useful for its anticholinergic effects.
Surgery should be considered if drug therapy proves ineffective. Endoscopic transthoracic sympathectomy involves resection of the sympathetic nerve supply to the affected area. This prevents nerve stimulation of the sweat glands of the palms. However, surgery has a host of complications, including exacerbating the problem or increasing generalized hyperhidrosis.

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