Palmar Hyperhidrosis – Essence, Causes, Treatment, Contraindications

Palmar Hyperhidrosis - Essence, Causes, Treatment, ContraindicationsHyperhidrosis is a condition characterized by excessive sweating that exceeds the natural needs for thermoregulation. Depending on the causes of excessive sweating, it is distinguished between primary and secondary hyperhidrosis.

Secondary hyperhidrosis is essentially a symptom of another medical condition (such as tuberculosis or a neurological disorder). Overheating and febrile conditions (a rise in body temperature to 37.1-38.0 ° C) are common causes of its occurrence. In addition, secondary hyperhidrosis can cause systemic disease and medication. Increased sweating is present regardless of the time of day, sometimes mostly at night. Such hyperhidrosis disappears after the cure of the underlying disease, which led to excessive sweating.

Primary hyperhidrosis (or essential hyperhidrosis) is not associated with any disease or natural thermoregulation. This diagnosis requires the exclusion of other medical conditions. It is this form of hyperhidrosis that should be given special attention.

The onset of primary hyperhidrosis cannot be explained by the body’s needs. People suffering from primary hyperhidrosis do not differ physically from completely healthy people, and even the most detailed examinations do not find deviations in the state of their organs and functional systems. But for one reason or another, in such people, the center of emotionally conditioned sweating functions at a more active level, leading to such clinical manifestations.

Primary hyperhidrosis is often hereditary, i.e. often found in families and close relatives. This indicates its genetic nature, which is confirmed by a detailed genome study.

What is palmar hyperhidrosis?

It is the most significant form of hyperhidrosis, which causes numerous problems in the social, emotional and professional spheres and can lead to severe personal consequences.

With severe palmar hyperhidrosis, everything that the patient touches becomes wet, so at school such children cannot write with ink pens, their notebooks and textbooks become wet, which causes misunderstanding of teachers and classmates. Since childhood, such people try to avoid shaking hands, touching, dancing, they cannot engage in some sports in which it is required to hold something in their hands – tennis, volleyball, shooting. There is difficulty with playing musical instruments (piano, violin, guitar).

In the professional field, constantly sweaty hands also lead to numerous restrictions – it is difficult to work with papers, precision mechanics, watches, electrical engineering and electronics, jewelry and optics, as well as work with people that requires handshakes and touching (masseur, hairdresser).

Palmar sweaty palm syndrome is isolated, but more often it is combined with plantar (foot), axillary, or both of the above forms at once.

Symptoms of sweaty hands condition

Sweaty hands disease is manifested by very characteristic signs:

  • when you touch paper, fabric and other materials, a wet trace of the palms remains on them;
  • the skin of the palms periodically turns red;
  • the palms are constantly wet or beads of sweat often appear on them.


There are several stages of this pathology, depending on the severity of the symptoms:

  • Light form. The palms are constantly wet.
  • Moderate. Not only the palms are wet, but also the fingers.
  • Severe form. Sweat trickles down the palms.

Causes of hyperhidrosis disorder

The most common form of hyperhidrosis is idiopathic. It develops for no reason from infancy and worsens during adolescence. This form is not hazardous to health, but can cause complicated psychological problems.

In addition, there are many reasons that lead to the excessive hand sweating:

  • excessive activity of the sympathetic nervous system (it is responsible for the secretion of sweat);
  • vegetative dystonia;
  • disorders of the hormonal system or the period of “body restructuring” (adolescence, pregnancy, menopause);
  • genetic predisposition;
  • psychological problems (for example, frequent stress).

Palmar hyperhidrosis treatment

Today, there are various ways to correct and treat the problem of increased sweating:

  • the use of special antiperspirants with aluminum salts in the composition;
  • physiotherapy methods such as electrophoresis;
  • taking medications;
  • injection of preparations of weakened botulinum toxin as pot-blocking agents;
  • surgical intervention. It is used extremely rarely when the above methods are ineffective.

One of the most effective, modern and safest ways to get rid of hyperhidrosis is the injection of Botox (USA) and Dysport (France). The procedure consists in injecting weakened botulinum toxin (which is part of the preparations) into the palms area. When injected into the problem area, the release of acetylcholine is blocked, which leads to long-term relief of the sweat glands’ functions.

The procedure is short in time, has no health consequences and does not require rehabilitation (there are no marks on the skin after treatment), and the effect develops as soon as possible (after one to two weeks).

How is the procedure looks like?conducted?

The procedure is performed very quickly, in several stages, gives an excellent lasting result and has no side effects.

At the first stage, in order to estimate the area of botulinum toxin injection, a specialist conducts the Minor’s test. To do this, an iodine solution is applied to the skin of the palms, and then sprinkled with starch. When the sweat glands begin to work and sweat is released, an interaction between iodine and starch begins, and a black spot appears, which outlines the area for drug administration.

At the second stage, anesthesia and drug administration are performed:

  • disinfection. The palms are wiped with an antiseptic solution;
  • anesthesia. Anesthetic cream is applied to the hands or the hands are very cooled;
  • applying markings to the skin;
  • sequential administration of the drug Botox or Dysport with an insulin syringe for every one to two square centimeters.

The dosage of the drug is determined individually depending on the severity of hyperhidrosis. The result is noticeable within 7 days, but the greatest effect is achieved after 2 weeks and lasts from 6 to 18 months.


As with any procedure, botulinum therapy has its limitations. Absolute contraindications to treatment with Dysport and Botox are:

  • acute infectious diseases;
  • inflammatory process at the injection site;
  • blood diseases (hemophilia) and problems with the neuromuscular system;
  • pregnancy, lactation;
  • immunity to drugs with botulinum toxin.

Relative contraindications for the administration of botulinum toxin are chronic diseases in the acute stage, a tendency to form keloid-type scars, hyperthermia.

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