Palmoplantar Hyperhidrosis: What It Is and How It Is Treated

Written by Medicover Team and Medically Reviewed by Dr Girishma J , Dermatologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Do you have sweaty palms and feet that bother you? You might have a condition called palmoplantar hyperhidrosis. This condition causes excessive sweating on the palms and soles of the feet. It can be embarrassing and affect your daily life. Understanding the factors that can trigger this excessive sweating can help you manage the condition better.

What are the Types of Palmoplantar Hyperhidrosis?

Palmoplantar hyperhidrosis is generally classified as either primary focal hyperhidrosis or secondary hyperhidrosis. Primary hyperhidrosis usually affects specific areas, such as the palms and soles, without an underlying medical condition. Secondary hyperhidrosis occurs because of another medical condition, medication, or other identifiable cause and may affect larger areas of the body.

Primary Focal Palmoplantar Hyperhidrosis: Excessive sweating mainly affects the palms and soles without an identifiable underlying medical condition. It often begins during childhood or adolescence and may run in families.
Secondary Palmoplantar Hyperhidrosis: Excessive sweating occurs because of an underlying condition, medication, or another identifiable cause. It may develop later in life and can occur along with generalized sweating.

What are the Symptoms of Palmoplantar Hyperhidrosis?

Symptoms include sweaty hands and feet, clammy skin, and an unpleasant odor. The condition can affect daily activities, causing embarrassment and discomfort. Treatment options are available to help manage excessive sweating and improve quality of life.

Excessive sweating on the palms and soles of the feet, even when not physically active, is a common symptom of palmoplantar hyperhidrosis.
Constantly clammy or sweaty hands and feet may make it challenging to grip objects or walk comfortably.
Visible sweat droplets on the palms and soles may lead to frequent wiping or drying.
Strong and unpleasant foot odor can occur because excess moisture encourages bacterial growth.
Skin irritation, maceration, or infections may occur in the palms and soles because of prolonged moisture exposure.

What are the Causes of Palmoplantar Hyperhidrosis?

Palmoplantar hyperhidrosis can be associated with overactivity of the sympathetic nervous system, particularly in primary focal hyperhidrosis. Genetic factors also play an important role, as the condition often runs in families. Emotional stress, heat, and physical activity can worsen sweating.

Secondary palmoplantar hyperhidrosis may occur because of certain medical conditions or medications. Identifying the underlying cause can help guide appropriate treatment.

Overactivity of the sympathetic nervous system can cause excessive sweating of the palms and soles.
Genetic factors can contribute to palmoplantar hyperhidrosis, particularly when the condition runs in families.
Hormonal changes may influence sweating in some individuals.
Certain medical conditions, such as hyperthyroidism or diabetes, may cause or worsen excessive sweating.
Emotional triggers such as stress, anxiety, or nervousness can increase sweating in susceptible individuals.
Certain medications may cause excessive sweating as a side effect.

When to See a Doctor?

Consult a dermatologist if excessive sweating of the hands and feet affects daily activities, as early treatment can improve comfort and quality of life.

Persistent sweaty palms and soles without clear triggers
Difficulty gripping objects or walking because of excessive moisture
Skin irritation, unpleasant odor, or recurrent infections

Get medical help immediately if:

Sudden excessive sweating occurs with dizziness, fainting, or chest discomfort
Signs of infection, such as increasing redness, swelling, warmth, or pain, develop
Excessive sweating is accompanied by other concerning symptoms of an underlying medical condition

These symptoms may require prompt medical evaluation to identify an underlying cause or complication.

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How Is Palmoplantar Hyperhidrosis Diagnosed?

To diagnose palmoplantar hyperhidrosis, your doctor will ask about your medical history, when the excessive sweating started, the areas affected, and factors that trigger or worsen it. A physical examination helps assess the pattern and severity of sweating.

A starch-iodine test or paper test may sometimes be used to demonstrate or measure sweating. Blood tests or other investigations may be recommended when secondary hyperhidrosis is suspected, particularly to identify an underlying medical condition or medication-related cause.

Medical history and physical examination: A detailed history and examination help determine the pattern, duration, severity, and possible cause of excessive sweating.
Starch-iodine test: Iodine and starch can be applied to the skin to visualize areas of increased sweating.
Paper test: Special paper can be used to assess the amount of sweat produced in affected areas.
Additional tests: Blood tests or other investigations may be performed when an underlying medical condition or medication is suspected.

What are the Treatment Options for Palmoplantar Hyperhidrosis?

Treatment options for palmoplantar hyperhidrosis include topical antiperspirants, iontophoresis, oral medications, and botulinum toxin injections. Treatment is selected according to the severity of sweating, the areas affected, and the individual's response to previous treatments.

Topical treatments can help reduce sweating, while iontophoresis uses a mild electrical current to reduce sweat production in the palms and soles. Oral medications and botulinum toxin injections may also be considered when other treatments do not provide sufficient relief. In severe cases that do not respond to conservative treatments, surgical options may be considered by a specialist.

Topical antiperspirants: Products containing aluminum chloride may reduce sweating by temporarily blocking sweat ducts and are commonly used as an initial treatment.
Iontophoresis: This treatment uses a mild electrical current applied to the palms and soles to reduce sweating. Regular treatment sessions may be needed to maintain the benefit.
Botulinum toxin injections: Botulinum toxin can block nerve signals that stimulate sweat production and may provide relief for several months.
Oral medications: Anticholinergic medicines may reduce sweating in some individuals but can cause side effects such as dry mouth, blurred vision, constipation, and difficulty urinating.
Surgery: Procedures such as endoscopic thoracic sympathectomy may be considered for severe, treatment-resistant palmar hyperhidrosis. Because of potential complications, including compensatory sweating, surgery is generally reserved for selected cases.

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What are the Risk Factors of Palmoplantar Hyperhidrosis?

Risk factors for primary palmoplantar hyperhidrosis include a family history of excessive sweating and younger age at onset. Certain medical conditions and medications can increase the risk of secondary hyperhidrosis.

Emotional stress and anxiety may trigger or worsen sweating episodes in people who are susceptible to excessive sweating.

Family history: Having relatives with hyperhidrosis increases the likelihood of developing primary hyperhidrosis.
Age: Primary focal hyperhidrosis commonly begins during childhood or adolescence.
Medical conditions: Conditions such as thyroid disorders and diabetes may cause secondary excessive sweating.
Medications: Some medicines can increase sweating as a side effect.
Stress and anxiety: Emotional triggers can worsen sweating episodes.

Frequently Asked Questions

1. What are the common signs of palmoplantar hyperhidrosis?

Signs of palmoplantar hyperhidrosis include excessive sweating on palms and soles, wet or clammy hands/feet, and an increased risk of fungal infections.

2. What lifestyle changes should I make to manage palmoplantar hyperhidrosis effectively?

Managing palmoplantar hyperhidrosis involves using antiperspirants, wearing breathable fabrics, practicing stress-reducing techniques, and avoiding triggers like spicy foods.

3. Are there any risks associated with untreated palmoplantar hyperhidrosis?

Yes, untreated palmoplantar hyperhidrosis can lead to skin infections, social anxiety, and decreased quality of life due to constant sweating.

4. What steps should I take for the management of palmoplantar hyperhidrosis?

Options include antiperspirants, iontophoresis, oral medication, botox injections, and surgery for severe cases. Consult a dermatologist for personalized treatment.