Sweating is the most normal thing in the world. Everyone does it sometimes. However, it does happen that in some people it occurs at very unfavorable times and that it can arise out of the blue. For example, there are people who have an excessive production of sweat in their hands in daily life. The medical term for this is also hyperhidrosis palmaris. This form of excessive sweating is considered one of the most damaging forms of hyperhidrosis. The reason for this is that treating the palms is more difficult compared to other forms. Also, it is very difficult to hide sweaty palms in everyday life

To sweat

People sweat to remove excess heat in their bodies. Sweat evaporates at the surface of the skin, making the skin feel cooler.The palms of the hands and soles of the feet in humans are covered with many ecrine sweat glands. These are the sweat glands that open directly onto the skin. These glands are involved in the body’s thermal regulation and secrete sweat. The glands in the hand are not intended for regulating body temperature, but for better grip.

Hyperhidrosis Palmaris

Hyperhidrosis Palmaris is excessive sweating on the palms. Research has shown that it occurs in most people between the ages of 10 and 20. This can sometimes last for decades. It is estimated that 0.5% of the population suffers from hyperhidrosis. The number for hyperhidrosis palmaris will therefore be lower.Excessive sweating can be aggravated by physical exertion, mental concentration, a warm environment or nervousness.When one speaks of primary hyperhydrosis , no other disease is the cause of excessive sweating. This concerns healthy people who have no other problems.

Causes

Hyperfunction of a certain part of the nervous system and above-normal size of sweat glands are seen as the cause of palmar hyperhidrosis. There is a local hyperfunction if excessive sweating only occurs in one part of the body. The exact cause is not known, but it can be said that there is a physical condition. The stimulus to sweat most likely originates in the brain. Some patients have a hereditary predisposition. This is the case for approximately 30 to 50%.In the fewest cases there may also be an underlying problem. Not only the glands in the hands are overactive, but everywhere in the body. Examples of this are being overweight, menopause, diabetes and excessive thyroid function.

Diagnosis

One of the ways to determine the degree of excessive sweating is the starch-iodine test. The skin must be thoroughly dry, after which it is rubbed with 20% iodine, which is dissolved in alcohol. After this has dried, starch will be applied to the skin. When starch comes into contact with iodine and water (sweat), it will turn a dark blue or black color. This can be used to determine to what extent a person sweats excessively and in which areas of the hand this occurs most.

Therapy

There are a number of treatment methods for excessive sweating of the hands:

Aluminum chloride therapy

By applying aluminum chloride to the skin, the drainage ducts of the sweat glands become clogged. This liquid should be applied before going to sleep. The skin must be completely dry when the solution is applied. Once excessive perspiration has stopped, you can switch to maintenance treatment once a week or once every two weeks.As a side effect, this solution can cause skin irritation.

Iontophoresis

One option is to apply water or certain medications electrically (iontophoresis) to the skin. It is believed that in this way the sweat ducts are temporarily closed. This especially helps with the milder forms of excessive sweating. It is a therapy that must be repeated often.Recently, equipment has also become available that can be used at home. However, for severe cases, this therapy is not always sufficient. It is especially suitable for hands and feet. A weak continuous current (maximum 20 mA) passes through a waterbed in which the hand or foot is immersed. This treatment takes 20 minutes. Sweat secretion normalizes during the first 10 treatments. Afterwards, it is advisable to maintain the achieved result with periodic treatments. On average, one treatment per week is sufficient.

Injection of botox

The sweat secretion could be blocked with the help of an injection of botox. This protein blocks the transmission of stimuli at the transition from the nerve to the sweat gland. The sweat gland no longer receives any stimuli, so it stops working.Yet this blockade only leads to a temporary effect. To maintain the effect, the treatment should be repeated regularly, because new nerve impulses arise again a few months after administration.

Operations

In the worst case, surgery may be necessary. This is a drastic treatment. One of the techniques is the thoracic sympathectomy. This involves removing some nerve nodes. This will be done with a small incision in the armpit. The results showed that there is a strong decrease in sweating in 60 to 80% of patients.It is also possible to remove a thin layer of skin with sweat glands. This is also called micro liposuction. As side effects, new sweat glands can often grow out.