Sunday, August 4, 2013

Sweaty Palms - Introduction, Symptoms and Treatment

Sweaty Palms is a common problem. Let us know about sweaty palms introduction, symptoms and treatment.

Definition of Sweaty Palms

The condition of sweaty palms is medically known as Palmer Hyperhidrosis. Hyperhidrosis is profuse perspiration of the body and Palmer Hyperhidrosis refers to the condition where there is excessive sweating in palms. However, there the term 'hypersympathetic activity' fits more since excessive perspiration is because of over activity in the sympathetic chain.

Symptoms of Sweaty Palms

In case of palmer hyperhidrosis there is a profuse perspiration in the hands. In severe cases, the sweat can be seen dripping down from the hands. The condition is very embarrassing while shaking the hands as a common custom. Some patients with this problem report that they are even embarrassed while holding hands to those whom they love and are closest. Because of the force to hide the problem of excessive palm-sweating, some patients say that this prevents them from being sociable the way they want.

Other problems due to sweaty palms include smeared ink while writing and uncomfortableness using electronic devices such as pianos and computer keyboard. Palmer hyperhidrosis can also affect one's life and career as a cop can drop a gun when needed. Similarly, a cashier may not be able to count the money fast.

Causes of Sweaty Palms:

Though neurological, metabolic and other health ailments may cause sweaty palms but generally, patients with this problem are otherwise healthy. Heat and some emotional factors may trigger perspiration in few but most patients suffer from Palmer hyperhidrosis almost all the time irrespective of mood swings or the weather. Sweating in palms is found reduced when the patient is sleeping.

A study published in the issue of the Journal of Vascular Surgery, University of California reveals that there is strong evidence that excessive sweating in palms is genetic. Generally, hyperhidrosis is because of sympathetic nerve that governs the nervous system. The nerve contracts the blood vessels in the palms leaving them cold and sweaty. The patients suffering from Palmer hyperhidrosis produce excessive sweat which continuous all the day.

Secondary hyperhidrosis could be due to diabetes, menopause, poisoning (such as lead and mercury), disorders of thyroid/pituitary glands, tumors, gout etc. Such secondary hyperhidrosis reflects more serious problems as compared to primary (uncomplicated) Palmer hyperhidrosis. Certain psychosis illegal drugs are also found to cause excessive sweating. Rheumatoid arthritis and SLE- systemic lupus erythematosus are also considered as triggering factors.

Risk Factors of Sweaty Palms:

The risk factors for Palmer hyperhidrosis include:

o Stress
o Tension or anxiety
o Hormonal changes
o Health conditions like diabetes
o Adolescence (where the body undergoes many physical and mental changes)
o Increased metabolic rate
o Obesity

Additional Investigations required for Sweaty Palms:

In most of the cases, Palmer hyperhidrosis is visible and it does not require any test or investigation to confirm the health ailment. However, tests are done in order to carry out the exact causes. For instance, thyroid function test - TFT is suggested to know the levels of thyroid hormones and also fasting blood glucose (FBG) is advised to detect low blood glucose. A chest X-Ray to rule out chest infection like pneumonia or tuberculosis and special X-Ray (called as Cranial CT Scan) may suggest any strokes. Hemogram and urine tests are also required to find any disorder that may cause excess sweating in the palms.

Thermoregulatory Sweat Test is the test that uses moisture-sensitive indicator powder that is being applied on the body skin. At room temperature, the change in color of the powder (yellowish green to dark purple) indicates the areas those sweat excessively.

Conservative management for Sweaty Palms:

The prevention of the sweaty palms depends upon the cause. For instance, profuse perspiration in the palms can be due to over-exercises or hot atmosphere and hence one can avoid this. Reduced levels of blood glucose can be avoided by taking enough diet or some medications. The conservative or non surgical treatment is often advised before undergoing any surgical intervention to treat primary hyperhidrosis. Some of the common ways to treat sweaty palms include: -

1. Anticholinergic Drugs: These drugs require prescription. They help to reduce the sweating.
2. Iontophoresis: This therapy uses an electric current passed through the solution in which, hands are to be kept. The current is very minimal and so bearable.
3. Botulinum A Neurotoxin (Injection): This therapy includes injecting Botulinum A Neurotoxin into the palms. Generally, the therapy is repeated every 7-12 months.
4. Aluminum Chloride: The solution containing Aluminum Chloride (20%) is used that serves as active chemical antiperspirant. The solution is directly applied on to the affected areas (palms).

Treatment (Surgery and Modern Drugs) for Sweaty Palms:

Generally, when the conservative treatment (including oral medications) fails curing primary palmer hyperhidrosis, the surgical treatment is indicated. The surgical procedure is known as Bilateral ETS (Endoscopic Transthoracic Sympathectomy). The surgery is considered as a standard, safe, effective and least invasive as compared to other surgeries. In the procedure, the patient is operated under general anesthesia. An incision near the axilla between 3rd and 4th rib is made and then thoracoscope is inserted to indentify the sympathetic chain that is finally divided. The surgery is performed under both the arms.

The drugs that block the effects of the nerves that stimulate the glands producing sweating. Drug such as propantheline bromide can be used, however, not too often. This is because the result may vary and side effects such as blurring of the vision and dry mouth are quite common. Nevertheless, in a few patients, such drugs work wonderfully and they do not require any other treatment.

In Ayurveda, the herbs that detoxifies blood can be used in the treatment of sweaty palms. Herbs such as shatavari, manjishtha, haridra, khadir, patola, nimba etc have been used to treat various health ailments including Palmer hyperhidrosis.


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