Why Do My Hands Sweat So Much For No Reason – A 16-year-old girl presented with excessive sweating of the palms for the past 1-2 years. Excessive sweating was present while awake but not during sleep. He had difficulty doing schoolwork because the paper he was holding often got wet and he had trouble writing. In addition, palm sweat severely limited his social activities. He tended to avoid shaking hands and was aloof from society.
She was otherwise healthy and on no medication. A detailed history failed to reveal any precipitating factors. Her father had mild, excessive sweating on the palms of his hands, which responded well to treatment with an over-the-counter prescription medication.
Why Do My Hands Sweat So Much For No Reason
During the examination, the girl’s palms are wet. Sensation was intact and no intrinsic muscle atrophy was observed in either arm. Physical examination results are normal.
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A clinical diagnosis of primary palmar hyperhidrosis is made. He was initially treated with an aluminum chloride tablet taken at night, but this was of insufficient benefit. She was then treated with botulinum toxin type A injections into the palms, resulting in over 90% reduction in sweating over 6-7 months.
Palmar hyperhidrosis refers to excessive eccrine sweating in the palms of the hands, beyond physiological needs to a degree that interferes with daily life, regardless of environmental conditions such as hyperthermia or psychological stress.
The condition may be primary (primary) or secondary to an underlying medical condition. In most cases, palmar hyperhidrosis is primary or significant, the cause is idiopathic, and it has a good cure. This review focuses on primary palmar hyperhidrosis.
Estimated prevalence ranges from 0.6% to 2.8% of the general population. This condition often begins in childhood and becomes more common between the ages of 18 and 30.
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Sweat glands in the palm of the hands are normal in size and histological appearance, with a density of about 600 to 700/cm.
Sympathetic nerve supply to these areas is also normal. This condition is thought to result from local hyperactivity of cholinergic sympathetic fibers innervating the sweat glands and passing through the dorsal sympathetic ganglion at T2-3, regardless of normal body temperature.
It has been suggested that overexpression of AQP5 in palmar sweat glands is involved in the pathogenesis of palmar hyperhidrosis.
It was assumed that the hypothalamic sweat center, which controls the palms of the hands and feet, is different from other hypothalamic sweat centers and is under the exclusive control of the cerebral cortex, without input from thermal elements.
Conditions That Cause Excessive Sweating
Thus, sweating of the palms and feet is rare, if it occurs during sleep or relaxation, and it does not increase in a hot environment.
Sweating occurs during waking hours, not during sleep. Sweating is not related to the temperature of the environment, but can become more intense during periods of emotional stress, embarrassment, fear, anger, excitement and anxiety.
The Hyperhidrosis Severity Scale is a validated 4-point disease-specific instrument, with a score of 4 describing sweating as “unbearable and always interfering with daily activities” and a score of 3 as “barely tolerable and often interfering.” Daily activities, a score of 2 describes sweating as “tolerable and sometimes interferes with daily activities” and a score of 1 describes sweating as “never noticeable and never interferes with daily activities”.
The scale can be used in the clinic to assess the severity of the problem and tailor treatment based on the severity of the disease.
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Quality of life can be assessed using the Hyperhidrosis Impact Questionnaire and the Dermatology Quality of Life Index.
Diagnosis is primarily clinical, based on history and physical examination findings. One of the main criteria for the diagnosis of primary palmar hyperhidrosis is visible and excessive sweating of the palms that lasts for at least 6 months without any known cause.
At least 2 or more of the following minor criteria must also be met: bilateral and relatively symmetrical involvement, impairment of daily activities, episodes lasting at least one week, age of onset over 25 years, positive family history, and cessation of palmar sweating during sleep. .
An iodine test for starch or the quinizarin powder technique can be used to determine the exact pattern and extent of involvement.
Sweaty Palms (palmar Hyperhidrosis): Causes, Symptoms & Treatment
Both methods produce calorimetric changes caused by contact with water (sweat). Gravimetry can be used to quantify sweat production.
Palmar hyperhidrosis has a negative impact on the quality of life, which is severe with diseases such as acne or psoriasis.
Affected individuals may have difficulty grasping objects such as pens. Also, the papers in their hands can get wet and the metals in their hands can rust. This can place limitations on the tasks and sports activities that people can do.
The situation is socially embarrassing; Affected people tend to avoid shaking hands. Thus, they may become socially isolated and have low self-esteem.
Medical Reasons Behind Excessive Sweating
Hyperhidrosis can lead to skin maceration and a tendency to bacterial, viral and fungal infections in the affected areas.
It improves from the fourth decade of life, as the activity of the eccrine sweat glands decreases with age.
For symptomatic treatment, local application of aluminum salt solution (especially aluminum chloride) is the first line of treatment.
The drug should be applied to completely dry palms at night before going to bed and washed off in the morning when you wake up.
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The drug acts by closing the opening of the sweat glands and causing the atrophy of secretory cells in the lumen of the sweat ducts. In general, topical antiperspirants are widely available, inexpensive, easy to administer, and well tolerated. These topical medications have excellent safety profiles. Adverse effects may include irritant dermatitis and rarely allergic dermatitis.
Topical medications do not work in all cases of hyperhidrosis and are generally less effective on thicker skin, such as the palms of the hands and feet, compared to the skin on the elbows.
Iontophoresis causes the sweat duct to be blocked with an ionized substance by directing a mild current through the skin. Adverse effects are generally mild and may include erythema, vesiculation, pain, burning, stinging, and dry, cracked skin.
Although iontophoresis is relatively free of side effects, the need for repeated treatments is a potential drawback.
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The treatment is contraindicated in pregnant women, in people with pacemakers or other metal implants, and in people with medical conditions such as epilepsy and heart disorders.
Unpleasant side effects such as dry mouth, blurred vision, drowsiness, dizziness, constipation, and urinary retention limit their use.
Also, these drugs are usually used to control generalized sweating and may not be suitable for localized sweating, such as foamy hyperhidrosis, if used alone.
Intradermal injections of botulinum toxin type A into the palms have been shown to be effective and safe for the treatment of palmar hyperhidrosis.
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Botulinum toxins work by blocking the presynaptic release of acetylcholine at the neuromuscular junction, thereby limiting sympathetic stimulation of the eccrine sweat glands. Side effects may include pain at the injection site, dry skin, hematoma, flu-like symptoms, and decreased appetite, all of which are temporary and will decrease over time.
The typical duration of the therapeutic effect is about 6 months, so repeated injections are needed to maintain the desired effect.
Sympathectomy removes eccrine sweat in all areas supplied by postganglionic fibers. In experienced hands, the success rate is 95% to 100%.
Complications may include pain, wound infection, hemorrhage, pneumothorax, hemopneumothorax, chylothorax, intraoperative asystole, recurrent laryngeal nerve palsy, brachial plexus injuries, post-sympathetic neuralgia, Horner’s syndrome, palatal hyperhydration areas, and achievement zones.
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Recent research has shown that the side effects of compensatory hyperhidrosis, although common and annoying, improve over time.
Is a clinical professor of pediatrics at the University of Calgary and a pediatric consultant at the Alberta Children’s Hospital in Calgary, Alberta, Canada.
Is a dermatologist and medical director and founder of the Toronto Skin Center in Toronto, Ontario, Canada. You can get a quick price and instant permission to reuse content in a number of ways.
An 11-year-old girl presented with excessive sweating and slowly increasing swelling of her palms and soles for the past 2 years. Her symptoms persist during the day and are minimal or absent during sleep. Symptoms are exaggerated when typing, reading, writing, and when watching it. There was no excessive sweating on other parts of the body, such as the face, armpits, and chest. Due to profuse sweating, he has difficulty holding a pen and doing schoolwork, and is shy in front of others. There is no history of recurrent skin infection, pain, strong body odor or heat intolerance. He denied any history of drug use. He was born to consanguineous parents, and his younger brother (8 years old) had similar complaints since the age of 6 years. His maternal grandfather also had similar symptoms since childhood (Figure 1).
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On examination, she had palmoplantar hyperhidrosis (Figure 2). The rest of the exam was impossible. Blood sugar and thyroid profile are normal. Based on the clinical history and examination, a diagnosis of primary focal hyperhidrosis was made
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