Hyperhidrosis of the hands and feet – Palmar and Plantar
Hyperhidrosis of the hands, otherwise known as Palmar Hyperhidrosis, is the most common place to suffer from excessive sweating.
It can be a distressing problem, as having constantly wet hands makes it hard to write on paper, hold pens, or use tools or keyboards. Having to shake someone’s hand is embarrassing. Aluminium chloride Antiperspirants can be very effective for some, although these are more successful for treating axillae (armpits). Anhydrol Forte (roll on), Driclor (roll on) and Odaban (spray) are available over the counter or on prescription. Maxim is a similar anti-perspirant available in the USA.
As these antiperspirants can cause irritation and soreness, it’s important to follow the instructions precisely – apply at night, to completely dry skin, and wash off in the morning.
Iontophoresis is the second choice of treatment, and in 85% of all cases is successful using just tap water. Those who do not get a complete cessation of sweating using only tap water can obtain, on prescription, Glycopyrromium Bromide (Robinul) which can be added to the iontophoresis baths.
Botulinum (Botox) injection is not licenced in the UK for palmar hyperhidrosis, but can be performed at some private hospitals. The skin on the hand is sensitive, and the treatment can therefore be uncomfortable. It would need repeating every 4 months or so, and so an anaesthetic each time is not always recommended. However some specialists do perform local anaesthesia for this.
Endoscopic Thoracic Sympathectomy (ETS) can also be performed, but this is radical surgery with potentially severe side effects. Iontophoresis is more popular now, more successful and less invasive.
If possible, wash hands with non-soap based emollient washes and moisturisers.
Hyperhidrosis of the feet (Plantar)
Hyperhidrosis of the feet, otherwise known as plantar hyperhidrosis is a common problem, and many people have sweaty feet. Plantar hyperhidrosis is often associated with an unpleasant odour, maceration of the toes and mycotic infections. It is made worse by wearing synthetic shoes and man-made fibre socks. The smell of sweaty feet comes from the bacteria that thrive in warm moist conditions, so wash
often and stick with leather shoes or sandals and 100% cotton socks. Change your socks often, and don’t wear the same pair of shoes 2 days in a row – give them time to dry out properly. Go barefoot whenever possible.
Anti-perspirants can be very effective.
Iontophoresis is very effective for most people if aluminium chloride antiperspirants don’t work.
Botulinum Toxin treatment (Botox) is not licensed in the UK for hyperhidrosis of the feet, and surgery is not generally recommended.