Treatment for palmar hyperhidrosis can involve a variety of options. These can include Botulinum toxin, Tap water iontophoresis, or Thoracic endoscopic sympathectomy. In some cases, a combination of treatments is necessary. Listed below are some of these options:
Botulinum toxin injections have been used to treat palmar hyperhidrosis. The procedure is not suitable for all patients. People with underlying diseases, previous surgery for debulking sweat glands, severe blood-clotting disorders, or a history of infections are not candidates for treatment. Female patients and pregnant women are also excluded.
In the study, 100 U of bovine botulinum toxin (BoNT/A) was diluted in 1.5 to three mL saline and injected into a 1-2 cm2 area of the palm. The injections were made into three areas of each digit in the palm. Patients received 20 to 40 injections. The procedure can be painful and may reduce handgrip strength. The patient’s condition should be assessed for at least 12 months to assess the effectiveness of the treatment.
For sustained relief from the symptoms of hyperhidrosis, additional injections of botulinum toxin are typically needed. Patients may need further injections at intervals of four to 17 months after the initial injection. One study showed that the treatment significantly reduced sweating compared to placebo. However, the average sweating rate increased after six months, but was still below the initial rate.
The study results indicated that the treatment was effective for patients with mild to moderate palmar hyperhidrosis. After a month of treatment, 75% of patients in the Type A group reported a two-point improvement on the HDSS. At six months, 80% of patients in the Type B group experienced similar results. The injections were well tolerated and no patients reported systemic adverse events.
In the study, the rates of sweat production decreased in participants after botulinum toxin A treatment. After two weeks, the mean rate of sweating was reduced from 168+-113 mg per minute to 32+-39 mg per minute. Moreover, a higher dose of botulinum toxin A did not show a greater decrease in sweating than the lower dose.
Palmar hyperhidrosis is a condition wherein sweating over a large area of the body occurs frequently. This condition affects about fifteen million people in the U.S.
Tap water iontophoresis
To treat palmar hyperhidrosis effectively, tap water iontophoresis is a viable treatment option. This therapy involves immersing the hands or feet in a solution containing minerals and electrolytes. These minerals and electrolytes act as conductive agents that carry a mild electrical current to the skin. The resulting current disrupts the sweat gland’s nerve signals, preventing sweating.
The treatment is safe and has a long history. It is also effective. Tap water iontophoresis is based on established physical, chemical, and biological processes. Unlike creams and antiperspirants, tap water iontophoresis has no serious side effects.
The procedure is inexpensive and safe and can treat palmar hyperhidrosis with a high success rate. One study conducted with 11 patients showed that tap water iontophoresis significantly decreased sweat production in both hands. Even more impressive, patients’ sweating decreased to a significant extent after only two weeks of treatment. This result was consistent over time, and patients reported an 81% reduction in sweating after regular maintenance sessions.
The treatment consists of two phases: an initial phase, and a maintenance phase. The frequency of treatments depends on the severity of the hyperhidrosis. After the first treatment, the patient may experience some redness or tingling in the hands, but these symptoms would subside within two hours.
The treatment is considered a safe and effective primary treatment for palmoplantar and axillary hyperhidrosis. Tap water iontophoresis can be used as a substitute for surgery. It can also be used in conjunction with other treatments.
This treatment is convenient because it can be performed in the comfort of the home. It does not require frequent clinic visits and is needle-free. The benefits of iontophoresis include a reduction in sweating symptoms and improved quality of life. However, patients should check with their doctors before using the treatment.
Although iontophoresis has been used for treating hyperhidrosis since 1952, it has had mixed results. The treatment has also been used for postsurgical hyperhidrosis. In one study, iontophoresis with tap water galvanism helped patients who had undergone traumatic digital amputation. The treatment reduced hyperhidrosis in the hands of the patient.
Thoracic endoscopic sympathectomy
Thoracic endoscopic sympathectomy (ETS) is a surgical procedure used to treat excessive sweating, also known as palmar hyperhidrosis. It works by removing the sympathetic nerves that control sweat gland activity. The procedure is performed under general anesthesia to ensure patient comfort and safety. The surgeon makes several small incisions under the arm and collapses one of the lung’s lobes for greater access.
The most common location for sympathectomy is the upper thoracic region. This region contains the sympathetic chain between the first and fifth thoracic vertebrae. The surgery is safe and effective, and results are generally positive. Although there is a risk of postoperative pain, the majority of patients have a substantial reduction in palm sweating and improved physical and mental functioning.
Initially described in 1942, thoracoscopic sympathectomy is a safe, minimally invasive procedure that provides excellent cosmetic and medical results. The procedure typically requires a brief hospital stay and is associated with very few complications. However, a small number of patients may experience compensatory sweating after the procedure.
The surgery requires two small incisions in the armpit and is effective for treating palmar hyperhidrosis. The procedure can also be performed on children. In both cases, patients will need to undergo postoperative monitoring. After the procedure, scarring is minimal and is practically invisible.
The procedure has several risks. Some patients may experience compensatory sweating, which is the excessive sweating in previously unaffected areas. However, this side effect is relatively rare and is not severe enough to cause discomfort. However, it may be difficult for patients to control compensatory sweating. In many cases, patients will experience a mild degree of compensatory sweating in the long-term, but it is less severe than compensatory sweating caused by an extensive sympathectomy.
The procedure is done under general anesthesia and requires two small incisions in the armpit. The surgeon uses a small camera called a thoracoscope to view the inside of the chest. Small tools are inserted through the remaining cuts to access the nerves controlling sweating in the affected area. Afterwards, the incisions are closed with stitches. A small drainage tube is sometimes left in the chest for a day or two. The entire procedure is typically completed in one to three hours.
Combination of treatments
Surgical intervention is one option for palmar hyperhidrosis. The surgeon can use thoracoscopic or endoscopic techniques to target the sympathetic nerves in the palms. This procedure can result in significant improvement in axillary and palmar hyperhidrosis. However, this type of treatment is not suitable for armpit or face hyperhidrosis.
Patients with palmar hyperhidrosis may experience excessive sweating, which often interferes with everyday activities. It can cause significant social embarrassment and impair social interactions. For children, it can also interfere with school activities. Oftentimes, sweating in the hands prevents children from writing on paper. It can also cause them to avoid holding hands, which is uncomfortable and embarrassing.
Combination of treatments for palmar hyperhidroses are available, and include topical therapy and dietary changes. For severe cases, treatment may involve either a surgical or nonsurgical method. The effectiveness of these treatments depends on several factors. Some studies measure their effectiveness by examining patient’s symptoms, while others measure treatment-related morbidity. Nonsurgical approaches include botulinum toxin injections, topical antiperspirants, and iontophoresis. Surgical interventions are reserved for patients with severe and persistent palmar hyperhidrosis.
Thoracic sympathectomy is one of the most effective treatments for palmar hyperhidrosis. This surgery divides the sympathetic nerves to eliminate excessive sweating. This is a safe procedure, but some patients experience complications. It is best to discuss treatment options with a dermatologist.
Iontophoresis is an electrical current introduced through the skin. It has long been used as a treatment for palmar and plantar hyperhidrosis. However, the mechanism of action of iontophoresis remains unclear. The device used to apply iontophoresis consists of water-filled trays with electrodes. The therapy can be administered in sessions of 20 minutes every two to five days.
Antiperspirants are another treatment option for hyperhidrosis. These creams prevent excessive sweating by mechanically blocking sweat glands. Examples of these products are Drysol and Xerac. These antiperspirants are applied to the affected areas once a day, usually at night. There are also oral medications called anticholinergic agents that block the innervation of the sweat glands. These drugs can have adverse side effects and must be used carefully.
A combination of treatments can be used to reduce palmar hyperhidrosis. The treatment for excessive sweating depends on the cause. Patients may be experiencing excessive sweating due to an underlying medical condition or a genetic predisposition. It is best to discuss this problem with a medical professional so that the appropriate treatment can be given.