Sweaty Hands and Feet

Who gets sweaty hands and feet, and why?

The palms of your hands and the soles of your feet have more sweat glands than any other part of your body. Some people have hands and feet that sweat a lot. This problem is common and can be very embarrassing.

Sweaty hands and feet usually are not caused by a disease. This problem tends to begin in childhood. It often runs in the family. The sweating becomes worse with emotion and stress. It does not happen when you are asleep.

How is this problem treated?

The treatment depends on how much you sweat, how much the sweating interferes with your daily activities, and how well a treatment works for you.

Several treatments are available.

• An aluminum chloride solution (brand name: Drysol) can be applied to the skin on the palms of your hands and the soles of your feet.
• Another treatment is tap-water iontophoresis. In this treatment, a mild electrical current is passed through water and applied to the skin.
• Most effective for people with severe sweating might be treated with injections of botulinum toxin type A (brand name: Botox).
• If all other treatments do not work, surgery can be done to cut the nerves that cause the sweating.

All of these treatments can have side effects. You and your doctor can decide which treatment is best for you.

 

Hyperhidrosis

Injections of BotoxÒ are safe and effective, and often improve quality of life in patients with hyperhidrosis.16 The purified protein inhibits the release of acetylcholine at the neuromuscular junction and affects the postganglionic sympathetic innervation of the sweat glands.17

An area about 1.2 cm in diameter is made anhidrotic around each injection site; therefore, multiple injections spaced 1 to 2.5 cm apart are necessary over the hyperhidrotic areas. Efficacy can be observed within one week. Anhidrosis induced by botulinum toxin injections persists for four to 13 months.18,19 For successful long-term therapy, injections must be repeated regularly.

Intracutaneous injections are recommended rather than subepidermal injections, which are too close to nerve endings.20 Botulinum toxin injections are painful and require the use of an anesthetic. Ulnar and median nerve blocks or intravenous regional anesthesia is more effective in preventing pain than is topical application of a local anesthetic.21

Potential side effects of botulinum toxin injections include transient, slight weakness in the muscles of the hand and the formation of small hematomas at the injection sites.

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