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What is palmar hyperhidrosis?

When a person sweats excessively and unpredictably it is called hyperhidrosis.

Palmar hyperhidrosis. What’s wrong with you?

Sweating makes the body stay cool. It is a normal body function if you are hot, exercising, nervous, angry, embarrassed or afraid.

If you have hyperhidrosis, what happens is a poor regulation of the activity of the sweat glands, which are more active than normal. That is why you can sweat excessively spontaneously, without a cause that triggers it. Also, stressful situations will make you sweat like everyone else.

This uncontrolled sweating can lead to discomfort on a physical level, such as cracks, wounds, infections and, the most serious, on an emotional level. It can have unpleasant effects on your daily life; you feel upset or uncomfortable with others; self-conscious about the humidity and the smell, afraid of coming into contact with or shaking hands with others, you wet the exams and you can’t write; you feel embarrassed in public, with friends, your partner or at school. All of this can cause social isolation and   anxiety  or  depression .

It can happen that you sweat all over your body, or areas such as your feet and armpits, face and genital area. When excessive sweating affects the hands, feet, and armpits, it is called primary or focal hyperhidrosis . In most cases the cause cannot be found and it is a condition that appears to be hereditary. It usually begins in childhood or puberty.

On rare occasions, sweating occurs due to a disease ( hyperthyroidism , sugar problems, cancer…); when this is the case it is called secondary hyperhidrosis . In this case, the whole body or in a rare area usually sweats and is usually accompanied by other symptoms: palpitations, chest pain, night sweats.

When to go to your pediatrician-doctor?

Many times, people who have hyperhidrosis don’t tell about it and don’t seek help because they think it’s ridiculous or embarrassing. You should talk to your pediatrician if:

  • You seem to sweat a lot more than normal.
  • When it has an unpleasant effect on your life since it makes you isolate yourself, be sad or anxious.
  • You sweat without a cause like exercising or being in hot weather.
  • If it is accompanied by chest pain, fever, shortness of breath or you notice that the heart is beating harder than normal.
  • You are unintentionally losing weight.
  • Most of the time, sweating occurs or is worse at night

What tests are they going to do?

Your pediatrician is likely to ask you questions about your medical history, how it affects you. And since the signs of your sweaty hands will be obvious, you may not need to do any testing. The dermatologist will see if your problem is important.

If specific tests are done for hyperhidrosis, these are used to measure the level of moisture in the skin (staining with iodine-starch, placement of special paper…)

Can I do something to control it?

A number of factors can help you manage sweating without killing it

– Avoid putting your hands in your pockets; Being warmer, they will sweat more.

– Do not dry them all the time because if you do, you remind your brain that you sweat and anxiety will make you sweat more.

– Do not eat or drink things that make you sweat more (caffeine, spicy foods and alcohol)

– Do physical exercise and relaxation techniques that help your nervous system to regulate itself better.

Treatment for hyperhidrosis

There are several treatment alternatives depending on the sweating you have: mild (on the palms, without drops); moderate (on the fingers with drops) or severe (on the back of the hands, with drops).

1. Antiperspirants on the skin: They are the first choice. They are usually made up of mineral salts such as aluminum chloride at different concentrations, in wipes, cream or gel. (Some brand names are Perspirex , Drysol , Hydrosal , Xerac , Anhydrol ). They react with sweat and close the sweat ducts.

You can try a product from the pharmacy but if you think you have a problem, you should better consult your doctor. These products are applied at night, after drying the skin very well, and washed off the next day. At first they are used several times a week, every night, and sometimes even 2 times a day; then once or twice a week. They can irritate the skin, especially if it is not completely dry, and their effects disappear if they are no longer used.

2. Iontophoresis This treatment option involves using a special machine that applies a small amount of electricity to shut down the sweat glands. It can be purchased online or at pharmacies. At first it is applied more frequently and then maintenance sessions are enough (1 every 4 weeks). It can cause skin irritation and is contraindicated if you have any prosthetics such as dental ones.

3. Surgery: endoscopic thoracic sympathectomy . In severe cases, and if other treatments have not worked, surgery may be a definitive option.

It consists of interrupting the chain of sympathetic nerve ganglia that are at the thoracic level and that activate some sweat glands. Holes are made at the thoracic level through which a small camera and the instruments to cut or burn the lymph nodes are inserted. It is done under general anesthesia, but it is a short intervention and sometimes with a 24-hour stay.

Most patients are satisfied with the result of the operation, since in the case of the hands the sweating completely or partially disappears. In the case of other areas, such as the armpits, the result is usually worse. The main complication is that compensatory sweating sometimes appears in another area of ​​the body such as the back and buttocks, which also usually disappears.

Surgery can be performed from childhood to adulthood, although patients and parents must agree with the doctor.

There are other treatments for palmar hyperhidrosis such as oral medications (anticholinergics, anxiolytics) and botulinum toxin that are not as widely used today.

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