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Palmar hyperhidrosis – increased sweating of the palms. Depending on the severity of the disease, sweat may protrude slightly or roll down to the fingers. Constantly sweaty palms, regardless of the temperature on the street or indoors, brings a person not only physical but also moral discomfort. Most people diagnosed with palmar hyperhidrosis cannot work or study normally.

Clinical signs

The main sign of palmar hyperhidrosis is constantly wet hands. Common symptoms of palmar hyperhidrosis are:

  • hands are cold to the touch;
  • unpleasant odour from the palms;
  • sweating intensity decreases in the cold season;
  • increased sweating after exercise.

Reasons for development

Hyperhidrosis of the palms occurs for the following reasons:

  • features of structure and localisation of glands;
  • dysfunction of the central nervous system;
  • dysfunction of hormonal system;
  • mental disorders;
  • infectious diseases.

Therapeutic measures

The doctor, depending on the severity of the symptom and the reasons that provoked it, selects methods of treating palmar hyperhidrosis individually. Antiperspirants help solve sweaty hands problems for those people who have low or medium intensity hyperhidrosis. Treatment methods for excessive sweating hands are:

  • pharmacotherapy;
  • the introduction of a neurotoxin type A drug into problem areas;
  • iontophoresis;
  • radiofrequency ablation of the sympathetic ganglia;
  • thoracoscopic (endoscopic) sympathectomy.

Iontophoresis is a technique for exposing sweat glands to high-frequency electric current. A positive effect can be achieved in 85% of cases. But the ionisation method does not give a permanent result, and the procedure will need to be repeated after a few months (on average, the effect of the method lasts for 6-9 months). Ionisation is strictly prohibited for patients with pacemakers and pregnant women.

Injection method for treating hand hyperhidrosis is injections of a special substance, type A neurotoxin, which blocks secretion of sweat glands. The duration of the effect is from 6 months to 1 year, after which the procedure must be repeated. Injections help almost all patients with the problem of hyperhidrosis, including in the presence of extremely intense sweating of the palms.

With a high degree of palm hyperhidrosis, when conservative treatment, injections and other methods do not have effect, minimally invasive techniques resort to radiofrequency ablation of the sympathetic ganglia and thoracoscopic sympathectomy.

The essence of radiofrequency ablation of the sympathetic ganglia is that the sympathetic ganglia are processed by high-frequency electric pulses, which are directed through a special radio-frequency cannula, with the aim of destruction or modulation of these structures. The procedure is carried out:

  • in an outpatient setting;
  • under local anaesthesia;
  • under the control of an electron-optical converter;
  • the duration of the manipulation is 20-30 minutes;
  • fast and lasting effect;
  • can be performed repeatedly (which is needed extremely rarely).

At the end of the procedure, the patient is under medical supervision for an hour and then returns to his normal lifestyle, without any restrictions.

The method of endoscopic sympathectomy is a minimally invasive operation that involves excision of a nerve. During the procedure the doctor makes small incisions in the armpits, through which a special needle is inserted with a camera at the end and the tool for excising the nerve. The operation requires:

  • hospitalisation;
  • is performed under general anaesthesia;
  • the duration of the operation is 40-60 minutes;
  • fast and lasting effect;
  • the length of stay in the hospital is 2-3 days.

Although after this procedure, excessive sweating in the treated area passes, it can occur elsewhere. And although the so-called compensation effect occurs in 5-7% of cases, you need to be prepared for it.