What causes palmar hyperhidrosis?

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Last updated: May 17, 2025View editorial policy

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Differential Diagnosis for Sweaty Palms

  • Single most likely diagnosis
    • Hyperhidrosis: This is the most common cause of sweaty palms, characterized by excessive sweating due to overactive sweat glands. It can be primary (focal) or secondary (generalized) and is often triggered by stress, anxiety, or heat.
  • Other Likely diagnoses
    • Anxiety or stress: Sweaty palms can be a physical symptom of anxiety or stress, often accompanied by other symptoms such as a racing heart, trembling, or nausea.
    • Overweight or obesity: Excess weight can lead to increased sweating, including in the palms, due to the body's increased metabolic rate and heat production.
    • Menopause: Hormonal changes during menopause can cause hot flashes and night sweats, which may also lead to sweaty palms.
    • Certain medications: Some medications, such as antidepressants, blood pressure medications, and hormone replacement therapy, can cause excessive sweating as a side effect.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Hyperthyroidism: An overactive thyroid gland can cause excessive sweating, including in the palms, due to the increased metabolic rate.
    • Pheochromocytoma: A rare tumor of the adrenal gland that can cause excessive sweating, palpitations, and hypertension.
    • Heart attack or cardiac arrhythmia: In some cases, sweaty palms can be a symptom of a heart attack or cardiac arrhythmia, especially if accompanied by chest pain, shortness of breath, or palpitations.
  • Rare diagnoses
    • Frey's syndrome: A rare condition that causes excessive sweating and flushing of the face, often triggered by eating certain foods.
    • Complex regional pain syndrome: A rare condition that causes chronic pain, swelling, and excessive sweating in one limb, often after an injury.
    • Neurological disorders: Certain neurological disorders, such as multiple system atrophy or autonomic dysfunction, can cause excessive sweating, including in the palms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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