What is the treatment for palmar hyperhidrosis?

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Last updated: May 17, 2025View editorial policy

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From the Research

For the treatment of sweaty palms, or palmar hyperhidrosis, the most effective method is botulinum toxin injection, as it provides 3-6 months of relief with significant improvement in symptoms, as shown in a comparative study published in 2014 1.

Treatment Options

  • For mild cases, start with aluminum chloride antiperspirants (like Drysol or Certain Dri) applied to dry palms at night, then washed off in the morning.
  • Iontophoresis devices, which pass a mild electrical current through water-immersed hands, can be used 2-3 times weekly for 20-30 minutes, then reduced to maintenance sessions, with a study in 2023 showing aluminum chloride hexahydrate gel iontophoresis to be an effective alternative treatment 2.
  • For moderate to severe cases, oral anticholinergics like glycopyrrolate (1-2mg twice daily) or oxybutynin (5-10mg daily) can reduce overall sweating, though they may cause dry mouth and blurred vision.
  • Botox injections into the palms provide 3-6 months of relief but can be painful and may temporarily weaken grip.

Lifestyle Adjustments

  • Simple lifestyle adjustments like avoiding triggers (spicy foods, caffeine, stress) and using absorbent powders can complement medical treatments.
  • The underlying cause of hyperhidrosis is overactive sympathetic nerves stimulating sweat glands, and treatment aims to block this pathway.

Considerations

  • For permanent results, endoscopic thoracic sympathectomy surgery can be considered, though it carries risks of compensatory sweating elsewhere, as mentioned in a study published in 2018 3.
  • A study in 2014 compared botulinum toxin versus iontophoresis with topical aluminium chloride hexahydrate in treatment of palmar hyperhidrosis, showing better improvements with botulinum therapy 1.

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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