FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

[GRANDDAUGHTER'S SWEATY FEET MAY BE JUST "NERVES"]

Question: My granddaughter has a problem with sweaty feet and palms. They are always wet. She even takes an extra pair of socks to work because her feet get that wet. She has been to a doctor with this, but with no success. Can you tell us something about this?

Answer: Sweating serves a very important purpose. It is one of the ways your body regulates temperature. When it's hot, you sweat, and as the sweat evaporates it cools your skin and the blood in the dilated vessels near the skin's surface. When this cooled blood circulates through the body it lowers your internal temperature as well.

In certain situations, the sweating reaction may be confined to a certain area of the body. This can be due to clothes that don't allow the skin to "breathe" - that is, the sweat can't evaporate. Similarly, I think most of us have a pair of shoes that are so snug and warm that our feet sweat even though the rest of the body is comfortable.

But, as you are no doubt aware, people also sometimes sweat when they are nervous or under emotional stress. A common example of this is the sweaty hands and feet that we all experience when under emotional stress. Remember how you felt the first time you met your in-laws? How about before taking that important test? Cold hands, fast heartbeat and wet underarms and feet. Your granddaughter's chronically wet hands and feet may be nothing more that a response to the stress of work and home.

Abnormally high levels of thyroid hormone, a condition called hyperthyroidism, can also produce sweaty hands and feet. Other causes include low blood sugar, intense pain, fever, most cancers and several disorders of the nervous system. Most of these conditions cause sweating of other body parts, too, but the hands and feet may be the most obvious areas in some individuals.

Let me explain all of this a bit more technically: Sweating is a complex activity that involves interaction between the sweat glands of the skin, the circulatory system and the nervous system. In fact, the condition is even more complex than this because the activity of the nerves controlling the sweat glands are under the influence of the nerves of the brain and spinal cord, not to mention the general influence on all body tissues caused by hormones. Problems - or normal physiologic signals - in any of these areas can cause sweating.

If your granddaughter is an otherwise healthy individual, it is most likely her sweating is part of the way she responds to emotional stress. Her doctor will certainly want to make sure that she doesn't have any of the other more serious conditions, though.

Increased sweating on your hands and feet can often be controlled using the same over-the-counter antiperspirant products that you use to keep your underarms dry. (Yes, they are just as safe to use in this manner as in their "normal" usage.) Other individuals may need additional help in the form of medication taken by mouth. Beta blockers and calcium channel blockers - most often used for high blood pressure and other circulatory problems - can offer significant relief. These medicines, along with stress management counseling, are usually successful in controlling excessive sweating of hands and feet.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.