FAMILY MEDICINE® COLUMN

By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

HYPERHIDROSIS, OR SWEATY PALMS AND FEET -- COMMON AND TREATABLE

Question: My teenage son has a problem with sweaty palms. They are always wet. His feet also seem to sweat a lot. His doctor checked him out and said it wasn’t caused by anything serious, but he’s still bothered by it. Do you have any suggestions?

Answer: I think your son may have a condition called “sweaty palms syndrome,” a form of hyperhidrosis. As you know, we all sweat, and it serves a very important purpose in helping to regulate body temperature. People with sweaty palms syndrome, however, sweat more than is necessary for good health.

A study at UCLA found that about 5 percent of us have sweaty palms syndrome and that it has a genetic basis. If one parent has this condition, the child has a 28 percent chance of also having it. The UCLA researchers said that in the past this condition was thought to be stressed related, and it was therefore, not taken seriously by the medical community.

While I find this research very interesting, I should point out that people do actually sweat more when they are nervous or under emotional stress. In some people, this sweat is particularly pronounced in the hands and feet as well as the underarm area. You may have experienced this type of sweat reaction the first time you met your girlfriend’s or boyfriend’s parents, or before taking that important test.

If your son’s hands and feet are wet when he goes to school and in other social situations, but are drier at other times, it might indicate that his problem is related to nervousness and anxiety. If it’s literally true that they are “always wet,” then he may have a more chronic form of hyperhidrosis.

You said that your son’s doctor had ruled out serious causes. That’s good. For the record, these would include abnormally high levels of thyroid hormone, low blood sugar, intense pain, fever, some 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 sympathetic 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 reactions -- in any of these areas can cause sweating.

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. 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 often successful in controlling excessive sweating of hands and feet.

In extreme cases, where the sweaty palms syndrome is continuous and severe, surgery may be an option. In this procedure the sympathetic nerve to the hands is cut. It can be very effective and does not harm the nerves that control hand and finger movements and the senses of feeling or touch.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.