A Singapore Dermatologist Explains “Sweaty Palms”

Updated on December 29, 2020

What are Sweaty Palms? 

Sweaty palms or Palmar hyperhidrosis involves a medical condition characterizing extreme sweating on hands that you cannot control. It can lead to several psychological, professional, or social problems. 

You may face routine issues like problems in handling paper, pen, tools, or equipment. If you feel like avoiding shaking hands with everyone, you should seek medical advice from a consultant dermatologist in Singapore

It is still not known what the pathological reasons for this type of uncontrolled sweating are. There are some nerves in our body over which we have no control, known as the sympathetic nervous system. Overactivity in this nervous system leads to such a medical condition. In some people, emotional stimuli appear to influence activity in the sweat glands significantly. 

Causes of Sweaty Palms 

There are 2 to 5 million eccrine sweat glands in our body, covering almost the entire skin. Whenever the body temperature increases, these glands start releasing sweat to the outer skin. The body temperature goes down when the sweat evaporates. 

Due to special apocrine sweat glands under the armpits, we feel excessive sweat in that area. 

There can be many triggers for excessive sweating in our palms or feet. They include hot and humid weather, stress, and anxiety. Besides, other factors include alcohol, caffeine drinks, painkillers, heart-related drugs, and antidepressants. Moreover, menopause and overactive thyroid glands may also be triggers. 

What is the treatment for Sweaty Palms? 

Over-The-Counter (OTC) Medication 

OTC scented antiperspirants can mask the lousy odour of sweat. They can control excessive sweating for a day or two. If you are looking for more extended relief periods, you may consider using strong antiperspirants having aluminium chloride.


A few dermatologists in Singapore use Botulinum toxin (Botox) injections to treat Palmar hyperhidrosis, but its effect lasts only 4 to 6 months. Some dermatologists use a low electric current method (iontophoresis), but it is also temporary. 

Endoscopic Transthoracic Sympathectomy 

When usual treatments fail in severely affected patients, the endoscopic transthoracic sympathectomy surgery is helpful. It is the only permanent solution available. 

In this case, doctors remove a small part of the sympathetic nervous system from the thoracic cavity. Doctors can perform this surgery in several ways, but the final result is always the same. However, it is not possible to reverse it. 

This surgery is a reliable and straightforward operation that eliminates the excessive sweat problem. It uses a keyhole or endoscopic method to inhibit the sympathetic nerves. Doctors use standard anaesthetic procedure,  and you need to spend only 1-2 nights in the hospital. 

The doctors operate by putting the patient on his side and make 1 to 3 small incisions of about 5-10mm in the armpit. After the surgery, the problem of excessive sweating is immediately over, and hands get dry. The chances of any complications are pretty low. 

Possible Complications 

Like other surgeries, there is some risk in this type of surgery also. Overall, it is a safe surgery with hardly any severe side effects. You can evaluate it in the context of the original condition by conducting a risk-reward comparison. Here are the results of the most extensive published study. In this research, many skilled surgeons performed this surgery on more than one thousand patients. 

It reported lung air leakage in about 1% of patients. Doctors treat this condition by using a chest drain tube.  They place the drain tube between the ribs and link it with a suction device for a couple of days. The patients remain hospitalized until tube removal. Similarly, in some rare cases, there is severe bleeding in the chest while operating the patients. In such cases, surgeons may have to open the chest. 

There is another complication involving eyelid drooping and a small reduction in pupil size without any visual problems. It is known as Horner’s syndrome, which occurs in only about one per cent of patients. This condition suddenly goes away on its own without any particular treatment in about 50% of the patients.  Besides, there is also a 0.1% risk of regrowth of cut nerves. 

Side Effects 

There may be a few side effects of this surgery. Many patients notice compensatory sweating in the legs and trunk. However, only 2% of those patients consider it as a significant issue. The hot surroundings or spicy food may trigger so-called compensatory sweating.

Tips To Cope Sweaty Palms 

If you regularly face sweaty palms or feet or armpits, you may consider the following tips

1. Before going to sleep, you may consider using antiperspirants. 

2. Avoid the consumption of spicy foods or caffeine. 

3. Take a bath every day. Do not use hot showers or sauna as they may increase the body temperature quickly. 

4. Bacteria growth causes a foul foot odor. Go barefoot whenever possible to improve air circulation. 

5. Your feet should be dry before putting on shoes. Similarly, dry your shoes before wearing them. 

6. Use loose-fitting clothes and socks made of cotton and similar natural fabrics. They can help by absorbing moisture and providing required breathability to your feet. 

7. Stress can trigger sweaty palms. You can control excessive mental stress by using relaxation methods like deep breathing and meditation. 

8. Find out the reasons behind excessive sweating and try controlling those factors. It should not become an obstacle in your regular social life. 

9. Finally, never hesitate to ask for medical help.


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