Sweaty hands are also known as palmar hyperhidrosis. Excess sweating of the hand affects millions of people al over the world. The exact number of people with this problem is not known because many are too shy to seek medical help. Sweating of the hands is common and is a physiological response of the body to regulate body temperature. However, in some people excess sweating of the hands occurs even at rest.

Sometimes the condition is silent and then unexpectedly starts up. The sweating episodes are frequently worsened by spicy foods, emotional lability, stress, and heat. Any situation that increases anxiety can worsen the sweating. In the majority of cases, the cause of sweaty hands is never discovered. The majority of individuals who develop localized sweating are under the age of 25. The condition appears to occur in three out 100 people. It is a chronic condition with no identifiable cause.

What is the big deal about sweaty hands?

The sweating can be so profuse that these people are even embarrassed to shake hands. Even holding a book or signing a piece of paper an be a big ordeal because everything gets drenched in sweat. Most people with excess sweat are not able to perform daily living activities like typing, writing, holding or even driving. The constant wetness can occasionally cause maceration and redness of skin. Others may develop severe itching around the area. Excess sweating of the hands can lead to a poor quality of life and many people become socially withdrawn, nervous and isolated.

So what causes sweaty hands?

Unfortunately in the majority of people the cause of sweaty hands is a mystery. More likely it is a case of bad luck and bad genes. A few people may develop sweaty hands as a result of an overactive thyroid, diabetes or some type of neuropathy. The diagnosis of sweaty hands is clinical. There are no tests or imaging studies required to make a diagnosis of this problem. Once sweaty hands are diagnosed, there are a few treatments. The major problem is that most healthcare providers are ignorant of this disorder and have no idea who to go about treating it.

Home remedies for sweaty hands

Most people try home remedies for sweaty hands. This may include soaking the hands in various types of tea. Unfortunately there is no evidence that soaking hands in green, blue purple, black or white tea can reduce sweating. The only thing tea does is stain your hands. So tea soaks should not be on the list of your treatment.

Witch hazel and rubbing alcohol are sometimes used to treat sweaty hands. These liquids act like astringents or drying agents. You basically soak a Q tip in rubbing alcohol and apply it where there is sweating. These products do work for a few minutes and can dry the sweat but they do not cure sweaty hands. If you use rubbing alcohol frequently, it will result in excessive drying and peeling of your skin. So for long term use these products are not recommended.

Powders like talcum powder can help soak the sweat. However, talcum powder only works for mild cases and the relief is very short lived. Plus walking around with talcum powder on your hands is not aesthetic. Plus if you sweat a lot, you will form cakes of the powder which will look unappealing. Some herbalist recommend mixing baking soda with borax, sage, orange and lemon peel, willow bark and frankincense. There is again no evidence this hodge podge of substances can decrease sweating.

Another very common home remedy for sweaty hands is use of rosewater & vinegar. This combined formula also acts like an astringent and does decrease sweating for a short time. But again, drying and itching of the hands is a common problem. Not a good long term solution. The only positive is that your hands will smell nice.

What are other options for long term treatment of sweaty hands?

In people with significant sweating of the hands, deodorants and antiperspirants are of no use. There are several oral medications one can take but most of them have way too many side effects, which are worse than the sweating problem. Anti-cholinergic medications, such as Robinul, have been around for decades and are often prescribed by healthcare providers. But drugs like Robinul offer temporary relief and may cause total body dryness, dry mouth, dry eyes, severe constipation, urine retention and drowsiness. Drysol also dries the skin and requires lengthy treatment, but does provide temporary relief. Oral pills are not the standard of care for sweating and one should avoid them.

Are there any topical medications for treatment of sweaty hands?

In the days past, sweaty hands were only managed with use of topical solutions. The reason is because at that time it was felt that excess sweating was a localized problem. Over the years many chemicals have been used for the treatment of sweaty hands. The list includes boric acid, anti-cholinergics, resorcinol, 2-5% tannic acid solutions, formaldehyde, methanamine, potassium permanganate and glutaraldehyde.

All the above chemicals are applied on to the dry skin at night. It is recommended that the skin be covered with a dry dressing. The results of these drugs are very variable. However, the major reason why all these drugs have fallen out of favor is that they all cause severe skin irritation, which is unbearable. In addition, most of these products can stain your clothes & linen and the staining is permanent.

Prolonged use of these topical agents has been associated with excessive dryness leading to peeling and cracking of skin. In most cases, the excess sweating is not affected. Another product on the market that is widely used for treatment of sweaty hands is Maxim. This product is more alkaline and consequently causes less skin dryness and irritation. Maxim is available without a prescription but it does not work in everyone and its benefits are very unreliable. For those who are not able to afford the expensive medications and taking into consideration the adverse effects, topical agents should be the first choice. However, the use of these agents should be for a very short duration of time because in the long run their adverse effects outweigh the benefits.

The best long term treatment of sweaty hands

Botox can provide temporary relief but the best way to stop sweating is to undergo thoracic sympathectomy. Surgery involves cutting of the nerve that is responsible for sweating of the hands. The surgery is done with scope and is very effective. The down side to surgery is the cost and there is a small chance it may not work. The biggest problem with surgery is finding a decent surgeon. Not too many surgeons know how to perform this procedure and serious life threatening complications can occur if the surgeon makes a mistake. The good news is that when the surgery is done well, the results are immediate and long lasting.