Plantar and palmar hyperhidrosis

Palmar Hyperhidrosis

This is a local hyperhidrosis that pertains to occurrence that only happens in one area specifically the hands and often called “sweaty palms”.

Plantar Hyperhidrosis

This is sweating that occurs in the feet in which people with palmar hyperhidrosis may also be affected. Fungal infections and shoe problems such as fitting of it can be common problems faced by people with this condition.

Signs and symptoms:

  1. Perspiration can be either between mild coldness of the hands or feet up to episodes of dripping of sweat.
  2. Peeling or sloughing off of the affected area.
  3. Episodes of excessive wetness then followed by an episode of dryness can occur

Types and Causes:

1. Primary Hyperhidrosis

This means that there is no obvious cause of the excessive sweating episodes. Hereditary tendencies, emotional extremes such as anxiety, fear or excitement can affect this.

2. Secondary Hyperhidrosis

This means that there is a known cause of the excessive sweating:

  • hormonal causes (diabetes, hyperthyroidism, thyrotoxicosis, menstruation, menopause)
  • metabolic disorders, malignant disease (lymphoma, pheochromocitoma)
  • autoimmune disorders (rheumatoid arthritis, systemic lupus erythrematosus)
  • drugs like hypertensive drugs and certain classes of antidepressants
  • chronic use of alcohol,
  • Parkinson’s disease
  • neurological disorders (toxic neuropathy)
  • homocystinuria
  • plasma cell disorders.

Conservative Management:

  • Psychological counseling can be applies of the cause of sweating is emotional in nature.
  • Smoking and consumption of caffeine-rich substances can worsen the condition
  • Minimize exposure to places such as high temperature and activities that needs intense energy consumption
  • Avoid consumption of alcohol and caffeine rich can lessen the occurrence of excessive sweating
  • Use anti-perspirant compounds such as aluminum chloride and aluminum sesquichlorohydrate foam can reduce the perspiration in that area


  1. Anticholinergic drugs are used as they target the excessive activity of the sympathetic nervous system
  2. Ionophoresis reduces sweat glands by using a small electric charger to deliver medications
  3. Botulinum injections (Botox) are also used to paralyze the nerve endings
  4. Endoscopic transthoracic sympathectomy done if the medications or conservative treatments are note effective. Sympathethic nerves are operated to stop the conduction of the nerve fibers to the sweat glands thus hindering it to overly function.

Nursing Management:

  1. Accept the client as what they are since they are affected by embarrassments or shyness about the condition.
  2. Encourage to use clothes or socks made of cotton since it prevents accumulation of odor.
  3. Emphasize the need  use of handkerchief to allow absorption of the sweat.
  4. Listen to the client as he or she voices out the feeling of uneasiness and discomfort during handshaking and other things that involves seeing their condition.
  5. Emphasize the compliance to recommended management and hygienic measures.

Photo credits:

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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