Palmar hyperhidrosis, or sweaty palms is the most common manifestation of hyperhidrosis, and is also the most socially disturbing. Sufferers fear any situation which may require hand contact. This impacts on one’s ability to interact effectively in the work place, and can have devastating effects on one’s social interactions.

Many patients can simultaneously experience plantar hyperhidrosis (soles of feet), axillary (arm pits) hyperhidrosis, or facial blushing. The different combinations of symptoms can vary between individuals, however, palmar sweating is the most difficult to control and is the most troubling.

There are many non-surgical hyperhidrosis treatments. Some patients with excessive palmar sweating have mild symptoms, which can be treated without the need for surgery. It is important to have a medical evaluation, to be certain that symptoms are not the result of an endocrine or hormonal imbalance, before trying any over-the-counter remedy.

People with excessive sweating often struggle to find treatment for hyperhidrosis. At the Center for Hyperhidrosis at Columbia University Medical Center, a team approach is used to evaluate and treat all patients with hyperhidrosis. Under the guidance of our physicians, a trial of topical remedies, or iontophoresis may be recommended if they have not yet been tried. Occasionally, temporary relief is only necessary, such as prior to a major social event, in that case BOTOX® for excessive palmar sweating may be an ideal solution. Patients with severe symptoms who fail to respond to these non-surgical remedies can be referred for ETS.

At the Center for hyperhidrosis at Columbia University, we were one of the first to advocate a T3 sympathectomy for patients with palmar hyperhidrosis or hyperhidrosis for hands. Many centers continued to perform a multilevel sympathectomy in patient’s with palmar hyperhidrosis which often results in significant compensatory sweating. By limiting the sympathectomy to T3, there is complete elimination of palmar hyperhidrosis with very little compensatory sweating in most patients. Since changing to performing T3 sympathectomy in the 1990s, we have performed well over two thousand sympathectomies for patients with palmar hyperhidrosis with excellent results. Patient’s satisfaction at six months and one year, is consistently above 98%.


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