Localised idiopathic Palmar Plantar hyperhidrosis (excessive sweating from the hands and feet) can be improved with several treatments offered at Perth Dermatology Clinic including clinical antiperspirants; iontophoresis; and anticholinergic tablet medications.
Clinical Antiperspirants containing higher concentrations of metallic salts can help to improve mild sweating from the hands and feet. However in moderate to severe cases of excessive sweating, this treatment is often insufficient and causes irritancy leading to discontinuation of application.
Iontophoresis delivers an electric current through water, which when applied to the palms or soles, reduces the amount you sweat. This treatment usually leads to a 60-70% reduction in sweating with ongoing use. A 20minute at home treatment 2 x per week may achieve this reduction in sweating for the long term. Currently, we consider this the best side effect free, minimally invasive long term solution for palmar and plantar hyperhidrosis management. You will need to purchase your own iontophoresis machine and conduct this treatment at home.
Oral anticholinergic medications can lead to a significant reduction in sweating from all locations, however can sometimes be poorly tolerated due to side effects or be inappropriate for use in the long term or in combination with other medications. Dry mouth is a common and manageable side effect.
If the above conservative measures for treatment of palmar hyperhidrosis are unsuccessful, you will be referred for consideration of endoscopic thoracic sympathectomy (ETS), a surgical procedure to reduce sweating of the palms only performed usually by a vascular or cardiothoracic surgeon. This treatment is considered when other treatments have been tried and proven unsuccessful, as ETS can lead to compensatory hyperhidrosis (sweating elsewhere) and potential other side effects.
