Why Do I Have Excessively Sweaty Hands? Here's What to Know
Excessively sweaty hands? Discover the causes, from stress to medical conditions, and learn effective ways to manage and treat clammy palms.
Sweaty palms are something we’ve all experienced at one point or another—whether from heat, nerves, or other common triggers. But how can you tell if your hands are sweating too much?
If you find that your palms are sweaty and slick—even in the absence of anxiety and heat—you may have palmar hyperhidrosis, a condition that causes excessive and uncontrollable sweating of the hands. Palmar hyperhidrosis is a fairly common condition—in fact, about 1-3% of the US population currently lives with excessive sweating of the hands.
This condition can definitely be a challenge to live with, after all, clammy palms are probably the last thing you want during a handshake with your new boss. But there’s good news too: for palmar hyperhidrosis, there are several effective treatments that can help you manage—and even keep dry—your sweaty hands.
What is Palmar Hyperhidrosis?
To truly understand how to manage palmar hyperhidrosis, let’s take a step back. This condition can be categorized into two different types, and understanding which type you have is an important first step in exploring the best treatment options for you.
Primary Palmar Hyperhidrosis
Generally, sweating is the body’s way of cooling itself off; your nervous system will automatically trigger sweat glands when your body temperature rises. Feeling hot or excited? Don’t worry, your body’s nervous system is about to kick in and help you sweat. But in the case of primary palmar hyperhidrosis, nerve signals trigger eccrine glands in the palms even when the body has no need to cool itself down. The eccrine sweat glands in the palms become overactive, which, in turn, causes those excessively sweaty hands.
In essence, primary palmar hyperhidrosis is a subset of something called focal hyperhidrosis, where just one part of the body gets a little extra wet– typically, the palms, underarms (axillary hyperhidrosis), and feet (plantar hyperhidrosis).
Secondary Palmar Hyperhidrosis
Secondary is another type of hyperhidrosis, and can be caused by an underlying condition or by certain medications, such as pain relievers, antidepressants, and some diabetes and hormonal medications.
What Causes Excessive Hand Sweating?
While the exact cause of primary palmar hyperhidrosis is unknown, it's thought to be caused by overactive eccrine sweat glands, and is often triggered by genetic factors or an overactive sympathetic nervous system. Secondary palmar hyperhidrosis, on the other hand, has a number of different causes.
Emotional Triggers
Picture this: you’re about to give a speech to a packed crowd. Or you’re about to ask your boss for that raise. The high stakes pressure of either of these situations can cause you to sweat– and I mean, sweat hard.
Certain emotions—like stress, social anxiety, fear, and embarrassment—are known to cause heavier sweating, including on your hands.
Separately, palmar hyperhidrosis can also be caused by a condition known as vasovagal syncope where the body overreacts to certain triggers (sometimes emotional upset) by fainting. Excessive sweating, particularly of the palms, is just one symptom of vasovagal syncope.
Hormonal Imbalances
Certain disorders can cause hormonal imbalances in the body that result in palmar hyperhidrosis. These conditions include:
Hyperthyroidism (overactive thyroid gland)
Hypopituitarism (underactive pituitary gland)
Diabetes
Menopause
Hypoglycemia (low blood sugar)
Pregnancy
Acromegaly (a condition where the pituitary gland produces too much growth hormone)
Medical Conditions
In addition to hormonal conditions, there are a number of health conditions that can cause heavy sweating as well as all over the body. These include neurological conditions, such as:
Parkinson's disease
Spinal cord injury
Stroke
Complex regional pain syndrome (a chronic pain disorder often caused by injury)
Some infections can also cause sweaty palms as a symptom—such as tuberculosis, endocarditis, and sepsis.
Medications
Medications can also cause sweating as a side effect. These medications include (but aren’t limited to):
Antidepressants: SSRIs, SNRIs, tricyclic antidepressants
Pain medications: Opioids, NSAIDs (like ibuprofen and aspirin)
Hormonal medications: Oral contraceptives, hormone replacement therapy (HRT)
Diabetes medications: Insulin, sulfonylureas
Cardiovascular drugs: Beta blockers, calcium channel blockers
If you suspect that a medication you’re taking could be making your palms sweat excessively, talk to your healthcare provider. They may be able to prescribe alternative medications or treatments, and/or adjust your dose.
Living With Sweaty Hands
If you are living with palmar hyperhidrosis, you know that it can cause both physical and emotional discomfort. Beyond the often frustrating physical symptoms, sweaty palms can negatively impact your well being, affecting your daily life, mental health, and social interactions.
Common Challenges
Palmar hyperhidrosis can have a significant impact on different areas of your life:
Social situations: You may feel the need to avoid shaking hands, dancing, or giving someone a high five because you’re fearful about what others are going to think. If someone sees your extra sweaty hands as a sign of social anxiety, this can sometimes result in a difficult and vicious cycle where you feel worse, causing you to sweat more.
Career and education: You may find it difficult to concentrate on school and work if you’re distracted by your sweaty palms. Chances are, you might be spending a lot of time thinking about smudging ink on your papers or random sweat stains appearing on your clothes.
Emotional well-being: Constantly worrying about your sweating, and thinking about your sweating, can lead to anxiety, depression, and low self-esteem.
Lifestyle Effects
Palmar hyperhidrosis can affect how you handle a number of different activities—everything from gripping a pen to write, to how you hold the controller when you play video games. Some common lifestyle impacts of heavy sweating include:
Social interactions: Many people with palmar hyperhidrosis avoid shaking hands at work and find it difficult to hold hands with their romantic partners. They may also feel self-conscious in social situations where hand movements are visible.
Occupational challenges: Sweaty hands can make it hard to write or grip certain tools, cause keyboard issues with your computer, or limit you in situations that require fine motor skills.
Daily activities: It might be harder for you to use touch-screen devices with sweaty palms. You might also find yourself changing clothes frequently if you are wiping your hands on them, or carrying around extra napkins to manage your sweat. Some people also avoid activities that require hand contact, like playing musical instruments, for example.
Medical Treatments
Now for the good news: palmar hyperhidrosis is a treatable condition. Let’s take a look at the different types of hyperhidrosis treatment options below.
Anticholinergics
Anticholinergics are a class of treatment that can be used for hyperhidrosis management. The most commonly used include, but are not limited to:
Glycopyrrolate: Glycopyrrolate is available as an oral and topical medication. It’s both effective for treating palmar hyperhidrosis and is associated with fewer neurological and ocular side effects than other anticholinergics.
Oxybutynin: Oxybutynin is another anticholinergic, and one of the most studied for hyperhidrosis. In fact, one study showed an improvement in palmar hyperhidrosis in 80% of patients.
Sofpironium: Sofpironium is another anticholinergic, but is used as a gel and is more commonly known as Sofdra. In sofpironium studies, more than 60% of participants had a 50% or greater reduction in sweat production.
Other medications that can be used to treat palmar hyperhidrosis include propranolol, clonidine, and diltiazem.
Botox
Botox injections for palmar hydrosis work by temporarily blocking the chemical signals that activate sweat glands, with results lasting anywhere from 6-9 months (repeat injections will be needed after that). And while the needles may seem daunting at first, many patients find the results (80-90% success) worth the temporary discomfort.
Iontophoresis
Iontophoresis uses a mild electrical current and water to temporarily shut off sweat glands. For palmar hyperhidrosis, you place your hands in separate water basins while a gentle electrical current is gradually increased and maintained for about twenty minutes. Iontophoresis is effective but also time consuming–in order to start seeing results, you’ll need to repeat the treatment three times per week, and then receive a maintenance treatment once per week after that.
Surgery
Surgery for palmar hyperhidrosis is known as ETS, or endoscopic thoracic sympathectomy. ETS is an invasive procedure where a surgeon cuts or clamps the sympathetic nerves that control sweating. While ETS is considered the most effective treatment for severe cases of uncontrollable sweating, it is typically reserved for severe cases and involves risks, side effects, and potential complications– so it’s important to speak with a healthcare provider and explore less invasive options first.
Key Takeaways
Now you know what palmar hyperhidrosis is, what may cause it (and that there's no one exact cause!), and how it’s treated. Let’s take a look at a few of the most important facts:
Palmar hyperhidrosis is a condition characterized by excessive sweating of the palms, occurring even when the body has no need to cool down.
It can be primary (caused by overactive nerve signals) or secondary (linked to medications or medical conditions).
The condition can affect emotional well-being, social interactions, and daily activities, making tasks like writing or using electronics challenging.
Treatment options range from over-the-counter antiperspirants and natural remedies to medical interventions such as anticholinergic medications, Botox injections, iontophoresis, or surgery.
Remember: if you’re living with palmar hyperhidrosis, you’re not alone and managing your condition is totally possible. Finding the right approach can significantly improve your quality of life! If you’re struggling with sweaty hands, consult a healthcare provider or explore resources like SweatRx for personalized, tailored solutions.
