Pediatric Sweaty Palms (Palmar Hyperhidrosis)

Sweating helps the body stay cool. In most cases, it is perfectly natural. People sweat more in warm temperatures, when they exercise, or in response to situations that make them nervous, angry, embarrassed, or afraid.

However, excessive hand sweating occurs without such triggers. Those with palmar hyperhidrosis appear to have overactive sweat glands. The uncontrollable sweating can lead to significant discomfort, both physical and emotional.

Hyperhidrosis of the hands, feet, and armpits, this group is called primary hyperhidrosis, affects 2-3 percent of the population, yet less than 40 percent of patients with this condition seek medical advice. In the majority of primary hyperhidrosis cases, no cause can be found. It seems to run in families.

If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body, or it may be in one area.

Conditions that can cause secondary hyperhidrosis include: 

• Acromegaly
• Anxiety conditions
• Cancer
• Carcinoid syndrome
• Certain medications and substances of abuse
• Glucose control disorders
• Heart disease
• Hyperthyroidism
• Lung disease
• Menopause
• Parkinson’s disease
• Pheochromocytoma
• Spinal cord injury
• Stroke
• Tuberculosis or other infections
• Visible signs of sweating may be noted during a doctor's visit. A number of tests may also be used to diagnose excessive sweating.

• Starch-iodine test. An iodine solution is applied to the sweaty area. After it dries, starch is sprinkled on the area. The starch-iodine combination turns a dark blue color wherever there is excess sweat.
• Paper test. Special paper is placed on the affected area to absorb the sweat, and then weighed. The heavier it is, the more sweat has accumulated.

Patients may be also be asked details about their sweating, such as:

• Location of excessive sweating
• Time pattern
• Excessive sweat triggers
• Other symptoms:
  
  • Weight loss
  • Pounding heartbeat
  • Cold or clammy hands
  • Fever
  • Lack of appetite

Endoscopic thoracic sympathectomy (ETS). In severe cases, a minimally invasive surgical procedure called thoracoscopic sympathectomy may be performed when other treatments fail. At Children’s National Hospital, Timothy Kane, MD, is experienced in endoscopic thoracic sympathectomy. The procedure eliminates the pathway from the nervous system to the palms of the hands which have led the body to have excessive sweating in the palms. It is usually done on patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating.