Life with Sweaty Palms

If you have sweaty hands, sweaty feet or sweaty anything, you know the huge burden on quality of life that it can be.

I have had sweaty hands (palms) and feet for as long as I can remember–at the very least since late elementary school.

The average reader may look at this and say–“sweaty hands?!,” that’s not that bad, there are worse things out there. Well, yes, there are worse things out there, but let me assure you, it’s bad. It’s very bad. I have a life-long auto-immune disease, and I often worry about my sweaty hands more than I do that.

Let’s focus just on hands for the moment (forgetting other areas like the feet or armpits). Hands are incredibly important appendages of the human body and the design of human hands is even credited with the evolution of primates into modern intelligent humans.

Think for a moment how integral your hands are to everyday life. You wake up, you pull the covers off with your hand. You may text a friend. Perhaps you go to play the piano. Now imagine doing all those things with sweaty hands. Texting is especially uncomfortable, and depending on your level of perspiration, it may be impeding your ability to press the correct letters. All of these things are infinitely more frustrating to do with sweaty hands.

That’s not even the tip of the iceberg. Hands are crucial to human interaction, and this is the absolute worst aspect about having sweaty hands-it can be absolutely detrimental to relationships.

When you arrive to work or school, you may shake hands with a colleague or high-five a friend. As an individual with sweaty hands, you have a couple of options to avoid having to lay your soaking, dripping sweaty hand on the flesh of another individual:

• You can avoid eye contact, act immersed in whatever it is you’re doing and act as if you didn’t see anyone as you approach.
• You can make up some weird alternative to hand to hand contact (back-hand five, hugs that day, you name it)
• You can let your friend or colleague know, you don’t shake hands or high five, and you can carry on business as usual.

Some of these don’t sound so bad, you might be charming enough to pull off the hug or special handshake if it’s with the right person (maybe choose a different strategy with a boss or teach). You could also be frank and just tell the world, “Hey, I’ve got sweaty hands”–and this definitely isn’t a bad option.

But the reality of it is that hands are used as indicators. One can consider them proxies of human health and relationships. If your mom feels your hand and notices it’s clammy, she’s going to ask if you’re sick. If your boss or friend shakes your hand and notices you’re sweating, they’re going to ask if you’re nervous. If your significant other wants to hold hands and you refuse, they’re going to ask what’s wrong.

So you can see this isn’t just “I sweat too much”, this is something that greatly impacts your quality of life, and is constantly on the mind of someone with hyperhidrosis.

Hyperhidrosis is a condition where the body perspires far more than what is needed to regulate body temperature. According to wikipedia (and confirmed by this author),

So what can you do? There are a lot of options out there, and I have tried most of them so you don’t have to.

Solutions

Over-the-Counter (OTC)

You can go to the store and pickup some over-the-counter anti-perspirant. This is likely going to be Certain-Dri. If you have hyperhidrosis of the armpits, this may solve your problem. Armpits are far more receptive to topical solutions than that of palmar or plantar forms of hyperhidrosis.

But if you fall into the latter two categories, Certain-Dri isn’t going to cut it (go ahead and try, if you don’t believe me).

Prescription Drugs

Next, go get a referral to see a dermatologist (if they can squeeze you in) and have them write up a prescription. They’ll do one of two things to start:

1. Drysol

   Give you prescription strength anti-perspirant. This will likely be Drysol, which works much in the same way as Certain-Dri or other over-the-counter anti-perspirants, but contains a higher percentage of aluminum chloride.

2. Prescribe you Glycopyrrolate. In the United States this is commonly known as the prescription drug Robinul. Robinul is an anticholinergic. Essentially what it does is causes your entire body to reduce the amount of secretions it produces. Secretions can be considered as any liquid produced by your body, sweat, saliva, tears, etc.. It works by blocking the activity of acetylcholine in the body, which decreases secretions and decreases side effects caused by medicines that may increase the action of acetylcholine in the body. Since you are taking this orally, the process is not localized to your hands and you will experience dryness pretty much anywhere where you typically have some amount of moisture. You’ll sweat less across your entire body, and your mouth and eyes may become dry.

Frankly, these drugs are pretty cheap, so if you try them and they don’t work (my guess if you’ve got serious hyperhidrosis–they won’t), it’s not the end of the world.

Surgery

If you’ve gone through the whole gambit of these treatments, your dermatologist might recommend an extreme solution, a surgery called Endoscopic thoracic sympathectomy, or ETS.

ETS is a very serious surgery, do not take this lightly. The surgery itself is complicated and invasive, and the ramifications are unpredictable and potentially irreversible.

You can read the Wikipedia page (above) for a more detailed description of the surgery, but I will give an outline of what it is below.

ETS Nerve Removal

A surgeon will make an incision under your arm, insert a camera, and deflate your lung. He then will navigate through your chest to your spinal cord where he will fine the nerves in the sympathetic nervous system that are responsible for controlling your sweating. These are typically the part of the sympathetic chain lying between the first and fifth thoracic vertebrae along your spine. He then will rip them out, cut them, or place a titanium clamp over the nerves preventing them from sending any signals out. If you get the titanium clamp, there is a chance you can have the surgery reversed, but you don’t have much time before the your body builds tissue around it and the clip cannot be removed. No full recoveries from ETS surgery have been reported, even with the use of the clamp.

Read about the risks on the National Library of Medicine.

The key problem of this surgery is that we do not have a full understanding of every individual nerve in the body. Each person’s body may respond differently to having a whole portion of their nerve roots ripped out. Often times (~80% of patients) see compensatory sweating in which the sweating that was on their hands or feet has now moved to their back or thighs.

Note that your sympathetic nervous system is key to determining your emotions, as well as anatomical responses such as sweating and temperature regulation. Here is an excerpt from Wikipedia describing the ramifications of removing functional (although overactive) portions of your sympathetic nerve roots:

Thoracic sympathectomy will distort many bodily functions, including sweating,^[13] vascular responses,^[14]heart rate,^[15][16] heart stroke volume,^[17][18]thyroid, baroreflex,^[19]lung volume,^[18][20] pupil dilation, skin temperature and other aspects of the autonomic nervous system, like the essential fight-or-flight response. It reduces the physiological responses to strong emotions, such as fear and laughter, diminishes the body’s physical reaction to both pain and pleasure, and inhibits cutaneous sensations such as goose bumps.^[13][18][21]

A large study of psychiatric patients treated with this surgery showed significant reductions in fear, alertness and arousal.^[22] Arousal is essential to consciousness, in regulating attention and information processing, memory and emotion.^[23]

So as you can see, ETS is only for those who are at the absolute end of their wits with their hyperhidrosis. And my guess is that’s a lot of people. Because none of the above strategies (note: I am referencing everything besides ETS, I did not have the surgery and neither should you) worked for me.

Even after reading the horrors of ETS surgery, watching eerie YouTube videos of people that have had them, who often show a clear lack of emotion and yet still emphasize their regret, I was considering it.

Thankfully, I found an amazing, amazing solution. One that works completely. Completely. My hands (and feet if I wanted) are bone dry now, and I haven’t looked back.

I’m talking about Iontophoresis.

Iontophoresis

Iontophoresis is the process of ions flowing into one’s skin due to an applied electric field. Essentially what happens is an electric current is applied to two tins of water and the circuit is completed when one’s palms or feet are placed into each tin. The current passes over the skin and draws ions into the body.

It’s actually not entirely understood why Iontophoresis inhibits sweating, and perhaps that’s why none of my dermatologists recommended it. There are some theories:

• The electrical current and mineral particles in the water act together to thicken the outer layer of the skin, thereby blocking the flow of sweat. Once output is blocked or interrupted, sweat production in the treated area stops.
• The electrical current may temporarily cause a functional impairment of the sweat duct; either by completely blocking sympathetic nervous system transmission to the gland, or changing the cellular secretory physiology. Some believe that it causes a plug on the sweat gland and others believe it induces an electrical charge in the gland that disrupts secretion.
• Finally, some believe that this treatment decreases the ph in the sweat duct, which may contribute to eccrine gland dysfunction, preventing sweat production.

All I can tell you is that it works, it’s safe, and it has changed my life.

And it’s very easy to do yourself, from home, without a prescription and for very little cost. Just get the following:

• AC to DC converter or lantern battery
• Two aluminum or steel pie pans.
• Alligator clips

Instructional video on how to build your own Iontophoresis machine.

I use around 36 volts, but I’ve not measured the current that actually is passing into my skin. I originally bought the lantern battery off Amazon (12 volts) and found it wasn’t strong enough, and then decided to buy a cheap laptop charger (24 volts) and then connect the two in series–leading me to use 36 volts for my setup. It’s simple, spend 3-4 20 minute sessions to cause sweating to stop completely,  and then do around one or two sessions a month for 20 minutes and your hands / feet won’t sweat at all. At all. I highly recommend you try this out. Iontophoresis is not painful, if you’ve got a cut simply apply a small amount of vaseline or petroleum jelly and that will prevent the redness from electrical burns.

Please tell me if you found this article helpful and your experiences with hyperhidrosis.