Dear Doctor,What causes hand sweating, and is there a solution to it?

Prilla

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Dear Prilla,

Normally everybody sweats in response to heat, extra physical work done or some anxiety. But some people sweat a lot (hyperhidrosis) even in an ambient or cold temperature or when relaxed and calm In majority of these cases of hyperhidrosis, no apparent reason is found, i.e. primary hyperhidrosis. Hereditary factors are said to be involved in part for this type of sweating. This occurs mostly due to eccrine sweat glands which are located more in number in the feet, palms and underarms, hence the sweating occurs mostly in these parts, making the affected person feel uncomfortable. Obesity, pregnancy, menopause, are some other conditions which can cause excess sweating. It is temporary and stops after one delivers or after menopause or extra weight is shed. Treatment consists of using on the counter or prescription antiperspirants containing aluminium. Botox injections are also useful, particularly for underarms. Iontophoresis is yet another treatment available for excess sweating, where low intensity electric current is passed to destroy the sweat glands. Drugs are available which can reduce excess sweating by reducing the nerve stimulation of sweat glands. However they cause uncomfortable side effects like drying of mouth, blurred vision, e.t.c.

Surgery is used as a last resort in severe, persistent cases, where sweat glands or nerves of affected part are cut. It is associated with the risks of surgery anywhere, like excess bleeding, risk of infection, damage to blood vessels, nerves, e.t.c.

Excess sweating can also occur in response to certain disease conditions (secondary hyperhidrosis). In these it is often generalised. It is profuse and occurs during night. It can occur in response to any infection in the body. In fact night sweats are the first sign of infections like T.B. Rheumatoid arthritis, gout, hyperthyroidism, lymphoma, parkinsonism, are some of the other medical disorders which cause excess sweating. It can be due to coronary artery disease, where blood supply to the heart is curtailed partially, due to blockade in the inner lining of blood vessels. Here sweating is associated with chest pain, breathlessness, restlessness, palpitations, one or more of these symptoms.

The medical disorders causing excess sweating are diagnosed clinically and with specific tests. Treatment depends on underlying cause.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital