Palmar Hyperhidrosis (Excessive Sweating of the Hands)

Hyperhidrosis is excessive sweating that can affect the entire body, but often occurs in the palms, which is called palmar hyperhidrosis. Extra sweating in the hands is normal when a child is anxious or has a fever. However, when the condition is excessively chronic, it may be hyperhidrosis.

To talk to a surgeon about palmar hyperhidrosis surgery,
Call 714-364-4050

Frequently Asked Questions About Hyperhidrosis in Kids and Teens

What causes hyperhidrosis?

In most cases, hyperhidrosis is a benign problem with no clear cause.

Sometimes it can be a sign of other medical problems such as thyroid problems, low blood sugar or nervous system disorders. These conditions should be ruled out before treating hyperhidrosis. Please talk to your child’s doctor for a complete evaluation.

In addition, contact your doctor immediately if your child has excessive sweating:

  • With or followed by chest pain
  • With fever, weight loss, shortness of breath or a rapid, pounding heartbeat
  • That most often happens during sleep.

What are the symptoms of hyperhidrosis?

Children and teens with hyperhidrosis have excessive sweating regardless of the environmental temperature and emotional factors. They may have sweating in one area, such as the hands, or in a combination of areas, such as hands, feet, under the arms and the small of the back.

Areas that produce excessive sweat usually appear pink or white, but, in severe cases, may appear cracked, scaly and soft (especially on the feet). Other symptoms may include a bad odor caused by bacteria and yeast in the wet skin.

Excessive sweating is often first noticed when it interferes with school and social activities. Excessive sweating in the hands can severely affect a child’s ability to hold a pen or pencil and to keep their school papers dry. They may have trouble using touchscreens and are reluctant to hold hands. Hyperhidrosis can cause social embarrassment and lead to psychological problems.

The symptoms of excessive sweating may resemble other medical conditions. Always talk with your health care provider for a diagnosis.

How is hyperhidrosis treated?

After ruling out other medical causes, hyperhidrosis is diagnosed with a physical exam and a detailed evaluation of the child’s signs and symptoms. The diagnosis is usually made by a pediatrician or dermatologist.

Treatment for mild hyperhidrosis involves topical and oral treatments such as prescription-strength antiperspirants, methenamine solution applications to the area and oral anticholinergic medicines.

For moderate and severe cases, surgical treatment may be recommended as a last resort. CHOC Children’s pediatric general and thoracic surgeons specialize in performing a minimally invasive procedure called endoscopic thoracic sympathectomy, or ETS surgery. This procedure interrupts the sympathetic nerve pathways that lead to the sweat glands and can eliminate excess sweating from the hands.

Your doctor or insurance company may recommend trying non-surgical treatments before surgery.

What is the long-term outlook for this condition?

The long-term outlook for children and teens who have surgical treatment for hyperhidrosis is very good. In most cases, sweating in the hands stops immediately and does not return.

Approximately 30-40 percent of patients treated with surgery will develop compensatory sweating, where sweating increases in other areas of the body such as the feet or the small of the back.

Living with Excessive Sweating: Sarah's Story

Sarah before ETS surgery

Not long ago, you could always find Sarah in long-sleeved shirts, even in the middle of the summer. Sarah tends to get cold easily, but she had another reason for the long sleeves: she needed something to continually wipe the excess sweat from her hands. It interfered with her daily activities and social life.

After visiting doctors across three different continents where the family lived, they relocated to Orange County and finally received a diagnosis: hyperhidrosis. When other treatments failed to help, the family came to Dr. Troy Reyna who specializes in ETS surgery.

To schedule a consultation with a CHOC Children’s pediatric surgeon, please call 714-364-4050 or contact us below: