Palmar Hyperhidrosis (Excessive Sweating in Hands)

What is Hyperhidrosis?

Hyperhidrosis is excessive sweating that can affect the entire body, but often occurs in the hands or feet. When excessive sweating is localized to a child’s hands, it 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. If your child is experiencing excessive sweating in their hands and feet, reach out to a CHOC specialist to schedule an appointment.

Frequently Asked Questions About Hyperhidrosis in Kids and Teens

What causes sweaty hands and feet?

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 in children?

Babies, 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 palmar hyperhidrosis may resemble other medical conditions. Always talk with your health care provider for a diagnosis.

How is hyperhidrosis diagnosed?

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. Other medical causes for excessive sweating may include:

How is hyperhidrosis treated?

Treatment for mild hyperhidrosis or palmar 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 for treating hyperhidrosis. CHOC 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.

Who is affected by hyperhidrosis?

About 2-3% of children are estimated to suffer from hyperhidrosis. Hyperhidrosis can develop at any age, but typically will start during childhood or shortly after puberty.

What is the long-term outlook for hyperhidrosis?

The long-term outlook for children and teens who have surgical treatment for hyperhidrosis is very good. In most cases, sweating in the hands and feet 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 Palmar Hyperhidrosis: 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 because of palmar hyperhidrosis. 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 pediatric surgeon, please call 714-364-4050.