Sweaty Hands and Feet: Why It Happens and How to Reduce It

The palms and the soles of the feet have more sweat glands than anywhere else on the body. The glands here respond less to heat than to emotional triggers such as nerves and stress. That is why a damp handshake, a palm that crumples paper or a foot slipping in a sandal so often appears at the most tense moments.

Sweaty hands and feet are one of the local types of sweating where excessive sweating (hyperhidrosis) treatment makes the most noticeable difference. The skin of the two areas, and conditions such as shoes and gloves, are different, so the precautions and the choice of treatment also vary by area.

What Causes Sweaty Hands and Feet?

Most cases of sweaty hands and feet are primary (focal) hyperhidrosis: the sweat glands are healthy, but the part of the nervous system that stimulates them works harder than it needs to. Others in the family may have the same problem. It usually starts in childhood or the teenage years, affects both hands and both feet equally, and is not noticeable during sleep.

Less often, the sweating is the result of an illness or a medicine. When sweating starts for the first time in adulthood, affects only one side or spreads over the whole body, we look for an overactive thyroid, diabetes and medicines as possible causes.

What Problems Do Sweaty Hands and Sweaty Feet Cause?

In both areas the problem is more than just wetness. Skin that stays damp all the time softens, gets irritated easily and becomes open to infection.

• On the hands: difficulty holding a pen, a phone or a steering wheel, damp paper, avoiding handshakes; in some people, hand eczema with itchy small blisters along the sides of the fingers.
• On the feet: slipping inside shoes, socks that get wet quickly, bad odour, athlete's foot between the toes and a bacterial infection that shows as small pits on the soles (pitted keratolysis).

If there is itching, peeling or cracking on the feet, it is worth checking whether a fungal infection or eczema is accompanying the sweating. These problems are dealt with through treatment for fungal skin infections and eczema, separately from the sweating treatment.

What Can You Do at Home to Reduce Sweaty Hands and Feet?

For the hands

• Apply antiperspirant at night to completely dry palms, and wash your hands in the morning.
• Keep a cotton handkerchief with you; drying a damp hand makes it easier to grip.
• If you wash your hands often, use a moisturiser after soap; skin that dries out and cracks is more prone to irritation.

For the feet

• Choose socks that draw moisture away, and change them once during the day.
• Do not wear the same shoes two days in a row; shoes take time to dry out completely.
• Air or replace removable insoles often.
• Dry carefully between your toes after a shower.
• When the weather allows, wear breathable shoes or sandals.

These measures do not stop the sweating, but they clearly reduce the problems that dampness causes, such as odour, fungal infection and irritation.

What Are the Treatment Steps for Sweaty Hands and Feet?

Treatment is planned by starting with the simplest method and moving to the next step when needed. The steps can also be combined.

Antiperspirants

Antiperspirants containing aluminium salts temporarily block the ducts of the sweat glands. They work better when applied at night, when the sweat glands slow down. If itching or stinging occurs, applying it less often is usually enough.

Iontophoresis

In iontophoresis, the hands or feet are placed in a tray of tap water and a weak electric current is passed through the water. Sessions are frequent at first, and the gaps are lengthened once the effect has settled. Because there are devices for use at home, it lends itself to regular use; it is not used in people with a pacemaker, during pregnancy or when there is a metal implant in the body.

Botox

Botox temporarily blocks the nerve signal to the sweat glands. On the palms and soles it is injected into the skin in many small doses. At our clinic we give Botox for sweaty palms and soles after mapping the area that sweats; the effect lasts 6 months on average and may be shorter on the palms.

Tablets

Anticholinergic medicines reduce sweat production across the whole body. Because they can have side effects such as a dry mouth and blurred vision, they are used in suitable people, at a low dose and under a doctor's supervision.

When Is Surgery for Sweaty Hands Considered?

Surgery that cuts the nerves to the sweat glands inside the chest (sympathectomy) is only considered for severe hand sweating when every other method has failed. Afterwards, compensatory sweating can develop on the back, abdomen and legs, and this may not be reversible. For this reason the decision is made together with the relevant surgical specialty, and as a last resort.

When Should You See a Doctor About Sweaty Hands and Feet?

If sweating affects your work, your studies or your social life and measures at home are not enough, there is no need to wait before having an examination. In the following situations, another cause needs to be looked for:

• The sweating has started for the first time in adulthood
• It affects only one hand or one foot
• You sweat enough to wake you up at night
• It comes with weight loss, fever or palpitations
• There is a sore that will not heal, a change in colour or severe itching on the foot

Sweaty Hands and Feet Assessment in Denizli

At the examination we work out whether the sweating is primary or linked to another cause, and check whether a fungal infection or eczema is also present on the hands and feet. At our clinic in Denizli, Botox for the palms and soles is given by our dermatologist, and we discuss the other steps at the same appointment. For the full range of options, see excessive sweating treatment in Denizli, and to book, give us a call.