Treatment modalities for palmar and plantar hyperhidrosis include aluminum chloride hexahydrate formulations, either in ethanol or in a salicylic acid gel, iontophoresis, oral anticholinergics, botulinum toxin type A injections and surgical procedures. Failure to respond to these conservative measures is often an indication to use surgical interventions such as thoracic or lumbar sympathectomy, which can be complicated by compensatory hyperhidrosis.
The involvement of Primary hyperhidrosis Is responsible for a higher prevalence of anxiety than general population and patients with other chronic diseases.
Patients with sweat dripping affecting professional and social life benefit from surgery. Compensatory sweating may be worth it in selected people.
The palmopalmar Primary hyperhidrosis is related to a poor quality of life. The surgical treatment is the best option and safe. The clinical treatment should not be the first option unless the oral anticholinergics.
We prefer to offer oxybutynin for patients with persistent plantar hyperhidrosis (after surgery) or mild/severe compensatory sweating.
One of the reasons to opt for surgical treatment as first choice is the low adherence to long treatments (with Daily pills) in young patients.
After the age of 40, we know that tablets will be part of our lives, but this is not the reality of patients below 30 years.
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Article Management Strategies Of Palmar Hyperhidrosis: Challenges An...
Palmar hyperhidrosis affects up to 3% of the population and inflict significant impact on quality of life. It is characterized by chronic excessive sweating, not related to the necessity of heat loss. It evolves from a localized hyperactivity of the sympathetic autonomic system and can be triggered by stressful events .
Clinical treatment may be topical or systemic. Among the topical treatment options, we highlight the use of astringents, iontophoresis and botulinum toxin. Systemic treatment consists of the administration of anticholinergic drugs and psychotherapy. In addition, some new therapeutic methods have been described in recent years.
References
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