Palmar Hyperhidrosis Treatment In Gurgaon and Delhi, India

What Is Palmar Hyperhidrosis

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. It inflicts significant impact on quality of life of patients, interfering with their labor, daily activities, social interaction and leisure, and can cause emotional and psychological distress.

Symptoms Of Palmar Hyperhidrosis

Symptoms are usually bilateral and symmetrical and there are no other associated conditions. Palms are cold, wet and present color that can ranges from pale to blush. The episode of sweating has abrupt onset, related or not with emotional stressful events, and presents more intensely on the palms and fingers and less intensely in the posterior regions of the hands. Rapidly, the hands are wet by the droplet detachment, and in some cases there may be swelling of the fingers.

Diagnosis Of Palmar Hyperhidrosis

The Palmar Hyperhidrosis diagnosis is eminently clinical, being conducted through history and physical examination. Individuals with palmar hyperhidrosis present cold and wet hands with color that can ranges from pale to blush. Plantar hyperhidrosis often (57% of cases) is associated with palmar hyperhidrosis, being described by some authors as part of the symptomatology of these individuals.

The main diagnostic criteria include visible sweat, exaggerated and located, lasting at least six months, without apparent cause, and with at least two of the following characteristics:

• Bilateral and symmetrical sweat
• Frequency: at least one episode per week
• Impairment in daily activities
• Age of the onset <25 years
• Presence of family history
• Absence of sweat during sleep

PH can be evidenced from the Minor test (starch-iodine), in which an alcoholic solution of iodine 2% is applied in the test area and subsequently starch (e.g. cornstarch) is sprinkled. The hyperhidrotic area solubilizes the iodine, which promotes a complexation reaction with the starch. As the iodine atoms are trapped in the helices of amylose chains, there is evidence of a dark blue staining.

Treatment Of Palmar Hyperhidrosis

Treatment remains a challenge: options include topical and systemic agents, iontophoresis, and botulinum toxin type A injections, with surgical sympathectomy as a last resort. None of the treatments is without limitations or associated complications.

Topical aluminum chloride hexahydrate therapy and iontophoresis are simple, safe, and inexpensive therapies; however, continuous application is required because results are often short-lived, and they may be insufficient.

Systemic agents such as anticholinergic drugs are tolerated poorly at the dosages required for efficacy and usually are not an option because of their associated toxicity.

While botulinum toxin can be used in treatment-resistant cases, numerous painful injections are required, and effects are limited to a few months.

Most of these treatments give a temporary relief to the patients.

Bilateral VATS sympathectomy is the treatment of choice. The safety and reliability of treatments for palmoplantar hyperhidrosis have improved dramatically, but side effects and compensatory sweating are still not uncommon.

This condition can permanently be treated by a surgical procedure through key-hole incisions. Usual hospital stay would be 1 or 2 days.

Hyperhidrosis best treated by VATS