Sweating in soles and palms: A cause for humiliation (Part – II)

In the earlier part, Dr. Kutikuppala Surya Rao explained various possible causes for sweating in soles and palms. This week he is narrating case studies, modern management, and home remedies for solving this malady and leading a comfortable saga of life.

Case study: A male college student of 21 years old presented to me with excessive severe bilateral sweating of his palms and soles for the past 4 years, which has been gradually worsening. His symptoms occur all day but exacerbate during exams or whenever he is anxious.

This situation made him difficulty in holding items and writing homework. All together it resulted embarrassment in public on several occasions. With a handkerchief, he has to clean his hands often. He needs to change his socks frequently. No other area of his body is similarly affected and no associated symptoms, such as pungent body odor or changes in weight, fever, heat intolerance, or changes in bowel habits. He has no known medical illness and is not on any medication. On clinical examination, it was revealed as primary hyperhidrosis.

The Initial management for palmoplantar hyperhidrosis is supportive, which includes keeping the hands and feet as dry as possible by the use of absorbent hand and foot powders. Treatment options for primary hyperhidrosis include medical and surgical treatments. Medical treatments include therapy, such as topical aluminum chloride, oral anticholinergic agents, iontophoresis, and sometimes botulinum toxin injections are helpful.

For chronic resistant cases, surgical therapy including endoscopic thoracic sympathectomy can be tried.

Modern approach: The condition of excessive sweating of the soles and palms is dealt with by washing them morning and evening with soap and lukewarm water. After the warm bathing, feet should be dipped into cold water. Next, they are to be thoroughly dried with a towel, and a de-odorized spray or ordinary talcum powder is to be applied.

If available, the application of surgical or methylated spirit gives good results. Socks should be changed once daily. The sufferers should wear sandals or soft shoes soon and they return home from work. Open sandals can be a solution in summer. Of late, soles containing activated charcoal and “medicated insoles”, have a deodorizing effect and quite cheap are available in the market, and can be easily fitted into normal shoes. They are a great relief to the chronic sufferers.

Simple remedies: Frequent bathing and thorough cleanliness with any good germicidal soap removing the hair from the armpits is quite effective. Application of potassium-permanganate compresses in the localized areas. For persistent odors external application of 5% neomycin solution is recommended.

Antiperspirants containing 6% to 20% aluminum chloride (Drysol, Xerac AC, and others) can temporarily block sweat pores. This reduces the amount of sweat that reaches the skin. This type of product may help with minor hyperhidrosis. Apply it to dry skin before going to bed and wash it off when you wake.

Home Remedies for Sweaty Hands and Feet: Antiperspirants containing 6% to 20% aluminum chloride can temporarily block sweat pores. This reduces the amount of sweat that reaches the skin. This type of product may help with minor hyperhidrosis. It has to be applied on dry skin before going to bed and wash it off after waking up.

Victims have to drink a generous amount of water throughout the day. Staying hydrated can cool core temperature and help reduce excessive sweating. A small amount of coconut oil to apply on sweaty soles and palms would comfort you. Lime juice, a cup of water with activated charcoal, green tea, and ice are also helpful in tackling the problem

Short-term oral anticholinergic can be taken, as required, in addition to other therapies by those patients with symptoms aggravated in known anxiety-provoking situations under medical supervision. In addition, good patient education regarding hyperhidrosis should be given as to manage treatment options and patient expectations.

This is because a severe form of hyperhidrosis can lead to great emotional distress and social humiliation that may result in depression. If the simple measures as told above don’t work, one must consult a doctor for further investigation and treatment accordingly.  (Concluded)