If you have sweaty palms, you don't have to live with it. Surgery can fix it.

The Problem With Sweaty Palms
Your first reaction to hearing about this condition might be to wince or smile. Either way, you might think having sweaty hands is nothing to really sweat about.

However, people whose hands sweat nonstop are often miserable. For one thing, it affects the person's ability to make a first impression, whether that person is a potential boss, or a potential first date.

So Dr Eric Vallieres of the University of Washington says he enjoys performing the surgery that ends this damp problem. "People just feel transformed. They're so happy," he says. "Their hands have just been dripping. Often, for many years, they've felt enormous social and professional embarrassment."

He tells the story of one young man who simply tolerated the sweaty hands until he graduated from college and got a job at a television network in New York City. "They do a lot of shaking of hands there," Vallieres says. The man came to UW Medical Center for treatment, and now can shake hands without worry.

How Hyperhidrosis Hinders Your Life
The condition is called essential hyperhidrosis: sweating above and beyond one's physical needs. The hands literally drip. Sometimes, Vallieres will walk in to meet a patient and find pools of sweat on the floor.

Science is not sure why some people sweat so much. Climate makes a difference. People in warmer areas tend to have the problem more often. People who live in damp and cold areas such as Puget Sound are less likely to be affected. One study in Israel - a warmer climate than many Northwest areas, of course - found that 0.6 to 1 percent of young people had the hand condition.

Some people blame stress for the condition, and think the sufferers could get better if only they would relax. Vallieres does not agree. He says it may be the other way 'round: people whose hands sweat profusely will understandably be anxious.

"If you had sweaty hands all the time - and you have to shake hands, do things where your sweat is very visible - you'd be nervous too," he says.

There are medications, such as ointments, that sufferers can try, but their effects don't last long.

The Way To Fix It
The surgical answer to the problem has actually been around since the 1920s. But before modern surgical techniques, you might have to spend five or six days in the hospital, and convalesce for a couple of weeks. It also involved a large scar on the chest, and sometimes much pain. The modern version is called thoracoscopic sympathectomy. Today's procedures allow the doctor to perform the surgery quickly, and the patient goes home that afternoon or the next day. He or she can resume normal activities in four or five days, after resting at home.

Vallieres makes two small incisions, five millimetres long, under the armpits. He enters through the armpits so that few people will ever notice a scar. In one incision, he puts a scope, in order to see. Into the other goes a thin surgical instrument that allows him to reach and remove a small piece of the sympathetic nerves running along both sides of the chest.

The nerve controls sweat reactions in the hands. Once removed, there's no nerve to signal for sweating. The patient's hands no longer sweat. It's as simple as that.

In as many as three out of four cases, though, the body may compensate for being unable to sweat through the hands. It may cause more sweat someplace else. The person may sweat more in the thighs or lower back.

Most people find that the compensatory sweating gets better with time, and that it's still preferable to the original condition, Vallieres says. For one thing, it's easier to absorb and conceal such sweating in places besides the hands. The side effect is more likely to affect people who live in hot climates, he says, and has not been a major issue for Northwest patients.

Source: Health Beat, University of Washington.

Date reviewed: May 16, 2000