What is Palmoplantar Hyperhidrosis?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 05 January 2019
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Palmoplantar hyperhidrosis is excessive sweating in the palms and the soles of the feet in response to emotional stress. This condition is the result of an overactive sympathetic nervous system and it can be socially stressful for patients, as other people tend to notice and comment on the sweat. There are a number of treatments available to help patients manage this condition, ranging from conservative options to surgery.

In this condition, when patients become stressed, they start producing copious amounts of sweat. This can also occur during high heat. The onset is often during puberty, although it can be observed earlier in some patients. When patients complain of excessive sweating, they will be evaluated for possible causes, including neurological disorders, before a doctor will confirm a diagnosis of palmoplantar hyperhidrosis.

Basic treatments can include applying antiperspirants, using medications designed to cut down on sweat production, or injections of Botox to prevent activation of the nerves involved. If these measures are not successful, a doctor may propose a surgery. In the surgery, a nerve will be cut so the sympathetic nervous system cannot trigger palmoplantar hyperhidrosis. One potential complication of surgery is a condition called compensatory hyperhidrosis, where patients start sweating more somewhere else to make up for the lack of sweat on the hands and feet.


This condition is not harmful or dangerous, leading many patients to believe that there are no treatment options or to think that they shouldn't pursue treatment because their health isn't at risk. The social difficulties associated with the condition are well documented, however, and many patients experience significant improvements with treatment, including improved mental health because they are not distressed by their palmoplantar hyperhidrosis. For these reasons, seeking treatment is encouraged; while treatment may be elective in nature, it can radically improve quality of life.

People with palmoplantar hyperhidrosis can seek treatment at any age. Young patients are often brought to the doctor by their parents and may be advised to try conservative methods first to see if they will be effective. Older patients may prefer more aggressive treatments because they feel like they have lived with the condition long enough. Specialists who focus on caring for patients with sympathetic nervous system conditions like palmoplantar hyperhidrosis can offer patients the most treatment options and the best treatment outcomes. Patients may want to ask for a referral to a specialist after the diagnosis has been confirmed.



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