Palmar and Plantar Hyperhidrosis

Excessive sweating of the palms of the hands (palmar hyperhidrosis) and the soles of the feet (plantar hyperhidrosis) usually occur together. In addition to being a source of discomfort and social anxiety, sweaty palms can interfere with many daily activities by making it difficult to grasp objects securely—a kitchen knife, for example, or the steering wheel of a car, or a musical instrument.

Excessively sweaty feet can also inhibit a person’s lifestyle. Individuals with plantar hyperhidrosis often cannot wear sandals or high heels, for example, because the shoes slip off their feet.

Why Feet Stink

Sweaty feet tend to produce a strong and unpleasant odor. This is because the sole of each foot has more than 250,000 sweat glands (out of a total of 2 to 4 million per person)—making our feet among the sweatiest areas of our body. Sweat (which is basically salt and water) doesn’t smell—that is, until, the bacteria that lives on our skin starts to eat it. The waste produced by the bacteria is what creates the noxious odor.

Why do sweaty feet smell but not sweaty hands? Because of socks and shoes. The sweat on our feet can’t escape into the air like that on our hands. Feet are therefore a great place for bacteria to dine. And the more your feet sweat, the more they’ll smell.

Treatments

The first line of treatment for palmar and plantar hyperhidrosis is often a prescription-strength antiperspirant. Botox injections are also very effective, particularly for treating excessively sweaty palms. Such treatments can last up to a year.

Botox treatments can weaken muscles in the hand, however, and therefore may be unsuitable for musicians, surgeons, and others who need exceptional hand dexterity. For these individuals, iontophoresis, a treatment that uses low levels of electricity to block nerve messages to the sweat glands, may be a better choice for reducing the sweating.

Surgery is an option for severe cases of palmar or plantar hyperhidrosis—but only when all other efforts at relieving the sweating have failed.