How to treat sweaty hands

How to treat sweaty hands
Sweaty hands or palmar hyperhidrosis is one of the most common areas of excessive sweating. Excessively sweaty hands can be seen in 2-3% of the population I always recommend simple treatments such as topical antiperspirants as first line management, increasing to creams, iontophoresis, BOTOX and finally surgery.

Idormed PS machines can be bought on eBay via Sweat Free for near cost pricing. Machines are shipped from Australia.

Decreasing trigger factors for sweating can improve but not eliminate excessive sweating. Decreasing caffeine intake can make a tiny bit of difference, but usually not enough to make an impact.

The first step is using Driclor. This antiperspirant can be bought at major pharmacies and works by blocking up the sweat glands on your hands. The success rate for Driclor is pretty poor, but worth a try!

The next step involves a process called iontophoresis. This treatment takes 10-15 minutes to perform. 2-3 sessions are conducted over the week, with relatively high success rates seen. The tap water in Brisbane has a high mineral content, and tap water ionto is our first step. For patients who don’t respond, we can add salt to the water, as the ions can block sweat glands in your hands. If this is unsuccessful we use glycopyrolate, and this is conducted once a week. The addition of glycopyrrolate into the solution increases the efficacy of iontophoresis to 80-85%.

Tablets such as Propantheline Bromide can help with sweaty hands, however side effects such as sedation limit the use long term.

Special creams can be compounded by specialist pharmacists for sweaty hands, these creams contain anticholinergic substances which can inhibit sweat production.

Can Botox injections help sweaty hands? Yes they can but unlike armpit sweating, Medicare does not cover Botox for sweaty hands. As a rule we leave this method of treatment as a last line resort for patients, prior to the consideration of surgery. Botox works in over 85% of patients with sweaty hands, but the cost of Botox is the rate-limiting factor.

Can surgery treat sweaty hands? A surgical procedure called ETS or Endoscopic Thoracic Sympatectomy can help reduce or eliminate sweaty hands. ETS works by destroying nerves that supply the sweat glands. A risk of this procedure is rebound sweating, a term called compensatory hyperhidrosis. This occurs in approximately 40-60% of patients. ETS is recommended if medical treatments such as creams, iontophoresis and Botox are ineffective-it is the last resort for sweaty hands.


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Dr Davin Lim
Laser and aesthetic dermatologist
BRISBANE, Australia.