What can I do about my sweaty palms?

I am a receptionist at a leading firm and I have a health problem that is affecting my job performance. My palms and feet sweat excessively.

Most of the time, when I shake clients’ hands, I notice that they look uncomfortable and wipe their hands – this makes me feel very inadequate and dirty. My boss thinks that I am an anxious person because my hands are always wet and clammy.

I also have problems with foot odour as my feet are always wet. Is there treatment for this type of excessive sweating? Is it available locally? Will my insurance cover pay for it?

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Excessive sweating (hyperhidrosis) can be a challenging condition to live with. There are two types of hyperhidrosis:

Primary focal hyperhidrosis

This affects the palms and the feet (and sometimes the underarms or face). It starts either in childhood or as an adolescent. It tends to run in families and there is no known cause for it. This sounds like what you are suffering from.

Secondary generalised hyperhidrosis

This is excessive sweating of the whole body. It takes place both during the day and at night. It involves the entire body. In some cases, it is a sign of an underlying health issue. This could be hormonal (thyroid or adrenal problems), infections like TB, anxiety, cancer, side effect of hormones or degenerative conditions like Parkinson’s disease.

Usually, these cases need to be investigated to find out the cause of the excessive sweating.

How is it treated?

See a dermatologist to manage your excessive sweating.

Topical treatment: This refers to antiperspirant solutions which can be applied to the hands and feet. Usually, they contain high amounts of aluminium salts and can only be obtained with a doctor’s prescription. These salts are thought to block the sweat glands. You are, however, supposed to apply the solution daily.

Lontophoresis: In this therapy, the hands and feet are submerged in a bowl of water and a painless electric current is passed through the water. This procedure is thought to block the sweat glands – the exact mechanism is not well understood. There are special iontophoretic devices which can deliver this current without giving you an electric shock.

Botulinum toxin (Botox injections): Botox injections help block the chemicals that trigger nerves to the sweat glands. These injections have been used successfully in excessive armpit sweating. In excessive sweating of the hands and feet, they can be used but the procedure is associated with significant pain. In some cases, injections to the hand can lead to some slight weakness on the affected side.

Anticholinergic drugs: These medications inhibit the transmission of nerve impulses (these impulses trigger the excessive sweating). These drugs can either be taken orally (as tablets) or used as a cream. The tablets can cause blurred vision, dry mouth and urine retention. For this reason, they are not a popular form of therapy.

ETS (Endoscopic thoracic sympathectomy): This is a surgical procedure reserved for people who are not responding to other treatment. It involves cutting the nerves that carry messages to the sweat glands. These nerves are cut in the chest. It has been used successfully to treat excessive sweating of the face, hands or armpits.

Lumbar sympathectomy: This is done to treat excessive sweating in the feet. The nerves are cut in the lower back. This procedure is done with caution as it can lead to possible sexual dysfunction (especially in men).

Your sweaty feet: The odour you are experiencing is due to bacteria on the skin of your feet and in your shoes. Clean and thoroughly dry your feet (at least twice daily). Avoid wearing the same shoe two days in a row. Allow the shoes to dry after each use. If you use stockings or socks, look for natural fibres like cotton. Look out for nail infections and foot fungus (athletes foot) and treat it early if it develops.

Is the treatment in Kenya?

Yes, it is. Hyperhidrosis is treated by a dermatologist (sometimes in conjunction with a surgeon). There are several consultants in these fields in the major private hospitals. In the public sector, these specialists are available at the national hospital.

Will insurance company pay?

If your health insurance company classifies hyperhidrosis as an illness, then it will pay for your treatment. However, some insurers consider hyperhidrosis to be a ‘cosmetic’ issue and will not pay for it. To get clarity on this, speak to your health insurance agent.

Talk to your employer

Clearly, your excessive sweating is affecting your work performance and confidence. Get a letter from your doctor explaining to your employer that you have a medical condition. This should help ease the undue pressure you are experiencing at work.