Localised idiopathic Palmar Plantar hyperhidrosis (excessive sweating from the hands and feet) can be improved with several treatments offered at Perth Dermatology Clinic including clinical antiperspirants; iontophoresis; sweat stopping injections and anticholinergic tablet medications.

Clinical Antiperspirants containing higher concentrations of metallic salts can help to improve mild sweating from the hands and feet. However in moderate to severe cases of excessive sweating, this treatment is often insufficient and causes irritancy leading to discontinuation of application.

Iontophoresis delivers an electric current through water, which when applied to the palms or soles,  reduces the amount you sweat.  Dr Tony Caccetta and Perth Dermatology clinic offer this treatment as a 2-4 week in clinic trial prior to considering purchase of your own at home iontophoresis machine.  This treatment usually leads to a 60-70% reduction in sweating with ongoing use.  In the long term a 20minute at home treatment weekly may achieve this reduction in sweating.  Currently, we consider this the best side effect free, minimally invasive long term solution for palmar and plantar hyperhidrosis management.

Sweat stopping injections often lead to a very significant reduction in sweating lasting for around 2-3 months in most people.   Injection into the palms and soles causes discomfort and requires various analgesia techniques to improve the comfort of injection.  This treatment if appropriate can be further discussed with Dr Tony Caccetta at Perth Dermatology Clinic.  No Medicare rebate is currently available for this treatment, however Private Health Insurance rebates may be sought.

Oral anticholinergic medications can lead to a significant reduction in sweating from all locations, however can sometimes be poorly tolerated dues to side effects or be inappropriate for use in the long term.

If the above conservative measures for treatment of palmar hyperhidrosis are unsuccessful, you will be referred for consideration of endoscopic thoracic sympathectomy (ETS), a surgical procedure to reduce sweating of the palms only.  This treatment is considered when other treatments have been tried and proven unsuccessful, as ETS can lead to significant compensatory hyperhidrosis (usually on the trunk) and potential other side effects.