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Abstract

Excessive sebaceous sweating in the palms is known as palmar hyperhidrosis. The incidence is estimated between 0.6 and 2.8 percent of the population. The disease is thought to be caused by localized sympathetic cholinergic fiber hyperactivity that passes through the upper stressful emotional conditions. Palmar hyperhidrosis has a negative impact on one’s quality of life. The majority of treatment is symptomatic. Injections of botulinum toxin should be considered when topical therapy with aluminum salts, iontophoresis, and systemic anticholinergic are unavailable, failed, or regarded unacceptable. For the rare patient with intractable palmar hyperhidrosis who has failed to respond to traditional therapies, endoscopic thoracic sympathectomy may be considered.

Keywords: Iontophoresis; Sympathectomy; Botulinum toxin