Skip to main content
SpringerLink
Log in

Treatment of Hand Eczema Caused by Hyperhidrosis

  • Chapter
  • First Online:
Textbook of Hand Eczema

Abstract

Although primary hyperhidrosis has no apparent underlying cause, secondary hyperhidrosis can be caused by substance abuse as well as neurologic, endocrine, infectious, and malignant disorders. Focal hyperhidrosis is confined to one or more body regions (e.g., the palms, foot soles, or axillae), whereas generalized hyperhidrosis involves the entire body surface. Excessive sweating of the palms can be a cofactor for hand eczema. Thus, hyperhidrosis may facilitate the development of allergic contact dermatitis or act in concert with irritants in the development of irritant contact dermatitis. Hand eczema may also be an adverse effect of the treatment of palmar hyperhidrosis. Treatment modalities for hyperhidrosis include topical antiperspirants, iontophoresis, botulinum toxin A injections, systemic anticholinergics, and surgical denervation of the thoracic sympathetic chain. These are briefly discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Renbourn ET. The history of sweat and the sweat rash from earliest times to the end of the 18th century. J Hist Med Allied Sci. 1959;14(2):202–27.

    Article  CAS  PubMed  Google Scholar 

  2. Ro KM, Cantor RM, Lange KL, Ahn SS. Palmar hyperhidrosis: evidence of genetic transmission. J Vasc Surg. 2002;35(2):382–6.

    Article  PubMed  Google Scholar 

  3. Jensen O. ‘Rusters’. The corrosive action of palmar sweat: I. Sodium chloride in sweat. Acta Derm Venereol. 1979;59(2):135–8.

    CAS  PubMed  Google Scholar 

  4. Jensen O, Nielsen E. “Rusters”. The corrosive action of palmar sweat: II. Physical and chemical factors in palmar hyperhidrosis. Acta Derm Venereol. 1979;59(2):139–43.

    CAS  PubMed  Google Scholar 

  5. Walling HW. Primary hyperhidrosis increases the risk of cutaneous infection: a case – control study of 387 patients. J Am Acad Dermatol. 2009;61(2):242–6.

    Article  PubMed  Google Scholar 

  6. Lee HJ, Ha SJ, Ahn WK, Kim D, Park YM, Byun DG, et al. Clinical evaluation of atopic hand-foot dermatitis. Pediatr Dermatol. 2001;18(2):102–6.

    Article  CAS  PubMed  Google Scholar 

  7. Strutton DR, Kowalski JW, Glaser DA, Stang PE. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol. 2004;51(2):241–8.

    Article  PubMed  Google Scholar 

  8. Adar R, Kurchin A, Zweig A, Mozes M. Palmar hyperhidrosis and its surgical treatment: a report of 100 cases. Ann Surg. 1977;186(1):34–41.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Hashmonai M, Kopelman D, Assalia A. The treatment of primary palmar hyperhidrosis: a review. Surg Today. 2000;30(3):211–8.

    Article  CAS  PubMed  Google Scholar 

  10. Lear W, Kessler E, Solish N, Glaser DA. An epidemiological study of hyperhidrosis. Dermatol Surg. 2007;33(1 Spec No):S69–75.

    Article  CAS  PubMed  Google Scholar 

  11. Higashimoto I, Yoshiura K, Hirakawa N, Higashimoto K, Soejima H, Totoki T, et al. Primary palmar hyperhidrosis locus maps to 14q11.2-q13. Am J Med Genet A. 2006;140(6):567–72.

    Article  PubMed  Google Scholar 

  12. Kaufmann H, Saadia D, Polin C, Hague S, Singleton A, Singleton A. Primary hyperhidrosis – evidence for autosomal dominant inheritance. Clin Auton Res. 2003;13(2):96–8.

    Article  PubMed  Google Scholar 

  13. Hoorens I, Ongenae K. Primary focal hyperhidrosis: current treatment options and a step-by-step approach. J Eur Acad Dermatol Venereol. 2012;26(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  14. Kippenberger S, Havlicek J, Bernd A, Thaci D, Kaufmann R, Meissner M. “Nosing Around” the human skin: what information is concealed in skin odour? Exp Dermatol. 2012;21(9):655–9.

    Article  CAS  PubMed  Google Scholar 

  15. Karaca S, Kulac M, Uz E, Barutcu I, Yilmaz HR. Is nitric oxide involved in the pathophysiology of essential hyperhidrosis? Int J Dermatol. 2007;46(10):1027–30.

    Article  CAS  PubMed  Google Scholar 

  16. Shimizu Y, Sakai M, Umemura Y, Ueda H. Expression of endothelial nitric oxide synthase in human eccrine clear cells. Br J Dermatol. 1997;136(4):572–4.

    Article  CAS  PubMed  Google Scholar 

  17. Sato K, Kang WH, Saga K, Sato KT. Biology of sweat glands and their disorders. I. Normal sweat gland function. J Am Acad Dermatol. 1989;20(4):537–63.

    Article  CAS  PubMed  Google Scholar 

  18. Hornberger J, Grimes K, Naumann M, Glaser DA, Lowe NJ, Naver H, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol. 2004;51(2):274–86.

    Article  PubMed  Google Scholar 

  19. Hamm H, Naumann MK, Kowalski JW, Kutt S, Kozma C, Teale C. Primary focal hyperhidrosis: disease characteristics and functional impairment. Dermatology. 2006;212(4):343–53.

    Article  PubMed  Google Scholar 

  20. Bahmer FA, Sachse MM. Hyperhidrosis area and severity index. Dermatol Surg. 2008;34(12):1744–5.

    Article  CAS  PubMed  Google Scholar 

  21. Ambrogi V, Campione E, Mineo D, Paterno EJ, Pompeo E, Mineo TC. Bilateral thoracoscopic T2 to T3 sympathectomy versus botulinum injection in palmar hyperhidrosis. Ann Thorac Surg. 2009;88(1):238–45.

    Article  PubMed  Google Scholar 

  22. Aydemir EH, Kalkan MT, Karakoc Y. Quantitative effect of anodal current in the treatment of primary hyperhidrosis by direct electrical current. Int J Dermatol. 2006;45(7):862–4.

    Article  PubMed  Google Scholar 

  23. Amir M, Arish A, Weinstein Y, Pfeffer M, Levy Y. Impairment in quality of life among patients seeking surgery for hyperhidrosis (excessive sweating): preliminary results. Isr J Psychiatry Relat Sci. 2000;37(1):25–31.

    CAS  PubMed  Google Scholar 

  24. Finlay AY. Quality of life measurement in dermatology: a practical guide. Br J Dermatol. 1997;136(3):305–14.

    Article  CAS  PubMed  Google Scholar 

  25. OCEBM. The Oxford 2011 level of evidence. www.cebm.net/index.aspx?o=5653. 2012. 9-6-2012. Ref Type: Online Source

  26. Holzle E, Braun-Falco O. Structural changes in axillary eccrine glands following long-term treatment with aluminium chloride hexahydrate solution. Br J Dermatol. 1984;110(4):399–403.

    Article  CAS  PubMed  Google Scholar 

  27. Benohanian A, Dansereau A, Bolduc C, Bloom E. Localized hyperhidrosis treated with aluminum chloride in a salicylic acid gel base. Int J Dermatol. 1998;37(9):701–3.

    Article  CAS  PubMed  Google Scholar 

  28. Flanagan KH, Glaser DA. An open-label trial of the efficacy of 15 % aluminum chloride in 2 % salicylic acid gel base in the treatment of moderate-to-severe primary axillary hyperhidrosis. J Drugs Dermatol. 2009;8(5):477–80.

    PubMed  Google Scholar 

  29. Innocenzi D, Ruggero A, Francesconi L, Lacarrubba F, Nardone B, Micali G. An open-label tolerability and efficacy study of an aluminum sesquichlorohydrate topical foam in axillary and palmar primary hyperhidrosis. Dermatol Ther. 2008;21 Suppl 1:S27–30.

    Article  PubMed  Google Scholar 

  30. Goh CL. Aluminum chloride hexahydrate versus palmar hyperhidrosis. Evaporimeter assessment. Int J Dermatol. 1990;29(5):368–70.

    Article  CAS  PubMed  Google Scholar 

  31. Bergstresser PR, Quero R. Treatment of hyperhidrosis with topical methenamine. Int J Dermatol. 1976;15(6):452–5.

    Article  CAS  PubMed  Google Scholar 

  32. Pagliarello C, Paradisi M, Paradisi A. Reply to: “Primary focal hyperhidrosis: current treatment options and a step-by-step approach.”. J Eur Acad Dermatol Venereol. 2012;26(9):1172.

    Article  CAS  PubMed  Google Scholar 

  33. Cullen SI. Topical methenamine therapy for hyperhidrosis. Arch Dermatol. 1975;111(9):1158–60.

    Article  CAS  PubMed  Google Scholar 

  34. Seukeran DC, Highet AS. The use of topical glycopyrrolate in the treatment of hyperhidrosis. Clin Exp Dermatol. 1998;23(5):204–5.

    Article  CAS  PubMed  Google Scholar 

  35. Kavanagh GM, Burns C, Aldridge RD. Topical glycopyrrolate should not be overlooked in treatment of focal hyperhidrosis. Br J Dermatol. 2006;155(2):487.

    Article  CAS  PubMed  Google Scholar 

  36. Levit F. Simple device for treatment of hyperhidrosis by iontophoresis. Arch Dermatol. 1968;98(5):505–7.

    Article  CAS  PubMed  Google Scholar 

  37. Chia HY, Tan AS, Chong WS, Tey HL. Efficacy of iontophoresis with glycopyrronium bromide for treatment of primary palmar hyperhidrosis. J Eur Acad Dermatol Venereol. 2012;26(9):1167–70.

    Article  CAS  PubMed  Google Scholar 

  38. Davarian S, Kalantari KK, Rezasoltani A, Rahimi A. Effect and persistency of botulinum toxin iontophoresis in the treatment of palmar hyperhidrosis. Australas J Dermatol. 2008;49(2):75–9.

    Article  PubMed  Google Scholar 

  39. Kavanagh GM, Shams K. Botulinum toxin type A by iontophoresis for primary palmar hyperhidrosis. J Am Acad Dermatol. 2006;55(5 Suppl):S115–7.

    Article  PubMed  Google Scholar 

  40. Kavanagh GM, Oh C, Shams K. BOTOX delivery by iontophoresis. Br J Dermatol. 2004;151(5):1093–5.

    Article  CAS  PubMed  Google Scholar 

  41. Na GY, Park BC, Lee WJ, Park DJ, Kim DW, Kim MN. Control of palmar hyperhidrosis with a new “dry-type” iontophoretic device. Dermatol Surg. 2007;33(1):57–61.

    Article  CAS  PubMed  Google Scholar 

  42. Sato K, Timm DE, Sato F, Templeton EA, Meletiou DS, Toyomoto T, et al. Generation and transit pathway of H+ is critical for inhibition of palmar sweating by iontophoresis in water. J Appl Physiol. 1993;75(5):2258–64.

    CAS  PubMed  Google Scholar 

  43. Hill AC, Baker GF, Jansen GT. Mechanism of action of iontophoresis in the treatment of palmar hyperhidrosis. Cutis. 1981;28(1):69–70. 72.

    CAS  PubMed  Google Scholar 

  44. Hill BH. Poldine iontophoresis in the treatment of palmar and plantar hyperhidrosis. Australas J Dermatol. 1976;17(3):92–3.

    Article  CAS  PubMed  Google Scholar 

  45. Abell E, Morgan K. The treatment of idiopathic hyperhidrosis by glycopyrronium bromide and tap water iontophoresis. Br J Dermatol. 1974;91(1):87–91.

    Article  CAS  PubMed  Google Scholar 

  46. Dolianitis C, Scarff CE, Kelly J, Sinclair R. Iontophoresis with glycopyrrolate for the treatment of palmoplantar hyperhidrosis. Australas J Dermatol. 2004;45(4):208–12.

    Article  PubMed  Google Scholar 

  47. Swartling C, Naver H, Pihl-Lundin I, Hagforsen E, Vahlquist A. Sweat gland morphology and periglandular innervation in essential palmar hyperhidrosis before and after treatment with intradermal botulinum toxin. J Am Acad Dermatol. 2004;51(5):739–45.

    Article  PubMed  Google Scholar 

  48. Shams K, Kavanagh GM. Immediate reduction in sweat secretion with electric current application in primary palmar hyperhidrosis. Arch Dermatol. 2011;147(2):241–2.

    Article  PubMed  Google Scholar 

  49. Maillard H, Fenot M, Bara C, Celerier P. Therapeutic value of moderate-dose oxybutynin in extensive hyperhidrosis. Ann Dermatol Venereol. 2011;138(10):652–6.

    Article  CAS  PubMed  Google Scholar 

  50. Krogstad AL, Skymne A, Pegenius G, Elam M, Wallin BG. No compensatory sweating after botulinum toxin treatment of palmar hyperhidrosis. Br J Dermatol. 2005;152(2):329–33.

    Article  CAS  PubMed  Google Scholar 

  51. Hund M, Sinkgraven R, Rzany B. Randomized, placebo-controlled, double blind clinical trial for the evaluation of the efficacy and safety of oral methantheliniumbromide (Vagantin) in the treatment of focal hyperhidrosis. J Dtsch Dermatol Ges. 2004;2(5):343–9.

    Article  PubMed  Google Scholar 

  52. Muller C, Berensmeier A, Hamm H, Dirschka T, Reich K, Fischer T, et al. Efficacy and safety of methantheline bromide (Vagantin(®)) in axillary and palmar hyperhidrosis: results from a multicenter, randomized, placebo-controlled trial. J Eur Acad Dermatol Venereol. 2013;27(10):1278–84.

    Google Scholar 

  53. Paller AS, Shah PR, Silverio AM, Wagner A, Chamlin SL, Mancini AJ. Oral glycopyrrolate as second-line treatment for primary pediatric hyperhidrosis. J Am Acad Dermatol. 2012;67(5):918–23.

    Article  CAS  PubMed  Google Scholar 

  54. Bajaj V, Langtry JA. Use of oral glycopyrronium bromide in hyperhidrosis. Br J Dermatol. 2007;157(1):118–21.

    Article  CAS  PubMed  Google Scholar 

  55. Wolosker N, De Campos JR, Kauffman P, Puech-Leao P. A randomized placebo-controlled trial of oxybutynin for the initial treatment of palmar and axillary hyperhidrosis. J Vasc Surg. 2012;55(6):1696–700.

    Article  PubMed  Google Scholar 

  56. Walling HW. Systemic therapy for primary hyperhidrosis: a retrospective study of 59 patients treated with glycopyrrolate or clonidine. J Am Acad Dermatol. 2012;66(3):387–92.

    Article  CAS  PubMed  Google Scholar 

  57. Wozniacki L, Zubilewicz T. Primary hyperhidrosis controlled with oxybutynin after unsuccessful surgical treatment. Clin Exp Dermatol. 2009;34(8):e990–1.

    Article  CAS  PubMed  Google Scholar 

  58. Schollhammer M, Misery L. Treatment of hyperhidrosis with oxybutynin. Arch Dermatol. 2007;143(4):544–5.

    Article  PubMed  Google Scholar 

  59. Wollina U, Karamfilov T. Botulinum toxin A for palmar hyperhidrosis. J Eur Acad Dermatol Venereol. 2001;15(6):555–8.

    Article  CAS  PubMed  Google Scholar 

  60. Solomon BA, Hayman R. Botulinum toxin type A therapy for palmar and digital hyperhidrosis. J Am Acad Dermatol. 2000;42(6):1026–9.

    Article  CAS  PubMed  Google Scholar 

  61. Doft MA, Hardy KL, Ascherman JA. Treatment of hyperhidrosis with botulinum toxin. Aesthet Surg J. 2012;32(2):238–44.

    Article  PubMed  Google Scholar 

  62. de Almeida AR, Kadunc BV, de Oliveira EM. Improving botulinum toxin therapy for palmar hyperhidrosis: wrist block and technical considerations. Dermatol Surg. 2001;27(1):34–6.

    Article  PubMed  Google Scholar 

  63. Cerfolio RJ, De Campos JR, Bryant AS, Connery CP, Miller DL, DeCamp MM, et al. The society of thoracic surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg. 2011;91(5):1642–8.

    Article  PubMed  Google Scholar 

  64. Reisfeld R, Nguyen R, Pnini A. Endoscopic thoracic sympathectomy for treatment of essential hyperhidrosis syndrome: experience with 650 patients. Surg Laparosc Endosc Percutan Tech. 2000;10(1):5–10.

    CAS  PubMed  Google Scholar 

  65. Inan K, Goksel OS, Ucak A, Temizkan V, Karaca K, Ugur M, et al. Thoracic endoscopic surgery for hyperhidrosis: comparison of different techniques. Thorac Cardiovasc Surg. 2008;56(4):210–3.

    Article  CAS  PubMed  Google Scholar 

  66. Vorkamp T, Foo FJ, Khan S, Schmitto JD, Wilson P. Hyperhidrosis: evolving concepts and a comprehensive review. Surgeon. 2010;8(5):287–92.

    Article  PubMed  Google Scholar 

  67. Gossot D, Kabiri H, Caliandro R, Debrosse D, Girard P, Grunenwald D. Early complications of thoracic endoscopic sympathectomy: a prospective study of 940 procedures. Ann Thorac Surg. 2001;71(4):1116–9.

    Article  CAS  PubMed  Google Scholar 

  68. Zacherl J, Huber ER, Imhof M, Plas EG, Herbst F, Fugger R. Long-term results of 630 thoracoscopic sympathicotomies for primary hyperhidrosis: the Vienna experience. Eur J Surg Suppl. 1998;580:43–6.

    PubMed  Google Scholar 

  69. Lin TS. Transthoracic endoscopic sympathectomy for palmar and axillary hyperhidrosis in children and adolescents. Pediatr Surg Int. 1999;15(7):475–8.

    Article  CAS  PubMed  Google Scholar 

  70. Hofbauer GF, Nestle FO. Irritant contact dermatitis of the hands following thoracic sympathectomy. Contact Dermatitis. 2000;42(2):119–20.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The National Research Centre for Allergy, University Hospital Gentofte, Niels Andersens Vej 65DK-2900, Gentofte, Denmark

    Majken G. Hougaard M.D. & Jacob P. Thyssen M.D., Ph.D., DmSci

Authors
  1. Majken G. Hougaard M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jacob P. Thyssen M.D., Ph.D., DmSci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Majken G. Hougaard M.D. .

Editor information

Editors and Affiliations

  1. Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA

    Ali Alikhan

  2. Department of Dermatology, Catholic University of Louvain, Brussels, Belgium

    Jean-Marie Lachapelle

  3. Department of Dermatology, University of California, San Francisco, California, USA

    Howard I. Maibach

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hougaard, M.G., Thyssen, J.P. (2014). Treatment of Hand Eczema Caused by Hyperhidrosis. In: Alikhan, A., Lachapelle, JM., Maibach, H. (eds) Textbook of Hand Eczema. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39546-8_34

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-39546-8_34

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-39545-1

  • Online ISBN: 978-3-642-39546-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation