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Palmar Hyperhidrosis - Sweaty PalmsBy leading hyperhidrosis expert Dr. Reisfeld who is a pioneer in this specialized field since the early 90s as one of the first surgeons to perform these procedures in the US. He continues to help develop new approaches and surgical methods towards advancing the treatment of hyperhidrosis.

What is Hyperhidrosis?

Hyperhidrosis in medical terms relates to a situation where the body in different locations is sweating more than the physiological needs. Sweat in general is one of the methods the body tries to control basic body needs for temperature. Excessive sweating can be divided into two major groups.

  1. Generalized Hyperhidrosis –  Body Sweat
  2. Local Hyperhidrosis – Hands, Feet, Armpit Sweat

Generalized Hyperhidrosis – Body Sweating:
In certain illnesses such as infections, endocrine disorders, cancer and aging processes (elderly) the body can react with all over the body sweating. In this particular clinical presentation a search for the underlying cause is needed in order to help with this generalized total body sweating. There is no known connection between hormone production and hyperhidrosis except in the elderly, especially female, population where hormonal imbalance can cause a lot of facial/neck sweating and those cases it is not considered primary hyperhidrosis.

Local Hyperhidrosis – Hands, Feet, Armpits
Plantar Hyperhidrosis - Sweaty FeetIn this clinical presentation which affects between 1.5 to 2% of the population otherwise healthy people without any underlying illnesses develop excessive sweating. Local hyperhidrosis typically starts at an early age. Those afflicted with moderate to severe cases will likely experience social and day to day functional challenges. In more than 50% of the cases hyperhidrosis is hereditary.

Males vs Females with Hyperhidrosis
Both men and women are affected. Women are typically more aware and therefore more affected by symptoms of hyperhidrosis. So far there are no statistical studies to prove the difference in presentation between male and females but the impression is that females are affected by a higher percentage than males.

Do I have hyperhidrosis?
Sweating is normal however if your sweating goes well beyond the physiological needs of the body it can be classified as hyperhidrosis. There are different levels of hyperhidrosis (mild, moderate, severe).

Common Symptoms of local hyperhidrosis:

  • Clammy or wet Palms or Feet
  • Frequent sweating for no apparent reason
  • Excessive sweating to the point of dripping

Learn more about the common symptoms of hyperhidrosis.

How severe is my hyperhidrosis?

  • Mild – Moisture throughout the day
  • Moderate – Wet enough to leave marks on whatever you touch
  • Severe – Continually Dripping sweat (less during sleep)

Hyperhidrosis is subjective, it is felt and experienced by the patient, their family, close friends and whoever interacts with them closely. The individual with hyperhidrosis defines how much this interferes with his or her life.

Unfortunately in the medical community there is not enough recognition and knowledge about it because it affects only about 1.5% to 2% of the world’s population. Many healthcare providers have never even seen the condition. Fortunately now thanks to the world wide web, information about this condition is more readily available, shared and it gives the patients and their families the ability to educate themselves and find the appropriate treatment.

Can Hyperhidrosis be cured by itself?
Unfortunately in the vast majority of the cases hyperhidrosis will not cure itself on its own. Obviously medicine is not an exact science so there are some rare exceptions where hyperhidrosis does go away. As a general rule patients who are suffering from severe for cases of hyperhidrosis where there is a history in the family of hyperhidrosis the chances of the disease being eliminated by itself are extremely slim. Having said that the necessity to try some alternative / conservative methods to treat it is an essential part of the decision making process.

Hopefully after reading this website more light will be shed on this problem helping those suffering make better decisions. For more information specific to your condition, please contact us.

What are the success rates of the surgeries for the hands and feet?
– The success rates for ETS surgery (Hands) is extremely high and it ranges from 98-99%. It has a very low recurrence rate of about 1%. Learn more about palmar hyperhidrosis for the hands.
Feet – The success rate for ETS to achieve dryness with the feet is limited to only about 30% but those who continue to suffer tremendously from their foot sweating can opt for the ELS surgery which has a high success rate in eliminating foot sweating, about 98 to 99%. Learn more about plantar hyperhidrosis for the feet.

The two above operations (ETS & ELS) cannot be performed at the same time so a latent period of about 4 months must be taken in between ETS and ELS.

Armpits – When armpit sweating (axillary sweating) is associated with excessive palmar hyperhidrosis (hand sweating) then at the same time when the surgeon performs ETS he ads one more level to the sympathectomy it has a higher success rate for excessive armpit sweating and the relief rate is around 85%. It important to always discuss any surgery with the performing surgeon.

What is the cost of the surgery?
Most of the insurance companies do cover the cost of surgery (ETS, ELS). In the US the current situation with insurance companies is evolving. Each case and its coverage should be discussed on an individual basis because of the complexities of the subject. In the case of no insurance or cash payment it should also be discussed on an individual basis. Learn more about the cost of hyperhidrosis.

Age Range of Hyperhidrosis:
Individuals affected with hyperhidrosis usually present that trend very early in life. Mothers often tell of their babies with severe sweaty hands and feet but the real clinical/social presentation starts around grade school on up. This of course presents a challenge for those children. How young can the procedure be done? Generally speaking 12-14 years is an accepted age for performing the operation after very careful review of each case and its individual merits.

Genetics and Hyperhidrosis:
Many studies have shown that in more than 50% of the patients there is a genetic history/connection, in that family, of hyperhidrosis. Also it appears that in those families, more comes from the mother’s side of the family.

Popular Questions:

  1. Am I eligible for the hyperhidrosis surgery?
  2. What is the cost of the surgery?
  3. Possible Complications and Side Effects of Hyperhidrosis Surgery
  4. Does hyperhidrosis improve or worsen with time?
  5. Why can’t ETS and ELS be done at the same time?
  6. Does the clamping method give a possibility of reversal?
  7. What if I have severe total body sweating combined with excessive hand and feet sweating?


  1. Thank you for this information. I’ve suffered from sweaty palms since I was a teenager, and want to find a cure. I will be looking into treatment options.

    • Hi Betty,
      I also suffered form excessive sweating of the hands and feet since my teens ,It totally ruined my social life. Last year I read an article about iontophoresis and having nothing to lose, decided to give it a try .I tried out the Idromed 5 PS iontophoresis machine and within six weeks my hands and both feet were dry. There is unfortunately no cure for Hyperhidrosis, but you can control the symptoms painlessly with iontophoresis. The machine is rather pricey but for me it’s worth every penny.

      • It is known that in a certain amount of cases iontophoresis can help with the reduction in the amount of sweating. It requires multiple uses over time and can be associated with some discomfort. So far the world literature has not shown any proof that it helps on a long term basis and one of the reasons is the necessity to increase the voltage as well as the frequency which can cause even more discomfort. Nevertheless a trial can be made to use this device.

  2. I have read that iontophoresis therapy has a success rate of 98%-and success means achieving complete dryness, not just a reduction in the amount of sweating.Iontophoresis does indeed require repeated (daily ) treatments at least in the beginning or initial phase until dryness is achieved .The achieved dryness is maintained with maintenance treatments at regular intervals that are determined for each user individually.Your statement that one must increase the voltage and the frequency of treatments is misinformed as is the statement that this results in an increase in discomfort.Iontophoresis therapy when done with a professional machinelike the Idromed 5 PC is easy and painless. I strongly recommend that hyperhidrosis sufferers give Iontophoresis a chance before trying expensive and risky invasive therapies like Botox or ETS.

    • As stated in the earlier comment, some people will get positive results from the usage of iontophoresis devices. If it does help anyone then it may be an appropriate solution as compared to the surgical approach.

    • How do I find out more about this treatment and whether or not it will be beneficial for me?

  3. Hi so I’m a teenage female and I am worried that I have hyperhidrosis because I would be just sitting down somewhere doing nothing and my underarms and hands would be dripping sweat. It’s really annoying to deal with, especially in school. Also it doesn’t help that I get really bad anxiety and that makes me sweat even more. I have tried to talk to my parents about this but they just think that I’m diagnosing myself but I’m not. I just really want to fix this because it is really annoying. I haven’t been to a doctor in a few years and this would be among the many things I want to get checked for and I don’t know how to talk to my mom about it :/


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