FDA approved drugs and treatment for sweaty palms

 Sweaty palms( palmar hyperhidrosis) is a condition caused by overactivity of the eccrine sweat glands in the hands. It often begins in childhood or adolescence and can significantly affect daily activities such as writing, shaking hands, or handling objects.  Several FDA-approved and recognized treatments are available, ranging from topical agents to surgical options, depending on the severity of the condition

 

Treatment	FDA Approval Date	How to Use
Glycopyrronium wipe (Qbrexza)	June 28, 2018	Applied topically using disposable wipes on dry palms. Hands often covered with gloves for 1-2 hours after application to enhance absorption and prevent transfer. Usually applied once daily. Minimizes systemic side effects compared to oral agents.
Sofpironium bromide gel (Sofdra)	June 18, 2024	Applied as a thin layer of gel to dry palms once daily, avoiding eyes and mouth. The gel selectively blocks sweat gland receptors to reduce sweat locally. Hands should not be washed immediately after application. Proprietary applicator may be used to avoid spreading to hands when used for axilla.
Botulinum toxin type A (Botox)	Approved for hyperhidrosis since 2004 (for axillary)	Multiple small injections into the palms by trained professionals, often with local anesthesia to reduce pain. Effects last about 4-6 months. Temporarily blocks nerve signals to sweat glands. Used off-label for palms but widely practiced.
Iontophoresis	Not FDA-approved drug/device specifically, but widely used clinically	Hands immersed in water through which mild electrical current is passed for 20-30 min sessions, repeated several times weekly initially, then maintenance less frequently. Can be done at home or clinic.
Mini-Endoscopic Sympathectomy (MES) Surgery	Surgical procedure, no specific FDA drug approval date	Performed under general anesthesia by thoracic surgeons through tiny chest incisions. Sympathetic nerve chain controlling sweating is clipped or coagulated. Recovery takes days to a week. Used in severe refractory cases. New hybrid cryoablation techniques under research.

Summary:

• Glycopyrronium wipe (Qbrexza) was FDA approved in 2018 for axillary hyperhidrosis, off-label for palms.

• Sofpironium bromide gel (Sofdra) is a newer topical FDA-approved in 2024 for axillary hyperhidrosis, with potential use on palms.

• Botox injections approved for axillary hyperhidrosis since 2004, used off-label for palms.

• Iontophoresis is a non-drug therapy widely used clinically.

• Surgical options like MES are established clinical procedures with ongoing refinements rather than discrete FDA approvals.

 

Medical Problems of sweaty feet

While Sweaty feet is a social embarrassment, the more important problem of sweaty feet is the medical portion of it. Sweaty feet can cause a few skin problem which should be treated. They are listed below.


Fungal Infection
This is commonly known as athlete's foot. The most environment provided by the sweat gives rise to a nice medium for fungus to grow. Tinea (fungus) then grows typically at the webspaces. This gives rise to a characteristic odour. Treatment is with anti-fungal agents. Good feet hygiene cannot be over emphasised.

Cornybacteria Infection
This bacteria infection thrives in moist environment and typically grows on the soles of the feet. They also cause a smelly odour and is often confused with fungal infection. Treatment is with antibiotic creams and good feet hygiene.

Abrasions and Blisters
The sweat causes increase friction withing the shoes and this often leads to abrasion and wear and tear. Wearing socks tends to help but the socks can worsen the sweatiness of the feet.

These are just 3 common medical problems of sweat feet. If you think you might have them, visit a doctor for some advice.

Medical Treatment of sweaty glands and sweaty palms

Medical Treatment for hyperhidrosis

1) Antipersirant
There are many different formulation but aluminium chloride is the most commonly used. This is particularly effective for the sweaty armpit but less so for the sweaty palms the anti-perspirant gets washed off easily.
Continue use for 3 to 5 days increases the effectiveness. The downside to it is that some people are allergic to this or are sensitive to the formulation.

2) Botox Injection for sweaty palms

Recently FDA has approved the use of botox to treat sweaty palms. The effect can last 3 to 9 months and has been shown to be effective. The drawn back is that it is expensive and a jab in the wrong place can injury arteries or nerves, causing numbness of the hands. The upside is that it is a fast and easy office procedure.

Medication for sweaty palms, feet and armpit.
Anticholinergic drugs like oxybutynin has been shown to help in sweaty glands. But the side effects are many and includes drowsiness, visual symptoms and dryness in the mouth and other mucus membranes

No other medication has been shown to be effective in hyperhidrosis.

Medical Causes of Sweaty palms and feet

Sweaty palms and sweaty feet is a result of overactive sweat glands and is a common problem. While most of the time this is benign other than the inconveniences of sweaty glands, sometimes this may indicate a medical problem.

Isolated sweaty palms is usually a dermatological condition. But there are other possible causes of sweaty palms and feet. These includes thyroid diseases, acromegaly, phaechromocytoma or even hypoglycemia (low blood sugar).
Menopause itself can cause hot flushes leading to increase sweating..
Heart attack can cause cold sweat(diaphoresis) and so does severe pain.
Cancer can cause sweating and tuberculosis infection typically causes night sweats.

How can you tell if you could be having any of these conditions?
If you sweaty glands are an isolated condition, it is likely to be benign. If you experience other symptoms, they could indicate a medical problem for your sweaty palms.
The list of symptoms includes:

• Weight loss or gain
• Pain
• Change in bowel habit
• Fainting
• Giddiness
• Palpitations
• Feeling anxious
• Fever

The list is not exclusive but should you have any of the above stated, please kindly see the physician.

Sweaty Palm Treatment: tap water iontophoresis

Sweaty palm affects people in their sporting life, social interaction and even in their work. Imagine not daring to hold the hands of the cute guy dating you because you hands are wet with sweat.

One of the only few proven treatment for sweaty palms is Tap Water Iontophoresis. Essentially, the person places his palms and feet into 4 trays of tap water, each with a conducting plate conducting small amount of electric current. The current runs through the body from the hands to the feet or vice versa.

This causes the nervous system of the skin of the palms and soles to lose their sensitivity to body triggers and therefore sweating in these areas are decreased.

The treatment is usually over 15 to 30 mins each time and repeated 1-2 weekly depending on the severity of the sweaty glands problem.

Please only do this a approved medical center as this involves electrical current and the use of sub-standard equipment or the lack of monitoring may result in electrocution.

Sweaty Armpit Advice

Sweaty armpit causes problems of odour. This is affect social interaction subtly. This is especially people generally feel embarrassed to tell you that you have bad odour. You could be going around with people avoiding you but without you knowing.

If you have sweaty armpits, please make sure you put on deodorant daily.
There are 2 types of deodorant. The anti-perspiration type is useful for mild sweaty glands cases. For the more severe once, you need to combine the anti-perspirant one with a anti-bacterial one to prevent odour from forming.

There are generally no side effects to using deodorants.

Sweat Glands

The sweat gland contains 2 portions. There is a deep part beneath the dermis called secretes the sweat. The more superficial portion consist of a duct to reaches to the surface the the skin to secrete the sweat

There are 2 main kinds of sweat glands, the eccrine and apocrine sweat glands. The Eccrine sweat glands are found all over the body and secretes sweat to aid in cooling the body.

The apocrine sweat glands are found in the axilla and perinium region of the body. These form little function in cooling is is believed to be the more primitive type of sweat glands by some people.