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:
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Glycopyrronium wipe (Qbrexza) was FDA approved in 2018 for axillary hyperhidrosis, off-label for palms.
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Sofpironium bromide gel (Sofdra) is a newer topical FDA-approved in 2024 for axillary hyperhidrosis, with potential use on palms.
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Botox injections approved for axillary hyperhidrosis since 2004, used off-label for palms.
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Iontophoresis is a non-drug therapy widely used clinically.
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Surgical options like MES are established clinical procedures with ongoing refinements rather than discrete FDA approvals.
