Excessive Sweating of the Hands (Palmar Hyperhidrosis) – Sydney

Excessive sweating of the hands, also called palmar hyperhidrosis, is a common condition that can significantly impact daily life. Those affected often report that it interferes with work, social situations, and confidence — for example, they may avoid shaking hands or handling paper.
In some cases, excessive sweating is genetic and can run in families.

Small, precise treatments using fine needles are used to help manage sweating in the hands.

Consultation for Excessive Sweating Assessment

A thorough consultation is essential for anyone considering treatment. Your clinician will take a full history and discuss the following:

Is there a family history of excessive sweating?
Have you had previous treatments?
Were you satisfied with the results?
How long did previous treatments last?
Which areas of the body are most affected (hands, feet, underarms, back, etc.)?
Have you experienced any side effects such as temporary weakness or perceived sweating elsewhere?
What is your occupation and activity level (as muscle function in the hands is important for certain professions, e.g. musicians)?

Examination

In some cases, your practitioner may perform an iodine starch test.
The area is gently cleansed and then dusted with starch powder, helping to identify the areas where sweating is most active. This ensures accuracy in planning your treatment.

Choosing the Treatment Plan

Your clinician will determine the appropriate approach after reviewing your history and examination results. Factors considered include:

Previous treatment response and duration
Desired longevity versus subtlety of results
History of sensitivity or side effects
Budget and treatment goals

If you prefer longer-lasting results, a higher dose may be recommended.
If a more conservative approach or smaller budget is preferred, a smaller dose can be chosen.
All decisions are made collaboratively during your consultation.

Pain Relief During Treatment

Because the palms are sensitive, pain relief options are offered to improve comfort:

Numbing cream (e.g. EMLA or LMX), ideally applied 45 minutes before treatment
Ice to cool the area and reduce bruising risk
Nitrous oxide (“Happy Gas”) for relaxation
Inhaled analgesic (Penthrox) if needed

What Happens During the Procedure

The treatment area is cleaned with an antiseptic solution
Ice is applied briefly before treatment
Small, precise injections are made in a grid-like pattern across the palms and fingers
Gentle pressure is applied with gauze afterward

The procedure typically takes less than 20 minutes, and most patients can return to daily activities shortly after.

Appearance After Treatment

Some patients notice no visible signs immediately after treatment.
Others may experience mild redness or small bumps (similar to minor skin irritation), which usually settles quickly.

Risks and Side Effects

Treatment for excessive sweating is generally considered low risk when performed by trained professionals.
Possible side effects may include:

Mild bruising or tenderness
Temporary redness
Headache (reported in a small number of new patients)
Slight asymmetry (one side improving faster than the other)
Rare: infection at the injection site
Very rare: temporary changes in hand strength
Occasionally, a perceived increase in sweating in other body areas

Who Is Unsuitable for Treatment

This treatment may not be suitable for:

Individuals who are pregnant or breastfeeding
People with specific medical or neuromuscular conditions (to be discussed during consultation)

Aftercare Instructions

Avoid heavy exercise on the day of treatment
Do not massage or rub the area
Follow any post-treatment advice provided by your clinician

What to Expect After Treatment

Results typically begin to appear within 2–8 days
Full results are usually seen around 3–4 weeks
A review appointment is recommended at 4 weeks to assess progress and consider any additional treatment if needed

If one hand responds faster than the other, this usually balances out before the review.
If asymmetry persists, further adjustments can be made at that appointment.

How Long Do Results Last

The duration of results depends on individual metabolism, dosage, and placement.

Higher doses may last up to 8–12 months
Smaller doses may require retreatment several months earlier

When Should I Have My Next Treatment

Most patients return when sweating begins to recur — typically between 8–12 months.
Your practitioner can help schedule maintenance based on your preference and response.

FAQs — Excessive Sweating of the Hands (Palmar Hyperhidrosis)

1. What causes excessive sweating of the hands?
Excessive hand sweating occurs when the sweat glands are overactive. It may be influenced by genetics, stress, or other factors and can affect people regardless of temperature or activity level.

2. How does this treatment work?
Small, precise injections are used to help manage sweating by reducing overactivity in the sweat glands.

3. Is the treatment painful?
Because the palms are sensitive, pain relief options such as numbing cream, ice, or Happy Gas are available to make the treatment more comfortable.

4. How long does the procedure take?
The treatment generally takes less than 20 minutes, and most patients can return to their usual activities soon afterward.

5. When will I notice results?
Results typically begin to appear within 2–8 days, with optimal improvement visible around 3–4 weeks.

6. How long do results last?
Results vary between individuals. Most patients find the effects last several months, depending on metabolism and dosage.

7. Are there any side effects?
Mild redness, bruising, or tenderness may occur but usually settle quickly. Temporary changes in hand strength or perceived sweating in other areas are rare.

8. Who is not suitable for this treatment?
This treatment may not be recommended for individuals who are pregnant, breastfeeding, or have certain medical or neuromuscular conditions. Your practitioner will assess your suitability during consultation.