SINGAPORE - Q My 17-year-old daughter has been experiencing sweaty palms since her childhood. Her palms sweat easily, especially when the weather is hot or when she is excited, nervous or stressed. Her condition has made her feel inferior and she has developed a low self-esteem.
She wants to opt for surgery but I read online that there may be side effects - for example, the excessive sweating may pop up in other areas of the body that are even more embarrassing.
I would like to seek your advice if there are other alternatives to ease her condition, including the use of traditional Chinese medicine (TCM).
A Sweaty palms are medically known as palmar hyperhidrosis.
It usually begins in early childhood and worsens in one's teenage years and early adulthood. The condition occurs when sweat glands overreact to changes in temperature, emotions and diet.
Some illnesses, such as autoimmune disorders, diabetes and hyperthyroidism, can also cause one to sweat excessively.
In TCM, palmar hyperhidrosis is likely due to deficiencies in the functions of the spleen, stomach, heart, liver and kidneys. Or, it could be due to pathogens in the body, such as heat, fire, cold and dampness.
LATE NIGHTS AND POOR DIET
According to TCM principles, the stomach receives and digests food, while the spleen absorbs and transforms these nutrients into qi (vital energy) and blood, and then transports them around the body.
Keeping late nights, drinking alcohol, smoking and eating too much spicy and oily food can weaken both the stomach and spleen.
When this happens, the transportation ability of the spleen is affected, leading to abnormal distribution of body fluids. This, in turn, can cause the palms to sweat excessively.
Similarly, the spleen's transformation function will be affected too, causing nutrients to be transformed into phlegm and heat (instead of qi and blood).
This can trigger excessive and sticky sweating in the palms, along with fatigue and a poor appetite.
Due to the pathways of the body's meridians (energy channels), certain pathogens - such as heat and cold - can be transmitted to the hands and trigger the sweating process.
For example, when "coldness" invades the stomach and spleen, or when there is too much heat in one's stomach and intestines.
Bad lifestyle habits, such as smoking and keeping late nights, will also reduce the amount of yin (the element responsible for cooling organs) fluids in the body.
This creates internal heat and fire in the heart and kidneys - another factor that can lead to sweaty palms.
In this case, the palms will also feel hot, and the person may also experience dizziness, insomnia and lower back pain.
STRESS AFFECTS LIVER
Another possible source of your daughter's problem is the liver. The organ, according to TCM theory, is responsible for circulating qi.
But emotional disturbances can weaken this process. These include stress and nervousness - as mentioned in your daughter's case.
When this happens, liver heat and fire arise in the body. The person may then suffer from sweaty palms alongside irregular periods, constipation, pain along the upper abdomen and a dry throat that comes with a bitter taste in the mouth.
Chinese herbal medicine, acupuncture and cupping therapy can improve your daughter's condition by strengthening her organs and eliminating pathogenic factors.
Cupping involves using fire and cups to create a vacuum on the skin to enhance blood and qi circulation.
Herbs such as codonopsis root, milkvetch root, atractylodes rhizome, Indian bread, talc and chicken's gizzard skin are used to strengthen the spleen and stomach, increase one's qi and blood, and dispel heat and dampness from the body.
The liver and kidneys can be boosted with the Chinese thorowax root, orange fruit, white peony root, turmeric root tuber, oyster shell, Chinese magnolia vine fruit and smoked plum.
To increase yin and dispel heat and fire, try the Chinese wolfberry root-bark, common anemarrhena rhizome, dwarf lilyturf tuber, glossy privet fruit and figwort root.
ADOPT GOOD HABITS
Besides consuming herbs, your daughter should move her bowels regularly, as this can rid the body of excess heat. She should also sleep early - for example, before 10pm - to boost her level of yin.
It will also be wise to abstain from caffeinated drinks, alcohol and food that is spicy, sour or raw, so as to strengthen her spleen and stomach.
In addition, she may wish to adopt relaxation techniques, such listening to music and meditation, to temper the effects of stress.
Regular exercise can help to strengthen her immune system and regulate body temperature too.
Lastly, wearing clothes that are made of natural fibres (cotton, wool or silk) will allow her skin to breathe better.
MS LIM LAY BENG,
traditional Chinese medicine practitioner at YS Healthcare TCM Clinic at The Adelphi
Sweat glands are located all over the body, with the highest concentration in our palms, soles and armpits.
The body uses sweat to cool itself down. Physical stress and activities or a hot environment will therefore trigger an increase in sweat production.
If you sweat excessively just on your palms, you have a condition called palmar hyperhidrosis.
Sufferers usually complain that this condition interferes with daily tasks, such as writing, because the sweat leaves wet prints on the paper or smudges the ink; and holding items, because the sweat reduces one's grip. They may also be embarrassed to shake hands or touch another person because sweat uncontrollably drips from their hands.
The condition can affect the person's self-esteem, interaction with people and job performance, while also impeding his participation and enjoyment in hobbies.
Furthermore, as the condition is chronic, starts at a very young age and is visible to others, many people may feel that their quality of life is adversely affected.
Palmar hyperhidrosis is attributed to an overactive nervous system (sympathetic nervous system).
This system plays an important role in the control of basic and automatic bodily functions, such as maintaining one's heartbeat, pupil dilation and regulating one's body temperature through sweating.
When this system is hyperactive, the sweat glands get overstimulated and this leads to excessive sweat being produced.
While no one is sure why the nervous system sometimes acts this way, there are a variety of treatments to address this sweaty issue.
Non-surgical options are usually employed first. For instance, the daily use of a topical anti-perspirant that contains aluminium chloride can block the opening of sweat ducts to reduce sweating.
Iontophoresis, on the other hand, involves immersing your hands in a bowl of water through which a weak electric current is passed. This treatment also blocks the flow of sweat to the skin's surface.
Another option would be to take oral medication that can interfere with the interaction between the nerve and the sweat glands. This dampens the sweat response.
The medication can work quite quickly; some people may just need to take it before physical activities to stop or minimise sweaty palms.
Botulinum toxin injections may also be beneficial. The chemical blocks nerve signals to the sweat glands - much like oral medication, though the effects are more focused.
Oral medication can result in general dryness, including dry eyes and dry mouth, which can be uncomfortable for some.
The effects of the injections are, however, not immediate. It takes a few days to four weeks for the person to experience its full effects.
The above treatments, while offering good and safe relief, do not cure the condition.
Maintenance treatment is required and the frequency of this depends on which treatment was used and the degree of dryness desired.
Although surgery for sweaty palms is now carried out as a minimally invasive procedure, it is still associated with complications.
Most experts tend to reserve this procedure for patients with severe symptoms who have failed to improve with the abovementioned treatments.
Do speak to your doctor or a dermatologist to determine the best way forward for your daughter.
DR RAYMOND KWAH,
dermatologist at Dermatology & Surgery Clinic at Paragon Medical Centre and Equity Plaza
This article was first published on June 26, 2014.
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