Plantar Hyperhidrosis: An Overview

Key points

Patient evaluation overview

Plantar hyperhidrosis is typically primary hyperhidrosis and idiopathic, but hyperhidrosis is divided into primary and secondary categories.² Primary hyperhidrosis tends to be an idiopathic increase in sympathetic nervous system activity; secondary usually is caused by either a medication or an underlying disease.² In the study by Walling² of 415 patients, 93.3% had primary and the remaining 6.7% had secondary. Primary hyperhidrosis tends to be typically distributed in the axilla, palms, soles,

Pharmacologic treatment options

Treatment of plantar hyperhidrosis has used various strategies. The first line of treatment has been application of an antiperspirant, such as topical aluminum chloride.¹ In 2011, Streker and colleagues¹ conducted a study on the effectiveness of two different concentrations of aluminum chloride, 12.5% and 30%, and found that both significantly reduced sweat production in plantar hyperhidrosis in 6 weeks. Because both were effective, they recommend using aluminum chloride 12.5%.¹ Although skin

Nonpharmacologic treatment options

Laser treatment of hyperhidrosis has been explored for treatment of hyperhidrosis. The miraDry (Miramar Labs, Santa Clara, CA) laser has been tested for treatment of axillary hyperhidrosis, but not plantar hyperhidrosis. It uses microwave energy at 5800 MHz, which is between infrared (CO₂ lasers) and radiowaves on the electromagnetic spectrum.²⁴ Using an antenna, the microwave energy penetrates the skin to the eccrine sweat glands, preferentially targeting the skin-adipose junction where most

Summary/Discussion

Plantar hyperhidrosis has a significant impact on the quality of life for patients. It is important to be able to understand and diagnose this condition, and to be familiar with available treatment options. Determining the cause, if possible, for the hyperhidrosis is paramount before initiating other systemic or more invasive procedures. Evaluating the disruption of the patient’s quality of life is useful in determining the treatment plan and understanding the unique needs of the patient with

Acknowledgment

Samantha M. Newstadt, BS for her assistance with this article.