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Patients who are suffering from Palmar hyperhidrosis will often complain of cold and wet hands. The reason for this clammy feeling is twofold. First the overacting sympathetic chain causes vaso-constriction (narrowing of the blood vessels) which slows down the blood flow to the fingers thus causing relative clamminess. Also the evaporation of the sweat also causes clamminess. Associated with this is also redish/blueish appearance of the fingers which is related to the vaso constriction.

The sympathectomy will produce a temporary warming of the fingers right after the surgery which is not on a permanent basis. For some it is months and on rare occasions years for others. The reason for this is that the sympathectomy is much more effective with regard to the action of the sympathectomy on the sweat glands compared to the blood vessels. The blood vessels are autonomous with regard to their ability to constrict or dilate and that explains why the cold aspect of the clamminess might come back.

Should I have the surgery if I only have clammy hands?

This is a common question. Basically clamminess alone is not an appropriate reason to do the surgery. In the above paragraphs the physiological mechanism of clamminess is explained. It is a difficult subject to understand, hopefully our explanation helps. Please post any questions you have in the comments below!

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