Could I Have Raynaud’s Disease and Hyperhidrosis?

Over the years, we have come across several patients who were told that they suffer from Raynaud’s disease as well as hyperhidrosis. This is a common mistake that exposes the patient to unnecessary treatment modalities.

The other problem is that it takes away attention from the real issue, which is hyperhidrosis. A certain amount of patients, on top of their severe palmar hyperhidrosis / plantar hyperhidrosis also have clammy extremities which also are bluish/reddish in color. The explanation for this is overactive sympathetic chain activity.

In order to diagnose Raynaud’s disease, a very simple test is required. This test is called Erythrocytes Sedimentation Rate (ESR). If it is normal, the likelihood that the patient has Raynaud’s is extremely low. Thankfully, it is an extremely simple and cheap test. A person who is suffering from these symptoms should request this test first.

The cold hands and feed (clammy) are also due to the overactive sympathetic chain which causes a narrowing of the blood vessels. If a patient does not have sweaty hands but only clammy extremities with discoloration (bluish, reddish), then a sympathectomy is not recommended for them.

The only reason nowadays for a thoracic or lumbar sympathectomy is an extreme level of hyperhidrosis in the extremities. With the sympathectomies, the patient will feel a warming of the extremities and the discoloration will disappear.

The aforementioned improvements are not long lasting. The warming effect and the improvement of the discoloration are temporary. As far as the excessive sweating is concerned, there are lifelong improvements with high success rates. The recurrence rate is in the range of about 1%.