palmm Relief from Excessive Sweating:
An Interview with Véronique Peiffer of palmm

What is the need palmm seeks to address?

When I was a Stanford Biodesign Innovation Fellow in 2015-16, we conducted our clinical immersion in the Stanford hospitals and clinics to identify compelling unmet clinical needs. But my co-founder Justin Huelman and I also decided to investigate some unmet needs that we ourselves or our close friends suffered from because we had deep personal experience with those conditions. This is how topics such as Reynaud’s syndrome [a problem that causes decreased blood flow to the fingers or toes] and palmar hyperhidrosis [excessive sweating of the hands] ended up on our needs list.

“They described how personally and professionally embarrassing it is to have sweaty palms when meeting someone.”

As we did our research, we discovered that hyperhidrosis is much more common you might think. In the US alone, more than 15 million people struggle with excessive sweating, and they’re largely left to suffer silently because most available treatments are ineffective, inconvenient, or both. Even though hyperhidrosis can affect different parts of the body, we kept coming back to the hands as we talked to people. They described how personally and professionally embarrassing it is to have sweaty palms when meeting someone. It's very difficult to hide. You might be able to hide a sweaty armpit, but you can't hide that first handshake. That's what resonated with us most and inspired us to tackle this debilitating problem.

Members of the palmm teamMembers of the palmm team (from left): John Zepeda, Daniel Francis (an Innovation Fellowship alum), Véronique Peiffer, and Thi-Vu Huynh.

What key insight was most important to guiding the design of your solution?

When we were looking through literature on palmar hyperhidrosis, we came across an existing treatment mechanism called tap water iontophoresis. This approach, which uses electrical stimuli to deactivate the sweat glands in the hands over time, is generally considered effective and has minimal side effects. The treatment involves two water baths with stainless steel plates inside them that are hooked up to a power supply. The patient places his or her hands into the water baths and the current flows over the affected sweat glands. Each session takes 20 to 30 minutes, during which you’re completely tethered to the treatment. You can't do anything because you have your hands in those baths. So it’s hugely inconvenient. Also, people describe experiencing strange or uncomfortable sensations because the current is going through their whole body, not just through their hands. This causes some individuals to discontinue treatment, or it prevents them from trying it in the first place.

So our insight was that we needed to devise a solution that was equally as effective and safe, but more comfortable and convenient. We also realized that, because this is a quality of life issue, our solution had to be non-invasive. And because most patients pay out of pocket to address their excessive sweating, it had to be affordable.

palmm product imageThe palmm experience is intended to be significantly more convenient for users than traditional tap water iontophoresis.

How does your solution work?

palmm provides a convenient at-home treatment for excessive sweating of the hands. Using the same general mechanism as tap water iontophoresis, the system applies a mild electrical current to the skin through a pair of gloves. We decided on a glove for the form factor so that people can still be active and perform normal daily activities during treatment. We've also been able to optimize the way the current is delivered to the hands so that the sensation is comfortable for the users. Both of these changes should increase adherence to the therapy so that more people experience safe and effective results that help them avoid embarrassment and regain confidence in their daily lives.

At what stage of development is the solution?

Early proof of concept testing was performed at Stanford University, demonstrating that we could reduce sweat levels with the wearable form factor. Now we’re working on finalizing the product design of our glove for formal clinical testing.

Tell us about a major obstacle you encountered and how you overcame it.

To be most effective, the electrodes in the glove must provide full coverage of the hand so that we can treat the entire palm. But it's not that easy to design something that’s in contact with the palm at all times. Also, the user has to be able to operate the device with one hand [since the other hand is inside the glove], which is another technical challenge. We ended up having to make dozens of prototypes before finding a design we really liked. Perseverance was key.

“We ended up having to make dozens of prototypes before finding a design we really liked. Perseverance was key.”

What role did your Biodesign training play in enabling you to design, develop, and/or implement this solution?

This whole project came through the Biodesign process. It started with diligently understanding the need and gaps in the competitive landscape that ultimately led us to a novel solution. And had I not gone through the Stanford Biodesign training, I wouldn't have understood everything that’s involved in advancing a technology toward patient care or have the network of professional contacts to make it happen.

What advice do you have for other innovators about health technology innovation?

Where there’s a will, there’s a way. Get the help you need to make it happen.

Véronique Peiffer co-founded palmm out of the Biodesign Innovation Fellowship in 2016. To learn more, visit palmm online.    

Disclaimer of Endorsement: All references to specific products, companies, or services, including links to external sites, are for educational purposes only and do not constitute or imply an endorsement by the Byers Center for Biodesign or Stanford University.

The original palmm team, co-founders Véronique Peiffer and Justin Huelman.
Early prototypes of the technology.
The current wearable technology.
The palmm system.

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