Antiperspirants
The treatment of hyperhidrosis with OTC antiperspirant products is usually the first method employed by those who suffer with this condition. There are no currently marketed
antiperspirants that are explicitly designed or claim to have a beneficial effect on excessive sweating. As stated earlier the FDA has not approved any marketed OTC antiperspirant product for an excessive sweating condition. In addition, all the currently marketed OTC antiperspirant products are explicitly labeled to be used only in the axilla and are not approved for any other body location. The FDA has, however, remained open to a claim for the treatment of excessive sweating if data are submitted for their review for this claim (12).
The currently marketed OTC antiperspirant products most likely offer only marginal effectiveness to those who suffer from hyperhidrosis. Because this condition is so socially devastating, a large number of those who suffer with hyperhidrosis seek the advice of a health professional (12,14).
There are prescription drug solutions available for those who seek medical treatment for their condition. These prescription products usually contain aluminum chloride concentrations greater than those which have been established as safe and effective in the final OTC antiperspirant monograph. These higher concentration products are usually recommended to be used at bedtime to allow for maximum absorption at a time when sweating may be at a minimum for the day. They are typically applied nightly for three nights under the occlusion of plastic wrap. The plastic wrap occlusion traps perspiration in the armpit and hydrates the skin enhancing penetration of the aluminum chloride solution, which increases efficacy. After this initial treatment period, the plastic wrap occlusion is discontinued and the aluminum chloride solution is only applied every other night for a week and then twice weekly for a week. Patients are advised to keep decreasing the frequency of aluminum chloride application until the minimum application frequency to maintain sweating control has been determined. Applications at this frequency are continued indefinitely as the aluminum chloride only decreases axillary sweating temporarily.
The higher concentrations of aluminum chloride can be more irritating to the skin than OTC antiperspirant products. These higher concentrations have also been known to be harmful to fabrics, and therefore caution should be used about clothing worn during treatment (12).
Other treatment options are also available to those who suffer with hyperhidrosis. These treatments include some of the following.