Seunga (Jasmine) Han, PharmD Student
Previously, we’ve covered a topic on excessive sweating (hyperhidrosis) and odorous sweating (bromhidrosis) to get a better understanding of what it is, what causes it, and what could be done to minimize it. If you haven’t already, make sure to check out that article first! Continuing with the very same topic, we’re going to take a different approach and take a look at some alternatives for you if these general approaches didn’t work.
Daily use of antiperspirants are often the go-to treatment to reduce sweating and body odour problems. It reduces sweat by blocking the sweat glands, causing the sweat to thicken and clump. When the glands get plugged, the body receives a signal to reduce or stop perspiration. It works the best for underarm sweating due to the ease of application, but it can also be applied to other areas such as: hands, feet, face, back, chest, and groin.
In terms of which antiperspirants you could use, first try using the standard commercial antiperspirants products which contain aluminum salts. These often last for 24 hours or longer with minimal irritation when used once or twice a day.
If this doesn’t work for you, you can step up the game and use “clinical strength” products which contain aluminum chloride or aluminum chloride hexahydrate. While they’re more effective as they create a deeper blockage, they can also be more irritating because of a chemical reaction that occurs when it comes in contact with water or sweat, forming hydrochloric acid. Therefore, it’s important to follow the instruction when using clinical strength products.
Tips on Applying Antiperspirants
For optimal benefits with these products, try the following tips!
- Apply at bedtime: All antiperspirants are more effective when applied at bedtime because sweat glands are less active, meaning more of the active ingredient can enter the sweat duct and create better plugs.
- Shower in the morning after bedtime application of antiperspirant: With aluminum chloride containing products, it’s recommended to wash off the product remaining on the surface of the skin to reduce any risk of skin irritation due to the aforementioned reaction. Depending on the severity of the irritation, hydrocortisone 1% cream may be used to ease the irritation. With standard products, it’s not as important, but it can be done without affecting the effectiveness of the antiperspirant.
- Do NOT occlude your skin: There is no evidence to suggest that this will increase the efficacy, but it will likely cause more harm (irritation) than good.
- Use the product continuously: This may allow you to use it less frequently over time, while maintaining its effectiveness.
- Apply 24 to 48 hours after shaving: This will help prevent any skin irritation especially with aluminum chloride products.
In addition to antiperspirants, there are a few other options that you can consider based on your needs.
- Deodorants are a good option if you have problems with body odour but not sweating. Aluminum or zinc containing products have antibacterial action which helps with the odour.
- Astringents such as formaldehyde, glutaraldehyde, methenamine, and tannic acid were used for hyperhidrosis in the past, but they are no longer used due to skin sensitivity and/or skin discolouration.
- OnabotulinumtoxinA injection is another option if you have primary hyperhidrosis, and antiperspirants didn’t work for you after a 1 month trial. It has been shown to reduce sweat production by 75 to 100% in two weeks, but you should start to notice the benefits as soon as 2 to 4 days. In Canada, it hasn’t been approved for use outside the underarm, but it has been used to treat hyperhidrosis of the hands, feet, face and groin. Even though the effects can last from 4 to 12 months, the treatment is painful and expensive. Also, its use is not recommended during pregnancy and breastfeeding and in patients with neuromuscular disorders.
- Glycopyrrolate is safe and effective when used topically, particularly for craniofacial hyperhidrosis for which there is the most evidence. It has also been used orally, but hyperhidrosis isn’t a Health Canada–approved indication.
- Oxybutynin has been used orally in patients with multifocal primary hyperhidrosis, compensatory hyperhidrosis, and in those for whom topical treatments, iontophoresis and onabotulinumtoxinA (or combinations of these), have not been successful. Use for hyperhidrosis is not a Health Canada–approved indication. Oral anticholinergics are not recommended in patients with glaucoma, impaired gastric emptying or urinary retention and may interfere with regulation of body temperature in situations where patients are at risk of becoming overheated as it may limit their ability to sweat for cooling purposes.
The Bottom Line
As always, we hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook or at firstname.lastname@example.org with your feedback. We’d love to hear back from you!