Topicals: -Try First. Often Effective and Inexpensive. Technique Important:
Aluminum salts: Aluminium chloride or aluminium chloride hexahydrate at 1-4%, combined with deodorant, is the most common ingredient in standard under-arm anti-perspirants. Hyperhidrosis requires greater concentrations. To minimize irritation, these stronger products are best applied at bedtime. Be certain the skin is dry, as these products may irritate moist skin. If tolerated, a second application in the morning is beneficial. Start slowly with a low concentration and increase as tolerated. These products may take a few days to take effect.
Examples are: Xerac AC 6.5%, Certain Dri Pads 12.5%, Hydrosal 15% +2% salicylic acid, Drysol 20%. A pharmacist can increase percentages, but local irritation is limiting. Adjust concentration to the skin area. ie: full strength on palms and soles but mild on the face. Gloves or Saran wrap at night, over palms and soles, increases penetration and results. Skin irritation can be reduced by hydrocortisone 1% cream (non-prescription in USA but prescription in Canada) or non-prescription hydrocortisone ½ % cream.
Topical glycopyrrolate( Secure Pads 1-3%):---particularly for the face. Available at www.pharmacy.ca (1-800-727-5048); 311 Sherbourne Street (at Gerrard), Toronto, Ontario, M5A 3Y1. (Please inform us of other distributors). Studies from Britain and South Korea, showed these pads to be effective for facial and scalp sweating. Several of our patients have confirmed this. Studies on other body areas are lacking. Systemic absorption of glycopyrrolate can occur, so read instructions carefully ;--and read the section below on the oral form.
Glutaraldehyde 10% aqueous for feet is available in many pharmacies, and can be applied to the feet by cotton swabs daily, or a few times a week. May be effective, but it produces brownish discolouration, which impairs summer use.