Antiperspirants are considered the first line of treatment for excessive sweating of the underarms, hands, feet, and sometimes face. They are called the first line of treatment because they are the least invasive and experts recommend that they be tried first, before other more invasive treatments. They are also inexpensive and easy to use-even when following our tips!
Antiperspirants are applied to the top of the skin (which is why you sometimes hear them called "topical" treatments). Once an antiperspirant is applied to the skin, perspiration in the underarm grabs and dissolves the antiperspirant particles, pulling them into the pores and forming superficial plugs that are just below the surface of the skin. When your body senses that the sweat duct is plugged, a feedback mechanism stops the flow. The plugs can stay in place at least 24 hours and then are washed away over time.
Antiperspirants are available either over-the-counter (OTC) or by prescription from your healthcare provider.
Over-the-counter antiperspirants are now available in different strengths with “clinical” strength products offering the most sweat protection (but at a higher cost). Clinical strength products seem to provide improved sweat reduction compared to traditional over-the-counter antiperspirants, and with less skin irritation than prescription products.
The most widely used active ingredients in antiperspirants are metallic salts. Clinical strength antiperspirants contain higher concentrations of active ingredients than “regular” strength over-the-counter antiperspirants (for example, two antiperspirants might contain the ingredient aluminum zirconium tricholorohydrex, but the clinical strength version might contain a concentration that is 25 percent higher.)
Prescription and specialty antiperspirants often contain aluminum chloride hexahydrate as an active ingredient. These are among the most effective antiperspirants, but can cause skin irritation if instructions aren’t followed precisely. Typically, aluminum chloride hexahydrate concentrations of 10% to 15% are recommended for excessive sweating of the underarms. For managing sweaty hands or sweaty feet, higher concentrations are needed - usually around 30%.
In general, experts recommend a systematic approach to combating hyperhidrosis with antiperspirants. Start with the most gentle-to-the-skin formulations (traditional over-the-counter products) and progress to clinical strength over-the-counter antiperspirants, and then try stronger and stronger products (such as prescription formulations) until relief is found. A number of antiperspirant makers support the work of the International Hyperhidrosis Society (IHhS) and are focused on the needs of hyperhidrosis sufferers. You can find out more about these companies and their products as well as discount offers on our Fan Faves page. (If antiperspirants aren’t effective enough, iontophoresis for hands and feet and/or Botox injections for hands, feet, underarms, face/scalp, and more, are the common next steps.)
Avoiding skin irritation is the key to success with antiperspirants, prescription and non-prescription alike: follow the product’s instructions, follow your dermatologist’s recommendations, apply at night before bed as opposed to only in the morning, and apply to completely dry skin.
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(Special note: As of Feb. 1, 2021, if you experience excessive sweating in your underarms, you may be able to join the “Cardigan Study”, a clinical research study taking place across the United States assessing an investigational topical drug for axillary hyperhidrosis (excessive sweating in the underarms). Learn more and see if you are eligible.)