Topical therapy for focal hyperhidrosis, or antiperspirant treatment, can be carried out with chemicals of several different classes—astringent agents, topical anticholinergics, local anesthetics, and aluminum and other metallic salt solutions. The general population in industrialized nations uses over-the-counter antiperspirants for cosmetic control of underarm sweating and odor, but patients with moderate-to-severe hyperhidrosis need stronger therapy. Prescription products as well as specially compounded solutions are often needed for these patients, but are not always effective. Other than aluminum chloride, many of the topical agents reviewed are not available commercially or do not have U.S. Food and Drug Administration approval for the treatment of hyperhidrosis.
Topical treatments for hyperhidrosis include: aluminum chloride, anticholinergics and local anesthectics (including 2018-FDA-approved topical anticholinergic wipes), and astringent agents.