Localized hyperhidrosis treated with aluminum chloride in a salicylic acid gel base

Abstract

A total of 238 patients with a clinical diagnosis of localized hyperhidrosis (HH) were treated on 332 anatomic sites (axillae, feet, hands, and groin). The purpose of the study was to evaluate the effectiveness of aluminum chloride hexahydrate (AC), in a salicylic acid gel base (SAGB) containing 4% salicylic acid (SA), for the treatment of localized HH. The SAGB was similar to a keratolytic gel, 1Keralyt® (Westwood Squibb). Because SAGB and anhydrous alcohol (AA), the standard vehicle for AC, have different consistencies, double blinding was not possible. Bromhidrosis (BH) was documented when present, whether of apocrine (axillae and groin) or eccrine (feet) origin. For the sake of uniformity, AC in SAGB was compounded by the same pharmacist. The concentration of AC varied from 10 to 40%, depending on the site to be treated. The improvement of HH was subjectively assessed through a questionnaire as follows: nil = no improvement; poor = <25%; fair = 25–50%; good = 50–75%; and excellent = >75%. Armpits: 20% AC was used to control axillary HH. When 20% AC failed to control HH, its concentration was gradually increased to 25% and, rarely, to 30%. When irritation occurred, the concentration of AC was decreased to 15 or 10%, and 1% hydrocortisone (HC) was added to the preparation. Patients were instructed to apply the medication initially 2–3 nights per week, gradually decreasing the frequency as required. When possible, only the active focal area of HH was treated. 2As with AC in AA, the medication was applied at bedtime. Patients were instructed to avoid rubbing and the application of the medication on recently shaved skin. Hands and feet: for these areas, the concentration of AC was 30% initially, but could be increased up to 40% if necessary. 3Application was daily at bedtime, and later at gradually longer intervals. Occlusion was never used.

Aluminum chloride 15% a hexahydrate in a salicylic acid 2% gel: A novel topical agent for hyperhidrosis with decreased irritation

“…This group was evaluated separately and also achieved similar results. 10 There are many possible reasons for improved efficacy with the combination formula. These include enhanced absorption of AC due to the keratolytic properties of salicylic acid and a possible synergistic effect with AC due to the astringent and antiperspirant properties of salicylic acid.…”

“…These include enhanced absorption of AC due to the keratolytic properties of salicylic acid and a possible synergistic effect with AC due to the astringent and antiperspirant properties of salicylic acid. [10][11][12] Finally, the gel formulation may improve hydration and mitigate the drying effect when compared to an alcohol solution. 10 Case 5 originally used a 12% AC solution with significant irritation.…”

“…[10][11][12] Finally, the gel formulation may improve hydration and mitigate the drying effect when compared to an alcohol solution. 10 Case 5 originally used a 12% AC solution with significant irritation. Interestingly, in this patient, a higher concentration of AC (15% gel) was well tolerated and effective.…”

Body malodours and their topical treatment agents

“…In an attempt to reduce skin irritation, salicylic acid was used in combination with ACH [5]. The formulation, consisting of aluminium salts and salicylic acid, had a reduced incidence of skin irritation and had good anti-bacterial and anti-fungal properties [53].…”

Hyperhidrosis: clinical presentation, evaluation and management

“…This irritation is thought to arise from the creation of hydrochloric acid upon mixing of sweat with the aluminum chloride, and may be limited by application of neutralizing baking soda, or hydrocortisone cream [22,23].…”