WHAT ARE THE LOCAL TREATMENTS USED IN THE TREATMENT OF EXCESSIVE SWEATING?

Some topical agents used in the past in the treatment of hyperhidrosis (excessive sweating) (anticholinergic drugs, formaldehyde, tanning agents) are no longer widely preferred due to low efficacy and side effects. Instead, more effective and tolerable agents are used.

Topical Agents Used

Boric Acid and Tannic Acid Solutions:
Tannic acid or boric acid solutions of 2-5% can be used.
Potassium Permanganate Bath:
In our clinic, a 0.1% potassium permanganate bath is applied for 10 days in the treatment of hyperhidrosis. After this treatment, a powder containing boric acid, talc and zinc oxide is used for a certain period of time.
Formaldehyde and Glutaraldehyde:
Formaldehyde reduces sweating by closing the sweat pores. However, it is short-acting and can cause skin sensitivity.
Glutaraldehyde is used especially on the soles of the feet and usually causes a temporary brown coloration. It is generally not effective for the axillary (armpit) area.

Methenamine Mandelate:
This antibacterial agent, effective for mild to moderate hyperhidrosis, reduces sweating by converting to formaldehyde. It can be applied 3 times a week and rarely causes allergic reactions.
Treatment with Metal Salts

Aluminum salts are antiperspirant substances commonly used in the treatment of hyperhidrosis. These substances reduce sweating by physically blocking the sweat glands and are more effective when applied at night.

Method of Application:

In the treatment of axillary hyperhidrosis, a 20% aluminum chloride hexahydrate solution in absolute alcohol is applied to dry skin before going to bed at night.

Treatment is usually started for 2-7 days and continued if necessary after sweating is under control.
To reduce irritation, the skin can be washed in the morning, 1% hydrocortisone cream can be applied or cleaned with carbonated water.
Advanced Application:

Aluminum chloride solution is covered with plastic sheeting and a 6-8 hour occlusion is applied. With this method, sweating can be reduced by up to 50% in a few days.
Hand and Foot Applications:

Concentrations of up to 30% may be required on the hands and feet. Treatment is continued regularly starting 3-5 nights a week. A plastic sheet can be sewn into gloves or socks for easier use.
Side Effects and Warnings

Stinging, burning, itching and irritation are common during treatment with aluminum salts.
Rarely, contact dermatitis may develop.
Since long-term use can cause atrophy in the sweat glands, treatment frequency should be reduced over time.
Treatment Success Rates:
The success rate in axillary hyperhidrosis is over 90%. However, it has disadvantages such as staining of fabrics.

Local antiperspirants offer an effective and easily applicable treatment option in controlling mild to moderate hyperhidrosis. However, in cases of severe hyperhidrosis, switching to other treatment methods may be necessary.