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Aluminum chloride hexahydrate for excessive sweating

Aluminum chloride is used to treat excessive sweating (Hyperhidrosis) affecting the axillae, hands, and feet. Hyperhidrosis is a condition that is characterized by excessive sweating. It may be focal affecting mostly the armpits, palms, soles, or the face. Typically, generalised hyperhidrosis develops as a result of an underlying systemic condition like hyperthyroidism.

Causes of Hyperhidrosis (Excessive sweating) [Ref]:

Generalized hyperhidrosis

Focal Hyperhidrosis

Endocrine Hyperthyroidism
- Pheochromocytoma
- Carcinoid syndrome
- Menopause
- Pregnancy
- Hyperpituitarism
- Diabetes mellitus
- Acromegaly
Drugs
- Fluoxetine
- Venlafaxine
- Doxepin
Neurologic
- Cerebrovascular accident
- Parkinson’s disease
- Spinal cord injury
Cardiovascular
- Shock
- Heart failure
Malignant disease
- Hodgkin’s disease
- Myeloproliferative disorders
Infection
Respiratory failure
Toxicity
- Alcoholism
- Substance abuse

Primary idiopathic hyperhidrosis
Gustatory sweating (Frey’s syndrome)
Neurologic
- Neuropathies
- Spinal injury

Treatment of Hyperhidrosis includes:

Hyperhidrosis may be treated with topical treatments, iontophoresis, Botulinum toxin injection, surgery, or systemic treatments. However, topical treatment is the most commonly used modality of treatment. Aluminum salts such as aluminum chloride are the most commonly used OTC medicine for the treatment of hyperhidrosis. It mechanically obstructs the sweat glands reducing the secretion of sweat from the glands. The effects of aluminum hydroxide may be seen within three weeks after it is applied daily or on alternate days. Side effects of topical applications include stinging, burning, and itching. Systemic therapy includes drugs that block cholinergic transmission such as glycopyrrolate. One study evaluated the role of subepidermal injections of botulinum toxin in patients who were not responding to conventional therapy. Botulinum toxin was found effective, safe, and had a long-lasting effect [Ref].

Treatment of Hyperhidrosis [Ref]:

Medical
- Systemic:
  - NSAIDs: indomethacin
  - Tranquilizers: Diazepam)
  - Anticholinergics: Propantheline bromide, glycopyrrolate, oxybutynin, or benztropine mesylate.
  - Calcium-channel-blockers: diltiazem
  - Clonidine hydrochloride
- Topical:
  - 5% to 20% formalin solution
  - Antiperspirants: Drysol (aluminum hexahydrate in alcohol)
  - 10% glutaraldehyde
  - Anticholinergics
  - 2% to 5% tannic acid solution
Botulinum toxin
Electrical
- Iontophoresis
Surgical
- Liposuction
- Sympathectomy
- Excision of axillary sweat glands

Aluminum Chloride dose in adults:

Aluminum chloride should be applied once daily (at night) to dried skin.
It should be washed off the next morning. It should not be applied on wet skin and the patients should be advised not to take a bath prior to its use.
If symptoms improve, reduce the dose to an alternate-days application and then twice weakly.

Aluminum Chloride dose in children:

Not recommended in pediatric population

Use in Kidney disease:

Does not require any dose adjustment in renal disease

Use in Liver disease:

Does not require any dose adjustment in liver disease

How to apply Aluminum Chloride Solution:

It should be applied to dry skin at night.
The area should be covered with a plastic wrapping held in place by a skin-fitting T-shirt

Use in pregnancy & lactation:

It has not been recommended for use during pregnancy or lactation.
It is best not to be used over breasts or nipples by lactating moms.

Aluminum Chloride Side effects:

It should be used with caution in patients who are allergic to any of its components.
It may cause local skin irritation, burning, redness, itching and prickling sensation.
Avoid coming into contact with your eyes, damaged skin, and mucous membranes.
The patient should be advised not to use depilatories or shave the axillae within twelve hours of applying driclor.