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Abstract:  Up to 1% of the population suffers from hyperhidrosis, a disorder characterized by excessive sweating. Topical therapies may be the most practical and common treatment; however, many agents that have proven useful in clinical trials are not available as commercial products. The compounding pharmacist can significantly affect patient care by compounding unavailable items and suggesting alternative therapies to patients with refractory disease and in whom first-line agents have failed. The author discusses anticholinergics, aluminum chloride hexahydrate, local anesthetics and formaldehyde and related agents. Formulations for Glycopyrrolate 1% Cream (for 100 g) and for Methenamine 5% Lotion (for 100 mL) are provided. The author concludes that topical treatment should be the first line of therapy and that pharmacists can sometimes assist patients with agents such as glycopyrrolate and methenamine, which are effective and cause less skin irritation than aluminum chloride. In addition, pharmacists should advise patients with refractory hyperhidrosis that some treatment options are more permanent than topical therapy; severe cases may be treated with iontophoresis, botulinum toxin or surgery.

Related Keywords: aluminum chloride hexahydrate, antichoinergics, formaldehyde, hyperhidrosis, local anesthetics, localized hyperhidrosis

Related Categories: DERMATOLOGY

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