No one likes to sweat, but with hot, humid summer weather, it's difficult to avoid. And for patients with hyperhidrosis, a medical condition that causes excessive sweating, fighting perspiration becomes an important part of daily life. Fortunately, several kinds of antiperspirants are available to help. FDA defines an antiperspirant as âa drug product applied topically that reduces the production of perspiration (sweat) at that site.â Through its drug approval processes, FDA ensures that OTC antiperspirant products are safe and effective for topical administration. In contrast, deodorants are formulated to neutralize or mask underarm odor and do not prevent sweating. Because they don't contain an active ingredient such as aluminum, deodorants aren't regulated by FDA. Most antiperspirants use metallic salts, which temporarily plug the sweat ducts and reduce sweat on the skin surface. According to FDA, the product must contain an aluminum and/or zirconium salt that meets the aluminum to chloride, aluminum to zirconium, and aluminum plus zirconium to chloride atomic ratios described in the U.S. Pharmacopeia-National Formulary. Common examples include aluminum chloride, aluminum chlorohydrate, aluminum chlorohydrex polyethylene glycol, aluminum sesquichlorohydrate, aluminum zirconium octachlorohydrate, aluminum zirconium tetrachlorohydrex, and aluminum sesquichlorohydrex propylene glycol in concentrations of up to 20% or 25%. OTC products typically contain both antiperspirant and deodorant ingredients. Because aluminum salts can aggravate razor burn and cause skin irritation and acne, aluminum zirconium productsâwhich are less likely to cause irritationâare increasingly common. Both aluminum and zirconium salts precipitate when contact with sweat raises the skin pH, plugging the sweat glands and helping the skin to stay dry. It's best to apply antiperspirants at bedtime, when the skin is dry, and they have sweat-free time to work. Applying antiperspirant after a shower isn't nearly as effective, as the antiperspirant may slide off the skin and not reach the sweat ducts. Antiperspirants are available in stick, roll-on, lotion, spray, or wipe form. All of these products are effective at preventing perspiration and the formulation used is primarily personal preference. Some antiperspirant brands are marketed as âprescription strengthâ or âclinical strength,â which generally means the product contains either a slightly higher active ingredient concentration or use of one of the newer active ingredients that may be more effective. These products are typically far more expensive than regular strength products and are generally needed only for patients with hard to control hyperhidrosis. Additional nonactive ingredients contained in antiperspirants include parabens (as a preservative to keep the product free of bacteria); castor, mineral, or sunflower oil to allow smooth application; alcohol; polyethylene glycol distearates (emulsifiers); butylated hydroxytoluene, which slows the deterioration of the antiperspirant ingredients once they're exposed to oxygen; and talcum powder. Fragrances are also commonly added to antiperspirants to appeal to users, though fragrance-free products are also available. Scents such as lavender and rose are often used, but other, less-clear names such as âfresh scent,â âpowder fresh,â and âsport freshâ are also used, so it's important to smell before you buy. These fragrances may irritate some patientsâ skin. However, an antiperspirant that's labeled as âfragrance freeâ can still contain ingredients to which a patient may be sensitive, so it's best to check the label for common chemical irritants. Numerous products that don't contain the active aluminum and/or zirconium compounds are available, and some say they can prevent perspiration as well as odor. Because these products are considered cosmetics, they're not regulated by FDA and thus their effectiveness hasn't been independently verified. Speculation that the use of antiperspirants is associated with an increased risk of breast cancer continues to circulate. However, the American Cancer Society (ACS) and FDA have both concluded there is no credible scientific/medical evidence linking the use of antiperspirants to breast cancer. There has also been some concern about the use of parabens in antiperspirants because of their weak estrogen-like properties. However, according to the ACS, clinical studies have not shown any direct link between parabens and any health problems, and FDA has indicated that most major brands of antiperspirants and deodorants do not contain parabens. Those that do can easily be identified by reading the label.