Aluminium Chloride Hexahydrate

• Primary Indication:
• Treatment of primary hyperhidrosis (excessive sweating), particularly of the axillae (underarms), palms, and soles.
• Additional Uses:
• Management of mild to moderate skin conditions characterized by excessive sweating and associated odor.
• Adjunct in controlling excessive sweating secondary to systemic causes when other measures are insufficient.
• Off-label Uses:
• Occasionally used to reduce sweat-related skin irritation or maceration in other body areas.

• Formulation: Typically available as a topical solution or roll-on containing 10–20% aluminium chloride hexahydrate.
• Adults:
• Apply to clean, dry skin once daily at bedtime for 1–2 weeks initially.
• Application should be on dry skin; allow to dry completely before covering or dressing.
• After initial control is achieved, frequency may be reduced to 2–3 times weekly for maintenance.
• Pediatrics: Safety and efficacy not well established; use with caution and under medical supervision.
• Elderly: Same as adults; monitor for skin irritation.
• Special Populations: No dose adjustment necessary; avoid use on broken or irritated skin.
• Administration Notes: Avoid shaving or applying immediately after shaving to prevent irritation; wash off in the morning if irritation occurs.

Aluminium chloride hexahydrate acts as a topical antiperspirant by precipitating and obstructing sweat gland ducts. It interacts with electrolytes in sweat to form a gel plug that physically blocks sweat flow. This temporary occlusion reduces sweat secretion from eccrine glands. Additionally, it may induce local atrophy of secretory cells, contributing to its prolonged antiperspirant effect.

• Absorption: Minimal systemic absorption occurs due to topical application and low skin permeability.
• Distribution: Localized action on sweat glands at the site of application.
• Metabolism: Not systemically metabolized to a significant degree.
• Elimination: Any absorbed aluminium is primarily eliminated via renal excretion.
• Onset of Action: Reduction in sweating usually begins within days of consistent nightly application.

• Pregnancy: Limited data available; topical use considered low risk but should be used only if clearly needed.
• Lactation: No sufficient data; minimal systemic absorption suggests low risk; caution advised especially if applied to breast area.

• Primary Class: Antiperspirant agent
• Subclass: Aluminium salt-based topical antiperspirant

• Known hypersensitivity or allergy to aluminium salts or any formulation excipients.
• Application on broken, irritated, or inflamed skin.
• Severe dermatologic conditions aggravated by topical agents.

• Potential for local skin irritation including redness, itching, and burning sensation.
• Avoid contact with eyes and mucous membranes.
• Discontinue use if severe irritation or allergic reaction occurs.
• Use cautiously in patients with sensitive or atopic skin.
• Avoid application immediately after shaving or waxing to minimize irritation risk.

• Common:
• Mild skin irritation, dryness, stinging, or burning sensation at the application site.
• Less Common:
• Contact dermatitis or allergic rash.
• Rare:
• Severe hypersensitivity reactions.

• No significant systemic drug interactions due to minimal systemic absorption.
• Concurrent use with other topical irritants may increase risk of skin irritation.

• Current dermatology guidelines continue to recommend aluminium chloride hexahydrate as a first-line topical treatment for primary hyperhidrosis.
• Emphasis on patient education for proper application to minimize adverse effects.
• Recent studies highlight the importance of avoiding use on broken or recently shaved skin to reduce irritation.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from excessive heat, moisture, and direct sunlight.
• Keep container tightly closed when not in use.
• Avoid freezing.