Dosing of Drysol (Aluminum Chloride) External Solution for Hyperhidrosis
For hyperhidrosis treatment, Drysol (aluminum chloride hexahydrate) solution should be applied to completely dry skin at bedtime, left on for 6-8 hours, and washed off in the morning.
Standard Dosing Protocol
Concentration and Application Schedule:
- Drysol is typically available as a 20% aluminum chloride hexahydrate solution in absolute alcohol 1
- Initial application: Apply nightly for the first week
- Maintenance: Apply 2-3 times weekly as needed 2
Application Method:
- Ensure skin is completely dry before application
- Apply a thin layer to affected areas at bedtime
- For enhanced effect in palmar/plantar hyperhidrosis: Cover with plastic wrap after application 1
- Leave on for 6-8 hours (overnight)
- Wash thoroughly in the morning
Dosing by Anatomical Location
Axillary (Underarm) Hyperhidrosis:
- Apply thin layer to completely dry axillae
- No occlusion needed
- Most responsive to treatment
Palmar (Hand) Hyperhidrosis:
- Requires more aggressive treatment approach
- Traditional method: 6-8 hour application of higher concentrations (20-30%) 3
- Alternative: Consider 4-day course of iontophoresis with 1% aluminum chloride for more persistent results 3
Plantar (Foot) Hyperhidrosis:
- Similar to palmar protocol
- Occlusion with plastic wrap may enhance efficacy
Efficacy and Response Assessment
- Onset of action: Most patients report reduced sweating within 48 hours of first application 4
- Duration of effect: Effects typically last 24-48 hours after discontinuation 4
- Response measurement: Reduction in Hyperhidrosis Disease Severity Score (HDSS) by at least 1 point indicates clinical improvement 2
Managing Side Effects
The most common side effect is skin irritation, which can be managed by:
- Starting with less frequent applications (every other night)
- Using lower concentration formulations initially
- Applying topical corticosteroids for irritation
- Consider newer formulations with 15% aluminum chloride in 2% salicylic acid gel base for reduced irritation while maintaining efficacy 5, 2
Special Considerations
- Avoid application to broken, irritated, or recently shaved skin
- Do not apply immediately after showering/bathing
- If severe irritation develops, discontinue use until skin heals
- Long-term use may lead to miliaria (heat rash) with exertion in some patients 1
For patients who fail to respond to aluminum chloride therapy or cannot tolerate it due to irritation, alternative treatments such as botulinum toxin injections, iontophoresis, or surgical interventions should be considered.