So do high tech sounding ingredients, low-tech "back-to-basics" approaches and a plethora of decidedly not-dermatologist-friendly ingredients. Know your sweating physiology, what really works (and doesn't) and why. Staying dry, fresh and confident can be just a quick roll-on away.

Only Make Believe?

If you are searching for a product that is going to keep you dry, don't be fooled by the labeling. Antiperspirants and deodorants are not necessarily the same. Believing a product labeled merely as a "deodorant" to be a cure-all solution may create an unpleasant surprise. A deodorant is technically a product that leaves a pleasant smell upon the skin and is meant to mask body odor. It doesn't necessarily contain an antiperspirant, the ingredient that works to keep everything dry. Also, it doesn't always hide the smell. To top it off, you may be allergic to all that fragrance.

To truly remain dry, an antiperspirant is essential. Antiperspirant ingredients fall under the auspices of the FDA. Categorized as over-the-counter (OTC) drugs, antiperspirants must comply with a lengthy FDA monograph, essentially a list of rules describing the exact types and levels of active approved antiperspirant ingredients, allowable claims and packaging requirements. Only ingredients that have gone through rigorous testing and study can apply for FDA approval.

Don't know what you're looking for as an antiperspirant ingredient? Traditionally, aluminum chloride and aluminum chlorohydrate have been the actives des jour. However, aluminum in these forms can be irritating to the skin, cause acne and aggravate razor burn. The newest generation ingredient, Aluminum Zirconium Tetrachlorohydrex Glycine, is much better tolerated by the skin and less likely to cause irritation or acne.

Allowable Antiperspirant Active Ingredients

Aluminum Chloride
Aluminum Chlorohydrate
Aluminum Chlorohydrex Polyethylene Glycol Complex
Aluminum Chlorohydrex Propylene Glycol Complex
Aluminum Dichlorohydrate
Aluminum Dichlorohydrex Polyethylene Glycol Complex
Aluminum Dichlorohydrex Propylene Glycol Complex
Aluminum Sesquichlorohydrate
Aluminum Sesquichlorohydrex Polyethlene Glycol Complex
Aluminum Sesquichlorohydrex Propylene Glycol Complex
Aluminum Sulfate Buffered
Aluminum Zirconium Octachlorohydrate
Aluminum Zirconium Octachlorohydrex Glycine Complex
Aluminum Zirconium Pentachlorohydrate
Aluminum Zirconium Pentachlorohydrex Glycine Complex
Aluminum Zirconium Tetrachlorohydrate
Aluminum Zirconium Tetrachlorohydrex Glycine Complex
Aluminum Zirconium Trichlorhydrate
Aluminum Zirconium Trichlorohydrex Glycine Complex
Aluminum Zirconium Trichlorohydrex Glycine Complex
Aluminum Sulfate Buffered with Sodium Aluminum Lactate

An antiperspirant works by blocking the sweat ducts, preventing sweat from reaching the skin's surface. Aluminum (whether combined with chloride or zirconium) is soluble as long as the formulation is acidic. Once applied to the skin, contact with sweat raises the pH, causing the complex to precipitate out and plug the glandular opening.

More is not always better. The FDA has set ranges that each active ingredient must comply with, but these are fairly generous. Thinking that more of one makes for a better antiperspirant than a product with less of the same ingredient may make sense, but it doesn't always make for a good choice of antiperspirant. The base an antiperspirant is in may alter the amount of "active" actually left upon the skin once applied.

In fact, a small amount of a more highly concentrated antiperspirant may be more irritating than a large amount of a more diluted formulation. Increasing the concentration of the aluminum antiperspirant ingredient increases the acidity of the material, which increases irritation of the skin. This is why an individual with sensitive skin might better tolerates a liquid roll-on than a stick or powder roll-on.

All too often patients are left to sort out the antiperspirant dilemma. Eventually some will filter in to see the dermatologist, which is a pale representation of the real problem faced by today's consumer.

Delicate underarm skin is a set-up to experience bad reactions to many products available on the market. Three major complicating factors involve the actual body architecture of the underarm region. First of all, the epidermis is thinner in this region, making it vulnerable to developing allergic reactions to a host of contact allergens. The underarm area is warm and moist, the ideal site for bacteria and yeast to thrive which complicates control of body odor. Finally, this area is under occlusion, meaning skin lies upon skin, driving any product or treatment deeper into the epidermis, making seemingly mild treatments more potent and potentially more irritating.

Who's at risk for developing a reaction to an antiperspirant? Anyone prone to eczema, sensitive skin concerns, suffering from razor burn, regional friction, acanthosis nigricans, diabetes or has a known contact, fragrance or dye allergy.

The ideal antiperspirant contains few ingredients (limiting exposure to potential irritants), is free of fragrance and dyes, is in an aqueous base (unlikely to parch or inflame delicate skin), doesn't leave an unsightly white residue and contains Aluminum Zirconium Tetrachlorohydrex Glycine. The latter ingredient is far less likely to inflame the skin, lead to acne or aggravate skin irritations already present. Naturally, the product should be thoroughly dermatologist and allergy tested and approved to insure it is suitable for the most sensitive patients.

Years of complaints from consumers and patients about the lack of acceptable options inspired our development of DERMAdoctor’s Total NonScents Ultra-Gentle Antiperspirant, the solution for the thousands of consumers searching for a truly skin-friendly antiperspirant.

But, what about all of those patients who've already experienced their irritation and inflammation due to ongoing skin concerns and aggravating deodorant or antiperspirant choices?

Irritation and inflammation routinely yield undesirable dark skin discoloration. The odds go up the darker one's baseline skin tone is and the length of time they’ve been confronted by the condition.

Anybody suffering with unsightly underarm darkness usually avoids wearing clothing that exposes the area so it's unlikely that the condition is commonly seen in public. Embarrassment prevents discussion about this problem. But, underarm discoloration, the aftermath of poor product selection and/or ongoing skin concern, is extremely common.

Most prescription options for bleaching hyperpigmented skin are more irritating when used in the underarm area, making the discoloration even worse. And they typically don’t include an antiperspirant. So, I chose to blend my Ultra Gentle antiperspirant with something to help brighten discolored skin with continued use. Kojic dipalmitate is a known, powerful botanical skin brightener. Unlike traditional kojic acid, kojic dipalmitate remains stable and effective in an aqueous (water) base. DERMAdoctor Total NonScents Ultra-Gentle Brightening Antiperspirant addresses, improves and helps eliminate embarrassing underarm discoloration. It's such a unique concept for solving this problem.

Don't Sweat About Body Odor

Dew, glow, perspiration are all pretty names for one distinctively unpleasant and inconvenient part of daily life...sweating. Intended as Nature's natural thermostat, sweating is meant to cool the core body temperature whenever heat, infection, activity, anxiety or emotion conspire to cause overheating. But sweating can be excessive, contribute to infection and lead to offensive body odor. That's why antiperspirants were developed.

Sweat is mostly water with tiny amounts of urea, salt, sugar and ammonia. Two types of sweat glands exist. "Classic" sweat is produced by the eccrine sweat glands distributed over the entire body. Unconscious triggering of the sympathetic nervous system releases the messenger enzyme acetylcholine, in turn causing the eccrine glands to release sweat onto the surface of the skin.

Using an antiperspirant will prevent body odor, right? The answer is yes, but not always.

Eccrine sweat is initially odorless, unless tainted by the stray problematic spice, garlic, alcohol, metabolic disorder or medications, which may transiently leach into the sweat. Since sweat itself lacks fragrance, it is really the presence of sweat that begins the cascade of odor-causing events. Sweat softens epidermal keratin, a move which itself can create smell. Bacteria feed upon stale eccrine sweat and softened keratin worsening the rancid smell. Macerated skin (moist, white, often tender skin) tends to develop in body fold areas. Protected, hot, damp skin is ripe for allowing continued growth of bacteria as well as yeast that further complicate the malodorous situation.

Apocrine glands have a limited distribution, located strictly around the breasts, in the axillae and the groin. A few apocrine elements also exist around the eye and ear areas. These glands do not produce much fluid; their primary function is to generate pheromones. While advertisers may leave you thinking pheromones exist solely to romantically attract a mate, in reality they make that "personal scent" that most of us find displeasing. They are primarily responsible for causing body odor, medically known as bromhidrosis.

Apocrine sweat is broken down by Corynebacterium that normally reside upon the skin. The result of the bacteria digesting and breaking down the secretions are strong-smelling short-chain fatty acids. The more bacteria present or the higher the level of apocrine sweat production, the worse the offensive odor can be.

Factors that must then be addressed are how to keep the area dry, thus inhospitable to bacteria, and how to normalize the bacterial counts.

Antiperspirants are the obvious choice to keep skin dry. In cases of medically excessive sweating (hyperhidrosis), the use of drionics, oral anticholinergic medication (Robinol) or injections of Botox may be necessary.

Hyperhidrosis most commonly affects the face, underarms, palms, soles of the feet, areas under the breast, cleavage and groin areas. DERMAdoctor MED e TATE Antiperspirant Wipes provide you with a blissfully dry existence with a single stroke of a towelette. They alleviate the need for cumbersome anti-sweating devices, ineffective topical prescriptions, drowsiness-inducing Rx meds and costly and painful Botox injections or invasive surgery.

Eliminating overgrowth of bacteria and yeast further controls the problem. Washing with an antibacterial cleanser is a good start. Prescription topicals like Erythromycin Solution or Cleocin T help prevent Corynebacterium from flourishing. Candida yeast that have taken advantage of hot, moist conditions can be controlled through the use of drying agents such as Zeasorb-AF Antifungal Powder, allowing air to circulate and topical anti-yeast preparations such as Miconazole or Nizoral.

Clothing continues to carry odor-producing bacteria until washed. Stench can actually build upon worn articles of clothing that have come into contact with sweat (particularly shirts and blouses). So, don't forget to launder shirts after each wear.

Don't let wetness, odor concerns or skin sensitivities get the better of you. With a bit of inspiration, you can reduce the ill effects of perspiration!

Audrey Kunin, M.D.

This content is sponsored by DERMAdoctor. The author receives compensation for its creation. All content is the legal copyright of DERMAdoctor, Inc, and it may not be used, reprinted, or published without written consent.

The information provided is for entertainment purposes only and is not intended to provide medical, legal or other professional advice.