2017 HCHB_digital

CONTINUING OTC EDUCATION
• tuberculosis or other infections.
Initial assessment
Offer customers suffering from hyperhidrosis some practical advice (see Advice
for customers) and discuss the difference between antiperspirants and
deodorants. Antiperspirants reduce the release of sweat, deodorants only contain
a fragrance to mask unpleasant smells. Deodorant crystals which have natural
antibacterial or antifungal properties to limit odour-causing bacteria may also be
considered as a “natural” alternative to chemical products; however, they will not
decrease sweating.
Explain that strong antiperspirants are usually applied at night and washed
off the next morning. Warn customers that aluminium antiperspirants can stain
clothing.
Treatment
Antiperspirants usually contain an aluminium salt such as aluminium chloride,
aluminium chlorohydrate, or aluminium zirconium. Aluminium zirconium tends to
be better tolerated by the skin and less likely to cause irritation or aggravation
after razor use. In low concentrations, aluminium ions cause a temporary closure
of the sweat glands, reducing the amount of sweat produced, but reapplication
is often needed.
In the higher concentrations used for hyperhidrosis, aluminium can cause a
more long-lasting closure and ultimately shrink the sweat gland, decreasing the
amount of sweat it can produce. Ensure strong aluminium chloride or zirconiumbased
antiperspirants are used exactly as directed. Most recommend to apply the
product once at night for a set period of time, then to decrease the frequency
of use. Sometimes aluminium salts are combined with salicyclic acid to enhance
penetration.
Customers who have tried strong antiperspirants with limited success may
need referral to a doctor for tests to exclude secondary causes or to try other
types of therapy which may include:
anticholinergic medication (eg, glycopyrrolate, oxybutynin) which helps
prevent the stimulation of sweat glands
beta-blockers for stress-induced sweating
botox (Botulinum toxin type A) – used for severe underarm sweating,
temporarily blocks the nerves that stimulate sweating
endoscopic thoracic sympathectomy – involves cutting of the nerve that
stimulates sweat production. More effective for palm sweating
iontophoresis – a procedure that uses a gentle current of electricity to
temporarily turn off the sweat gland (most effective for sweating of the hands
and feet)
removal of the sweat glands by liposuction, curettage, microwave thermolysis
or surgery.
Refer to
PHARMACIST
The following questions aim to identify customers who would
benefit from further input from a pharmacist. Your initial assessment
may have already provided some answers. Decide if any further
questions still need to be asked and refer any “yes” answers to a
pharmacist.
• Does the person have any other health conditions (eg, heart or
lung problems, immunosuppression, diabetes, is pregnant or
breastfeeding)?
• Does the person take any other medication, either prescribed by a
doctor or bought from a shop or supermarket (including herbal/
complementary medications)?
• Does the sweating most often occur during sleep?
• Is the sweating accompanied by other symptoms such as fever,
weight loss, chest pain, shortness of breath, or a rapid heartbeat?
• Is the sweating occurring in a child without the effects of heat or
physical exercise?
• Is the excessive sweating a new occurrence in an adult?
• Is the person allergic to any topical ingredients?
Advice for customers
• Avoid clothes that show up sweat marks more easily.
• Wear loose-fitting clothing, made of natural fibres (avoid Lycra or nylon).
• Use a soap-free cleanser.
• Dress shields (also known as armpit or sweat shields) can help absorb excess
sweat and protect delicate or expensive clothing.
• Look up the International Hyperhidrosis Society’s website for more information,
support, or to purchase products (www.sweathelp.org).
• See Foot Care for advice for people with excessively sweaty feet.
Now you can complete
your ENHANCE modules on
your phone or tablet
www.pharmacytoday.co.nz
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