Deodorant use and related adverse effects: A cross-sectional survey among Palestinian students.

Background: Deodorants are widely used to mask unpleasant body odors. They are reported to cause some adverse effects depending on the form and ingredients. The purpose of this study was to assess the prevalence of deodorant use and related adverse effects among Palestinian students. Methods: This cross-sectional study was carried out at An-Najah National University from Aug 2018 to Mar 2020. A questionnaire was constructed using a Google survey form. All analyses were done using SPSS 21.0, Fisher test was used for comparative analysis and the P-value < 0.05 was considered as statistically significant. Results: A total of 554 students participated in the study. About 93% of the participants were using deodorants and adverse effects were reported by 25% of the participants. The reported adverse effects were itching (26%), coloration (25%), sneezing (21%), and eye redness (8%). Only 4.1% of the participants visited a physician for counselling regarding various adverse effects. Conclusion: Deodorants were widely used by Palestinian students with reported adverse effects, but these side effects rarely prompted the participants to seek medical advice.

Exploring the Potential Link between Aluminum-Containing Deodorants/Antiperspirants and Breast Cancer: A Comprehensive Review.

The potential association between aluminum-containing deodorants/antiperspirants and breast cancer has been investigated and debated. This paper comprehensively analyzes existing literature to examine the evidence and provide insights into this relationship. This comprehensive review discusses aspects related to the absorption and distribution of aluminum compounds, its effects on the induction of oxidative stress, the estrogenic activity of aluminum, and potential disruption of hormonal pathways, and the potential role in breast cancer induction. Currently, available research, consisting of epidemiological studies as well as clinical trials, together with meta-analyses and previously published reviews conducted on identifying the relationship between aluminum-containing deodorants/antiperspirants and the risk of breast cancer were also analyzed and discussed. Societal factors, personal hygiene considerations, and lifestyle changes contribute to the increased usage of antiperspirants, but they do not establish a direct causal connection with breast cancer. Further research employing larger-scale studies and rigorous methodologies must validate the existing findings and explore the underlying mechanisms involved. Continued multidisciplinary research efforts and collaboration between researchers, regulatory bodies, and public health authorities are vital to developing a more definitive understanding of this complex topic.

Uso de antitranspirante en pacientes en tratamiento de radioterapia por cáncer de mama / Use of antiperspirant in patients undergoing radiotherapy treatment for breast cancer / Uso de antitranspirante em pacientes submetidos a tratamento radioterápico para câncer de mama

Patients who are diagnosed with breast cancer face multiple challenges and fears: from the diagnosis, the acceptance of the diagnosis and the beginning of the treatments, as well as the side effects that they entail, the most worrying for the patients being the possible anatomical alterations due to surgery, alopecia due to chemotherapy treatment, and radiodermatitis due to radiant treatment. A systematic review was carried out in MedLine/Pubmed following the PRISMA 2020 criteria on the use of antiperspirant during radiant treatment in the axilla and its relationship or not with the increase in acute adverse effects. Based on the analysis of the results of this search and with emphasis on: dosimetric aspects, psychological impact, treatment acceptance, feeling of well-being and adherence. We justify its use.

As pacientes diagnosticadas com câncer de mama enfrentam múltiplos desafios e medos: desde o diagnóstico, a aceitação do diagnóstico e o início do tratamento, bem como os efeitos colaterais que estes acarretam, o mais preocupante para as pacientes são as possíveis alterações anatômicas devidas à cirurgia, alopecia devido ao tratamento quimioterápico e a radiodermatite devido ao tratamento radiante. Foi realizada uma revisão sistemática no MedLine/Pubmed seguindo os critérios do PRISMA 2020 sobre o uso de antitranspirante durante o tratamento radiante na axila e sua relação ou não com o aumento dos efeitos adversos agudos. Com base na análise dos resultados desta busca e com ênfase em: aspectos dosimétricos, impacto psicológico, aceitação do tratamento, sensação de bem-estar e aderência. Justificamos seu uso.

Las pacientes que son diagnosticadas con cáncer de mama se enfrentan a múltiples desafíos y temores: desde el diagnóstico, la aceptación del mismo y el inicio de los tratamientos, así como los efectos secundarios que ellos conllevan, siendo los más preocupantes para las pacientes las posibles alteraciones anatómicas por cirugía, la alopecia por el tratamiento quimioterápico, y la radiodermitis por el tratamiento radiante. Se realizó una revisión sistematizada en MedLine/Pubmed, Google Académico, EMBASE, SciELO y Epistemonikos, siguiendo los criterios PRISMA 2020 del uso de antitranspirante durante el tratamiento radiante en axila y su relación o no con el aumento de efectos adversos agudos. En función del análisis de los resultados de dicha búsqueda y con énfasis en: aspectos dosimétricos, impacto psicológico, la aceptación al tratamiento, el sentimiento de bienestar y la adherencia. Justificamos su uso.

Topical glycopyrronium tosylate in Japanese patients with primary axillary hyperhidrosis: A randomized, double-blind, vehicle-controlled study.

Glycopyrronium tosylate cloth, an anticholinergic drug, has been approved for the topical treatment of primary axillary hyperhidrosis in the USA, but its effects in Japanese patients have not been previously investigated. This 4-week, randomized, double-blind, vehicle-controlled, multicenter study was conducted to evaluate the efficacy and safety of glycopyrronium tosylate cloth for primary axillary hyperhidrosis patients in Japan. Eligible patients, who were ≥9 years of age and had primary axillary hyperhidrosis ≥6 months, with gravimetrically-measured sweat production ≥50 mg/5 min, and Hyperhidrosis Disease Severity Scale ≥3 (moderate) were randomized 1:1:1 to once daily topical glycopyrronium tosylate 3.75%, 2.5%, or vehicle. Overall, 497 patients (163 in the glycopyrronium tosylate 3.75% group, 168 in the glycopyrronium tosylate 2.5% group, and 166 in the vehicle group, hereinafter in this order) were randomized. Statistically higher proportions of patients in the glycopyrronium tosylate groups achieved ≥2-point improvement in Hyperhidrosis Disease Severity Scale and ≥50% reduction in sweat production from baseline versus vehicle at week 4 (51.6%, 41.1%, and 16.4%, respectively; p < 0.001 in both cases). Higher responder rates in the glycopyrronium tosylate groups compared with the vehicle group occurred as early as week 1. The most common treatment-emergent adverse events in patients treated with glycopyrronium tosylate were photophobia, mydriasis, thirst, and dysuria. Most treatment-emergent adverse events were mild as determined by the investigators. The incidence of treatment-emergent adverse events leading to treatment modification was low in the three groups. The 4-week use of topical glycopyrronium tosylate improved the patient-reported outcome measure Hyperhidrosis Disease Severity Scale and objectively-evaluated sweat production with a favorable benefit/risk profile.

Review of aluminum, paraben, and sulfate product disclaimers on personal care products.

BACKGROUND: Product disclaimers listed on personal care products face limited regulation. These disclaimers may be helpful or may mislead the public. OBJECTIVE: Review the evidence supporting the potential harms of 3 compounds commonly addressed by product disclaimers: parabens, aluminum, and sulfates. METHODS: Reported cases of adverse events to these compounds were identified. Trends in allergic contact dermatitis reactions to chemicals used in place of these compounds were also identified. RESULTS: There is limited evidence that parabens and aluminum pose a threat to human health; there is even less evidence that topical sulfate-containing products pose a danger to consumers. In the setting of paraben avoidance, there has been a steady increase in cases of allergic contact dermatitis to preservatives that are more allergenic, specifically the isothiazolinones. LIMITATIONS: Assessment of the toxicology of these compounds is ongoing and may change with new data. CONCLUSION: There is limited evidence that parabens, aluminum, and sulfates used in personal care products pose a health risk. There is evidence that avoidance of parabens has resulted in an epidemic of allergic contact dermatitis to isothiazolonine preservatives.

Aluminum Content of Human Milk and Antiperspirant Use.

Background: Aluminum exposure may originate from numerous sources, including antiperspirants. Aluminum toxicity can cause a wide range of neurological impairments. Infants are exposed to aluminum through human milk (HM), formulas, total-parenteral-nutrition and vaccines. Due to potential risk of toxicity to both infants and women, it has been advised that lactating women decrease their use of aluminum-based products and antiperspirants. Our study aimed to determine whether the use of aluminum-based antiperspirants (ABA) affects aluminum levels in HM. Methods: This cross-sectional study included healthy mothers who exclusively breastfed infants (1 week to 5 months). Questionnaires were used to collect data on demographics, antiperspirant use and aluminum exposure. Mothers were instructed to express HM during the morning at first breastfeeding session. Aluminum levels were measured by atomic absorption spectrometry with a 5 ppb limit of detection. Results: Fifteen of the 58 (26%) recruited mothers used an aluminum-free antiperspirant (AFA) and 43 (74%) used an ABA. The range of aluminum concentration in HM was 0-100.8 µg/L (mean 11.4 ± 17.4 µg/L). The median aluminum level (Q1-Q3) was 6.5 µg/L (5.2-11.9) and 5.2 µg/L (3.46-9.4) in the AFA and ABA groups, respectively (p = 0.19). The aluminum levels were not affected by maternal age, education, diet, number of children, infant age, lactation stage or self-reported aluminum exposure. Conclusion: The data from this preliminary study demonstrate that the use of an ABA by lactating mothers does not increase their HM aluminum content. Additional studies with a larger cohort are warranted to confirm these findings.

Efficacy and tolerability of 20% aluminum sesquichlorohydrate vs 20% aluminum chloride for the treatment of axillary hyperhidrosis: A randomized controlled trial.

This study evaluated the efficacy and tolerability of topical aluminum sesquichlorohydrate (AS) when compared to aluminum chloride (AC) as a treatment for primary axillary hyperhidrosis (PAH). Twenty subjects were included in this randomized, controlled, split-side 8-week study. All participants applied 20% AS and 20% AC lotions in their axillae (one treatment per axilla) every night for 2 weeks; next, the application was reduced to three times a week for 4 weeks. The assessment was performed using the sweating intensity visual scale (SIVS), hyperhidrosis disease severity score (HDSS), patient satisfaction score, and the appearance of adverse effects on weeks 0, 1, 2, 4, 6, and 8. Both AS as well as AC application showed positive results, significantly differing from the baseline, as assessed using SIVS, HDSS, and patient satisfaction score at every follow-up visit; however, no significant difference was observed between the AS and AC groups at any follow-up visit. The mean time of response was 1.14 weeks for both treatments. A side effect was observed in one subject (5%), who reported itching on the AC axilla. The therapeutic effects persisted even after reducing the frequency of application and lasted for at least 2 weeks after cessation of use. In conclusion, topical 20% AS demonstrated similar efficacy to topical 20% AC in the treatment of PAH, with a high safety profile.

Serum analysis in women and in vitro skin assay for the assessment of exposure to parabens in antiperspirants.

The present study assessed the exposure to methylparaben (MP) and propylparaben (PP) from antiperspirants in serum of 24 women aged 20-30 years old and an in vitro skin assay. An effective liquid chromatography-tandem mass spectrometry method for the determination of MP and PP levels in serum was developed and validated in the range of 10-100 µg/L; the method was fast, simple, sensitive, linear, precise, and accurate. In addition, a simple and rapid liquid chromatography-ultraviolet detection method for the determination of MP and PP levels in antiperspirants was developed and validated in the range of 2-26 mg/L, which presented satisfactory linearity, precision, and accuracy. Using these two methods, 20 commercial antiperspirants were evaluated, and only three showed MP and PP in the formulation. The antiperspirant containing 0.2% and 0.1% w/w MP and PP, respectively, was given to the volunteers, to estimate the internal dose, and submitted to a pig ear skin permeation assay in Franz diffusion cells, presenting a permeation flux of 32% for MP and 71% for PP. In this assay, both MP and PP permeated the skin; however, there was no correlation between antiperspirant use and paraben serum concentration in the volunteers. Graphical abstract.

The Treatment of Primary Focal Hyperhidrosis

Primary focal hyperhidrosis is a relatively common disease that has a significant impact on afflicted patient's quality of life. The pathogenesis of the disease is thought to stem from increased cholinergic activity on eccrine sweat glands. Topical aluminum chloride based antiperspirants are good first-line agents for all affected body sites. Anticholinergic agents are emerging as effective topical alternatives. Iontophoresis passes an electrical current through the skin and is an excellent treatment option for palmoplantar disease. Botulinum toxin type A injections remain a mainstay second-line treatment. Local procedural advances including microwave thermolysis, laser therapy and focused ultrasound are emerging as safe and effective alternatives for refractory disease. Oral anticholinergics are generally well tolerated and can also be used for intractable disease. Last-line interventions include local surgical options and sympathectomy, though some patients may prefer permanent treatment. Further investigation of novel treatments as well as ways to optimize existing therapeutic options are needed.

The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Therapeutic options.

Hyperhidrosis (HH) is a chronic disorder of excess sweat production that may have a significant adverse effect on quality of life. A variety of treatment modalities currently exist to manage HH. Initial treatment includes lifestyle and behavioral recommendations. Antiperspirants are regarded as the first-line therapy for primary focal HH and can provide significant benefit. Iontophoresis is the primary remedy for palmar and plantar HH. Botulinum toxin injections are administered at the dermal-subcutaneous junction and serve as a safe and effective treatment option for focal HH. Oral systemic agents are reserved for treatment-resistant cases or for generalized HH. Energy-delivering devices such as lasers, ultrasound technology, microwave thermolysis, and fractional microneedle radiofrequency may also be utilized to reduce focal sweating. Surgery may be considered when more conservative treatments have failed. Local surgical techniques, particularly for axillary HH, include excision, curettage, liposuction, or a combination of these techniques. Sympathectomy is the treatment of last resort when conservative treatments are unsuccessful or intolerable, and after accepting secondary compensatory HH as a potential complication. A review of treatment modalities for HH and a sequenced approach are presented.

Avoiding antiperspirants during breast radiation therapy: Myth or sound advice?

Breast cancer patients are typically advised to avoid antiperspirants for fear of increasing radiation dermatitis in the axilla. We hypothesized that antiperspirants would have minimal effect on skin dose. We found no difference in surface dose±antiperspirants using 6MV photons at gantry angles of 0°/30°/60°/90° regardless of aluminum concentration.

Manejo médico de la hiperhidrosis / Medical management of hyperhidrosis

La hiperhidrosis es un aumento patológico de la sudoración, que puede asociarse a patologías médicas y fármacos, afectando en forma significativa la calidad de vida. La hiperhidrosis focal primaria es una patología común, cuyo manejo es un desafío. Están disponibles múltiples terapias para el tratamiento de hiperhidrosis, incluyendo productos tópicos, iontoforesis, toxina botulínica, fármacos sistémicos, cirugía y nuevos equipos para destrucción selectiva de las glándulas sudoríparas. El propósito de este artículo es revisar la literatura, enfocándose en las terapias no quirúrgicas y opciones de tratamiento emergentes.

Hyperhidrosis is a pathological excessive sweating. It can be associated with medical conditions or drugs and affect significantly the quality of life. Primary focal hyperhidrosis is a common disorder for which treatment is often a therapeutic challenge. Multiple therapies are available for the treatment of hyperhidrosis, including topical products, iontophoresis, botulinum toxin, systemic medications, surgery and new devices aimed at the destruction of ecrine glands. The purpose of this article is to review the literature, with a focus on non-surgical therapies and emerging treatment options.

Breast Cancer and Deodorants/Antiperspirants: a Systematic Review.

BACKGROUND: Over the last decade, the possible association between underarm deodorants/ antiperspirants use and breast cancer risk has raised important interest in the scientific community. The objective of our systematic review is to estimate the pooled risk of deodorants/antiperspirants use for breast cancer. METHODS: All observational studies that evaluated the association between breast cancer risk and deodorants/antiperspirants use were reviewed. We have only identified two case-control studies, carried out between 2002 and 2006. RESULTS: The first study was conducted in USA and investigated the possible relationship between use of products applied for underarm perspiration and the risk for breast cancer in women aged 20-74 years. This population-based case-control study gathered information by in-person interview. The second study was conducted in Iraq and investigated the possible relationship between use of antiperspirants and the risk for breast cancer in women attending a teaching hospital. This study also gathered information by in-person interview. There was no risk of antiperspirants use in the pooled risk (odds ratio 0.40, 95% confidence interval 0.35-0.46). CONCLUSION: Our comprehensive search has identified an insufficient number of studies to conduct a quantitative review and obtain reliable results. Further prospective studies are strongly needed.

Aluminium chloride promotes tumorigenesis and metastasis in normal murine mammary gland epithelial cells.

Aluminium salts, present in many industrial products of frequent use like antiperspirants, anti-acid drugs, food additives and vaccines, have been incriminated in contributing to the rise in breast cancer incidence in Western societies. However, current experimental evidence supporting this hypothesis is limited. For example, no experimental evidence that aluminium promotes tumorigenesis in cultured mammary epithelial cells exists. We report here that long-term exposure to concentrations of aluminium-in the form of aluminium chloride (AlCl3 )-in the range of those measured in the human breast, transform normal murine mammary gland (NMuMG) epithelial cells in vitro as revealed by the soft agar assay. Subcutaneous injections into three different mouse strains with decreasing immunodeficiency, namely, NOD SCID gamma (NSG), NOD SCID or nude mice, revealed that untreated NMuMG cells form tumors and metastasize, to a limited extent, in the highly immunodeficient and natural killer (NK) cell deficient NSG strain, but not in the less permissive and NK cell competent NOD SCID or nude strains. In contrast, NMuMG cells transformed in vitro by AlCl3 form large tumors and metastasize in all three mouse models. These effects correlate with a mutagenic activity of AlCl3 . Our findings demonstrate for the first time that concentrations of aluminium in the range of those measured in the human breast fully transform cultured mammary epithelial cells, thus enabling them to form tumors and metastasize in well-established mouse cancer models. Our observations provide experimental evidence that aluminium salts could be environmental breast carcinogens.

Evaluation of Human Exposure to metals from some popular brands of underarm cosmetics in Nigeria.

The concentrations of metals (Cd, Pb, Ni, Cr, Cu, Co, Fe, Mn, Zn and Al) were determined in thirty brands of popular of underarm cosmetics in Nigeria with a view to providing information on the levels of metals and the risk of exposure to metals by humans through long time usage of these products. The concentrations of metals in these samples of underarm cosmetics were measured by using atomic absorption spectrometry after acid digestion. The concentrations of metals in these types of underarm cosmetics studied ranged from <0.15 to 1.2 µg g(-1)Cd, <0.02 to 11.2 µg g(-1)Pb, <0.03 to 4.9 µg g(-1)Ni, <0.1 to 25.0 µg g(-1), <0.02 to 2.8 µg g(-1)Co, 2.0 to 6.4 µg g(-1)Cu, 4.7 to 91.2 µg g(-1)Fe, <0.05 to 14.1 µg g(-1)Mn, 77.9 to 132 µg g(-1) and 69.2 to 83,500 µg g(-1)Al. The results of this study indicate that Cd, Pb, Ni, Cr and Co were presents in these types of underarm cosmetics at concentrations below the regulatory control limits for metal impurities in color additives for cosmetics and suggested limits following good manufacturing practice. The estimated margin of safety (MoS) indicated that the concentrations of the examined metals in these underarm cosmetic products present no potential risk to the users. The continuous use of these brands of underarm cosmetics represents a potential source of human exposure to metals such as aluminum in the local area of the breast, particularly to the upper outer quadrant.

[Management of hyperhidrosis]. / Prise en charge d'une hyperhidrose.

Hyperhidrosis continues to be undertreated in our view, despite its propensity to considerably impair quality of life. We shall break down therapeutic approaches to hyperhidrosis into several steps: (a) determine the physiological causes of excess sweating; (b) establish the type of hyperhidrosis involved and screen for causes of secondary hyperhidrosis before diagnosing essential hyperhidrosis; (c) evaluate the severity of the hyperhidrosis by means of a validated scale (HDSS score), Minor's starch-iodine test or gravimetric analysis; (d) select one of the medical therapies currently available, i.e. topical therapy (antiperspirants, iontophoresis or botulinum toxin injection), systemic therapy (oxybutynin) or surgery (thoracic sympathectomy).

Systematic review of potential health risks posed by pharmaceutical, occupational and consumer exposures to metallic and nanoscale aluminum, aluminum oxides, aluminum hydroxide and its soluble salts.

Abstract Aluminum (Al) is a ubiquitous substance encountered both naturally (as the third most abundant element) and intentionally (used in water, foods, pharmaceuticals, and vaccines); it is also present in ambient and occupational airborne particulates. Existing data underscore the importance of Al physical and chemical forms in relation to its uptake, accumulation, and systemic bioavailability. The present review represents a systematic examination of the peer-reviewed literature on the adverse health effects of Al materials published since a previous critical evaluation compiled by Krewski et al. (2007) . Challenges encountered in carrying out the present review reflected the experimental use of different physical and chemical Al forms, different routes of administration, and different target organs in relation to the magnitude, frequency, and duration of exposure. Wide variations in diet can result in Al intakes that are often higher than the World Health Organization provisional tolerable weekly intake (PTWI), which is based on studies with Al citrate. Comparing daily dietary Al exposures on the basis of "total Al"assumes that gastrointestinal bioavailability for all dietary Al forms is equivalent to that for Al citrate, an approach that requires validation. Current occupational exposure limits (OELs) for identical Al substances vary as much as 15-fold. The toxicity of different Al forms depends in large measure on their physical behavior and relative solubility in water. The toxicity of soluble Al forms depends upon the delivered dose of Al(+3) to target tissues. Trivalent Al reacts with water to produce bidentate superoxide coordination spheres [Al(O2)(H2O4)(+2) and Al(H2O)6 (+3)] that after complexation with O2(•-), generate Al superoxides [Al(O2(•))](H2O5)](+2). Semireduced AlO2(•) radicals deplete mitochondrial Fe and promote generation of H2O2, O2 (•-) and OH(•). Thus, it is the Al(+3)-induced formation of oxygen radicals that accounts for the oxidative damage that leads to intrinsic apoptosis. In contrast, the toxicity of the insoluble Al oxides depends primarily on their behavior as particulates. Aluminum has been held responsible for human morbidity and mortality, but there is no consistent and convincing evidence to associate the Al found in food and drinking water at the doses and chemical forms presently consumed by people living in North America and Western Europe with increased risk for Alzheimer's disease (AD). Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of AD or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic. Aluminum exposures during neonatal and pediatric parenteral nutrition (PN) can impair bone mineralization and delay neurological development. Adverse effects to vaccines with Al adjuvants have occurred; however, recent controlled trials found that the immunologic response to certain vaccines with Al adjuvants was no greater, and in some cases less than, that after identical vaccination without Al adjuvants. The scientific literature on the adverse health effects of Al is extensive. Health risk assessments for Al must take into account individual co-factors (e.g., age, renal function, diet, gastric pH). Conclusions from the current review point to the need for refinement of the PTWI, reduction of Al contamination in PN solutions, justification for routine addition of Al to vaccines, and harmonization of OELs for Al substances.

Topical therapies in hyperhidrosis care.

Primary focal hyperhidrosis affects 3% of the US population; about the same number as psoriasis. More than half of these patients have primary focal axillary hyperhidrosis: sweating that is beyond what is anticipated or necessary for thermoregulation. Most topical therapies are based on aluminum salts, which work by a chemical reaction that forms plugs in the eccrine sweat ducts. Topical anticholinergics may also be used. Instruction on proper methods and timing of antiperspirants enhances effect and may be effective alone or in combination with other treatments in patients with hyperhidrosis.

Resources for hyperhidrosis sufferers, patients, and health care providers.

The excessive sweating of hyperhidrosis creates profound psychosocial, professional, and financial burdens on the individual sufferer; it contributes to impaired self-worth and self-efficacy, decreased satisfaction in all relationships, avoidance of specific careers, and increased expenditures on everything from clothing to medical treatment. Despite morbidity equal to other well-known dermatologic conditions, hyperhidrosis has historically been underacknowledged and undertreated because of the lack of accessible, scientifically accurate information and dispersal of that information within patient and medical communities. Thankfully, the development of the Internet and the work of the not-for-profit International Hyperhidrosis Society (IHHS) have increased awareness of hyperhidrosis.