Gel Antiperspirants for Hidradenitis Suppurativa: A Pilot Study

Abstract

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory condition predominantly affecting intertriginous areas. Despite its association with sweat, the role of deodorants and antiperspirants in HS remains poorly defined, with many patients avoiding their use due to concerns about irritation.

Methods: After experiencing personal clinical improvement with a gel-based aluminum salt antiperspirant, a dermatology resident began recommending similar gel-based aluminum salt antiperspirants to patients with Hurley stage I HS. Outcomes were tracked in seven patients. Additionally, a TikTok video was posted discussing gel antiperspirant use in HS, and user comments describing personal experiences were reviewed. A literature review was later conducted using PubMed, Scopus, and Web of Science.

Results: All seven patients experienced complete resolution of axillary HS lesions after initiating gel antiperspirants, including those who had failed previous treatments. Among 16 TikTok commenters who described their experiences, 94% reported disease improvement or clearance with gel or spray antiperspirants, while only 6% reported worsening with spray and/or gel antiperspirant. The literature revealed limited evidence, with three prior studies cautioning against antiperspirants despite some data suggesting spray and gel vehicles may be better tolerated than solid sticks.

Conclusion: Gel antiperspirants containing aluminum compounds appear safe, well-tolerated, and effective for managing or use in mild HS. These findings challenge prior concerns about antiperspirant use and suggest that product vehicle plays a key role in symptom control. Spray and gel formulations are preferable to solid sticks, and laser hair removal is favored over shaving. Prospective studies are warranted to formalize hygiene guidelines in HS management.