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Writer's pictureDr. Erum Ilyas

Antiperspirants and Deodorants | Understand the difference

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What is the difference between an antiperspirant and a deodorant?



The words antiperspirant and deodorant are good to differentiate. Antiperspirants are products used to block or reduce overall sweating, ultimately reducing the amount of sweat produced.
Deodorants are products used to mask the odor. They do not actually stop or alter the amount of sweat produced, they simply mask the odor that develops as a result of sweating. The odor from sweat is the result of bacteria acting on sweat to produce an odor. Some deodorants may contain ingredients such as baking soda to absorb sweat. However, they are not actually stopping the sweat. Think of deodorants as “perfume for your pits”.


The recipe for odor is sweat + bacteria = odor. If there was no sweat, chances are there would be reduced or no odor. Also, If no bacteria then no or reduced odor. By not addressing the sweat itself, deodorants are left to focus on altering the scent emitted from the underarms. The challenge is that even if a product has a particular scent, once applied to the underarms, the scent may be altered based on the odor produced by sweat and bacteria. In addition to the fact that the sweat is not altered.


 

 



​Recipe for odor SWEAT + BACTERIA = ODOR

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Is there research to support that aluminum-based antiperspirants are bad for you?


I often hear marketing for natural deodorants focused on giving the impression of a health risk associated with their competitors. The implication they are making is attempting to link the development of breast cancer with antiperspirant use. There are actually limited to no human studies that support a verified link between breast cancer and aluminum-based antiperspirants.

So where did this claim come from? The theory is based on the notion that most breast cancers are found in the upper outer quadrant of the breast. The thought was that maybe if women who shave their underarms and use antiperspirants introduce more aluminum into their bodies as a result of minor nicks. It's easy to see how this theory takes off because at first glance it appears to make logical sense. However, epidemiological studies (these are studies that measure the prevalence of a disease in the population) have not shown any difference in the incidence of breast cancer between women who use and do not use antiperspirants. Also, remember that based on this theory, women should theoretically have breast cancer in both breasts given that few if any women use antiperspirants under only one arm.

This all being said there are a few laboratory studies in mice that show a possible link. It's obviously difficult to say how relevant this is to humans. It is also difficult to explain if a link truly exists between antiperspirants and breast cancer, then why breast cancer tends to be unilateral (occurring in one breast first) as opposed to bilateral (both sides) when it presents.

 


 




Are natural deodorants better than antiperspirants? Do natural antiperspirants exist?


Natural deodorants and antiperspirants do not serve the same function and cannot be compared for their tasks directly. The reality, however, is that consumers consider them interchangeable leading to expectations that may not be met when it comes to sweat reduction.
“Natural antiperspirants” do not technically exist. Most products marketed for this purpose contain cornstarch, baking soda, and essential oils. These ingredients do not stop sweating. Instead, they absorb sweat in an attempt to keep the area dry.
True antiperspirants that contain aluminum salts physically block the sweat ducts to prevent sweat secretion. Glycopyrrolate is a class of topical and oral medications called anticholinergics to reduce the amount of sweat produced used in prescription antiperspirant formulations.


Those that get frustrated with natural products seem to struggle with persistent sweating that is difficult to control.
Due to the difference in how these products work, I cannot find a study that says that natural antiperspirants are better. This is simply not really a fair comparison. Aluminum salts and glycopyrrolate will clearly perform better simply because they reduce the overall amount of sweat produced. Practically speaking, most people find that natural antiperspirants have improved over the years but can still be somewhat unpredictable in terms of effectiveness simply because their effectiveness depends on how much they can keep up with the overall sweat produced.


 


 


How can I make the switch to a natural deodorant?

Natural deodorants have become so popular but they take a lot of getting used to. Natural deodorants work by masking the smell of sweat. They do not block the sweat itself. This is where it takes some getting used to. In the first weeks of use, it is common to hear complaints of a damp feeling. The first thing to remember is that time alone will make this seem less uncomfortable. If you have been used to the dryness that comes from traditional antiperspirants, this will simply be a whole new feeling to get used to.
Sometimes the damp feeling can start to turn into sweat stains on your clothes. Unfortunately, it's not always easy to be prepared for this. Although using powders or witch hazel on a cotton swab can help, it's not always practical to find these when you are at work or in a restaurant for dinner.
Are there any tips or tricks to address the potential damp feeling from natural deodorants?
A quick fix to help evaporate the excess dampness when needed is to apply hand sanitizer directly or on a tissue and then swipe across your underarm. These tend to be everywhere these days, easy to use and they tend to dry quickly.
Wearing clothing that wicks away moisture helps as well. Moisture-wicking textiles can help wick away some moisture to avoid it from building up under the arm making the area feel damp. Athletic wear or performance gear commonly uses this but other clothing will often have it as well. Some clothing even has antimicrobial qualities by weaving silver in the textile to help with the odor while adapting to these deodorants.

 


 


Are there common rashes to see under the arms?

Rashes that I see develop under the arms are helpful to breakdown by cause:
Irritant contact dermatitis: Think red, itchy, scaly.. irritation can occur with natural deodorants that have too high a concentration of baking soda. Look for products that have a lower concentration of baking soda or options without baking soda. The essential oils in these products can also lead to contact dermatitis. To figure out if it could be the oils, it helps to swatch the product on your inner forearm and see if a rash develops after a day or two. If it does you may have a sensitivity or allergy to one of the ingredients.
Intertrigo or candida/yeast infections: Think red, glossy, peeling from edges, and sometimes pus bumps along edges (just like a diaper rash). Whenever we alter the pH of our skin, we change the bio flora (the community of good and bad bacteria and yeast that live on our skin) and sometimes yeast can overgrow. If you start to feel that the area is somewhat raw and uncomfortable it can help to use a little cortisone cream with an over-the-counter anti-yeast cream for a couple of days. If it doesn’t get better you may need to see your doctor to help clear this.
Heat rash/ chafing: This develops from the extra moisture, the skin can start to feel raw as well. If this is the case, wearing clothing that can wick this moisture away will help.
Folliculitis: Folliculitis is a bacterial infection that occurs in the hair follicles. With the bio flora change, sometimes bacteria can overgrow. When we shave we can spread the bacteria in this area. This will look different than the other rashes because the bumps will be based around hair follicles and look like pus bumps that get crusty and scabby. It can help to start with an over-the-counter anti-bacterial cream and change your razor.



Does it help to constantly reapply a natural deodorant throughout the day?

It may not help to keep reapplying natural deodorants throughout the day to help them work. Repeated applications of these products do not necessarily make them kick in faster. What may help is to try to work with how they work. As they are trying to improve the bio flora under your arms, gently exfoliating once weekly with a washcloth or gentle scrub can help remove excess bacteria. Washing with a charcoal acne cleanser under your arms a couple of days a week can even help during your showers. The charcoal can draw out impurities and the salicylic acid in these products can provide a little chemical exfoliation to help. It is also important to make sure your skin is dry before applying. They are much less effective on damp or wet skin.
These products do not work overnight! If you are committed to the switch then set your expectations to understand that these will take a few weeks to really kick in. I have read so many reviews that talk about how someone tried one product one week, another the next, and so on. Of course, these will rate poorly – a week is not going to cut it! It’s hard to get used to a new normal but our bodies are incredibly able to adapt to our habits and environment. I try to convince patients to cut out various products from their skincare routines to minimize what our skin is exposed to. The first few weeks can feel like something is missing. Then, suddenly, you just cannot remember why you used these products in the first place.

What are crystal deodorants? Are they as effective as natural deodorants?

Crystal deodorants form a mineral layer on the skin to prevent the overgrowth of odor-causing bacteria. Although traditional aluminum chloride is not found in this product, there is a different type of aluminum compound in these. Because it can take a few days for this to change the bacterial environment under the arms, it may not be as effective initially on odor but can gain effectiveness over time by reducing bacterial overgrowth.
The only case reports in the medical literature on crystal deodorants are reflective of some of the irritant reactions to the product.

If you are looking for an alternative to traditional antiperspirants, this is a reasonable option to try. Although still focused primarily on odor and not reducing sweat, many do find it is effective as a deodorant.

It is always such a difficult question as to whether it is worth the hype. The answer is completely based on the patient’s perspective. The overall answer is that it really has not been shown in epidemiological studies that breast cancer and traditional antiperspirants have a connection. Alzheimer's is clearly a big unknown in terms of etiology and also not definitively linked to antiperspirant use as well. (I have even published with a colleague a possible connection between untreated Lyme and Alzheimers- this potential link has nothing to do with antiperspirants).

What do you use?


Personally, I have a family history of breast cancer and I use traditional antiperspirants. I have not seen convincing data to support trying other options. I have tried natural products and find them to be unpredictable in terms of effectiveness. Some days they work, some they don’t.
That being said, it is important to do what makes you feel best. If you have a personal concern then by all means this is why the alternative market exists. These products can help those looking for a reasonable option.


What should I do if I cannot find an effective product for sweating?


If you are not seeing enough improvement from a natural option or over-the-counter options, it is worth discussing your options with your dermatologist. Dermatologists can offer alternative topical, oral, and/or injectable options as well as laser interventions. The other topical prescription ingredient to consider is glycopyrrolate. This is also available as an oral medication for those with extensive sweating concerns. The option is considering botulinum toxin injections under the arms to reduce sweat for 6 to 9 months.


Can deodorants stop working?



It’s not uncommon for people to feel as though their deodorant is no longer as effective as it once was.
If a deodorant stops working, either there is more sweat than before or more or different bacteria in the area. How can you tell which is the trigger?

  • If there is more sweat, then the result will be a “damp” feeling along with the odor.

  • If there is more odor then generally people will feel “dry” but know there is an odor.

  • If there is a damp feeling we have to re-evaluate our game plan with sweat production itself. We either increase the strength of the antiperspirant or choose an alternate method of blocking sweat.

  • If there is a dry feeling with an associated odor, then it may help to choose one of a few options. Either change up your scent choice, consider an antibacterial soap or lotion for a week or two to cut down on bacterial overgrowth, or consider using a mild scrub in the shower to gently exfoliate any buildup of bacteria.

Can I develop an allergy to my deodorant?

It is possible to develop an allergy to your antiperspirant or deodorant over time. There is a distinction, however, between a true allergy and an irritation.


 


 

A true allergy suggests that one of the ingredients has triggered an immune response. This can look or feel almost like poison ivy - red, itchy, swollen, and perhaps even some blisters. This is referred to as allergic contact dermatitis.

An irritation can often occur at varying times from antiperspirants if they over-dry. This can lead to dry irritated skin. The medical term for this is irritant contact dermatitis.
If there is an excessively dry sensation resulting in the constant sensation of itching, it is possible your antiperspirant is so effective that it overdries your skin so much that it is actually irritating your skin. In this case, the masking scent of deodorant is not necessarily the trigger and we would just adjust the antiperspirant ingredient or concentration choice.

If you see a rash in what we refer to as the ‘axillary vault’, this is the area we rub the deodorant on directly, that appears pink, swollen, crusty, and itchy then you may have developed a reaction to the scent or another ingredient used. There are so many essential oils used in deodorants that it is possible to develop an allergy to these products over time with repetitive use. To test this, it helps to swatch the product on your inner forearm and see if a reaction develops. It’s not a perfect test but can show a rash where you swatched to diagnose true allergic contact dermatitis.
The other possible rash that I see here is folliculitis. Bacteria can find their way onto our razors, get into our hair follicles and infect them. It’s often misinterpreted as a reaction to our products. The key to diagnosis here is that the rash is concentrated around the hair follicles with the potential for pus bumps. This will require a trip to your dermatologist for possible antibiotics, topical and/or oral.

How do you choose a deodorant for kids and teens?


Before discussing natural deodorants for kids and teens, I think it is very important to first discuss that the best choice revolves around the day-to-day needs of your child. Natural deodorants are again just that: "perfume for your pits". They do not provide the much-needed antiperspirant coverage that this age group may benefit from socially.

If you are seeking a natural deodorant that is aluminum-free then it is important to read the label to make sure the ingredients are all-natural. A common ingredient that is used to neutralize odors is eucalyptus oil. Often times arrowroot powder, baking soda, and kaolin clay are added to absorb sweat. Coconut oil, vitamin E, and Shea butter can be found to help the products moisturize and soothe the skin. The main caution with these ingredients would be the baking soda- a common rash I encounter is the reddish-brown discoloration that can be sore and itchy under the arms. This is most often a result of baking soda.

Are kids and teens different from adults when it comes to sweating?


Kids and teens can be more unpredictable with their sweat patterns with excess sweating known as hyperhidrosis is more commonly diagnosed in teens and preteens and young adults. Their skin can be a bit more sensitive at times to products as well so being cautious about the ingredients used can help.

What are things to avoid in natural deodorant? What makes some better than others?


I tend to have my patients be cautious with baking soda as an ingredient. It’s not harmful per se but it can be really irritating to the skin.
Lots of fragrances added to a product can be pretty uncomfortable for sensitive skin types as well. Remember that natural deodorants are deodorants NOT antiperspirants. This is an important distinction because they do not stop people from sweating. They only work by trying to absorb sweat and neutralize odors.

Is sweat-wicking technology in clothing good for teens and kids?


The concept behind sweat or moisture-wicking technology is to pull moisture away from the skin. This is achieved by absorbing or pulling the moisture into the fabric away from the skin, migrating the moisture through the fabric to the outer layers so it can evaporate from there. This allows the moisture from sweat to not accumulate close to the skin.
You will see moisture wicking quite often in athletic wear as it has become quite popular. Since I study functional textiles I find this to be brilliant as it avoids a chemical finish and focuses on the manufacturing of the textile to achieve this effect.

Kids and teens often get acne and skin issues--what should I look for in natural deodorant to support this?


Breakouts associated with the use of natural deodorants may be linked less to traditional acne and more to a change in the ‘bio flora’ of the skin. With yeast and bacteria present in these areas they may be inclined to overgrow and cause their own irritation.
It can help to exfoliate under the arms once a week to remove residue buildup from products. Remember that since they do not stop sweating they just absorb it, there can be a build-up of product that develops over time. Using a sugar scrub, an apricot scrub, or a clean washcloth can help to gently clean this area once weekly to remove any buildup.

Do you have any recipes for DIY natural deodorant?


Many people seeking natural deodorants seek out recipes for at-home preparations to simply have a better sense of what is going into their product.


Here is a recipe for a baking soda-based natural deodorant if you would like to make one at home. There are options without baking soda that can involve a few more steps. I will post one of these in a future post. The challenge with baking soda is that it can be more effective to keep the area dry however it is also associated with certain types of rashes. Some of my patients that have challenges with baking soda-based natural deodorants find that they can get a red-brown discoloration in their underarm area. This is temporary and not permanent.

DIY Natural Deodorant 1/4 cup baking soda 1/4 cup cornstarch 1/4 cup coconut oil (keep some extra to add to help the consistency of the final product to help it spread easily) 5-10 drops of essential oil (I used Lavender in my video!) Mix these together and apply a thin layer under the arms. Add a little extra coconut oil if needed to help it spread easily.



What is an armpit detox?


An armpit detox is a method of attempting to treat the underarm skin of “toxins” and product buildup. The belief of those that support this concept is that it may help treat the bacteria under the arms to help your deodorants or antiperspirants work more effectively.

Do armpit detoxes work?

The concept of an “armpit detox” is not that far off base, however, the reasons given to consider one by those that support this concept may not be the right ones. I have had patients tell me that they hear that an armpit detox “rids the body of toxins” or “helps lymphatic drainage”. First off, I cannot find any studies that support this type of reasoning. I have also heard from patients that they feel that they should treat the bacteria under the arms to help with the deodorant efficacy. This is also a challenging concept to support without studies to verify.
That being said, it is true that part of the mechanism of action of traditional aluminum-based antiperspirants is the plugging of sweat ducts through precipitates created. The use of aluminum-based antiperspirants does result in a reduction in the number of bacteria under the arms which likely contributes to less odor.
Deodorants used in isolation without antiperspirants, according to studies, do not have a significant impact on the number of bacteria. These bacteria can impact the ability of deodorant to work effectively simply because the scent of the deodorant may interact with the odor from the bacteria to alter the odor released.
Aside from bacteria, there is also hair growth, the possible impact of shaving or other forms of hair removal, and the potential for ingrown hairs. The consideration of gently exfoliating the axillae once weekly can help smooth out areas of keratin and sebum buildup, product removal, and an attempt to reduce bacterial overgrowth. This process could potentially help antiperspirants and/or deodorants be more effective.

Do you have a recipe for a DIY armpit detox?


Most DIY recipes call for one part bentonite clay to one part apple cider vinegar (ACV).
Clay in a detox mask is usually added to help draw excess oil or sebum away from the skin.

At full concentrations, ACV is effective topically against bacteria, yeast, and fungus. By diluting the ACV, it does lose some effectiveness. However, at the one-to-one ratio, it appears to retain activity against yeast. ACV is slightly acidic. Our hair is also naturally acidic from the oils and sebum from our scalp. Antiperspirants and deodorants often disrupt the pH balance of our hair. By using ACV, the theory is that the normal acidity of our hair is restored and the product buildup resolves.

Another method to detox the axillae would be to consider mechanical exfoliation with the use of a sugar scrub. Physical exfoliants are products that work by manually removing buildup through the abrasive or gritty quality. This can be through the addition of granules, sugar, seeds, or nutshells to a cleanser or devices such as loofahs or brushes.

I personally am a big fan of sugar scrubs for multiple reasons. I will put them in the physical exfoliant category simply because the gritty texture of sugar before it dissolves allows us to manually remove dead skin cells and oil. What is nice about sugar scrubs is that they do not tend to be too harsh or abrasive in their quality and dissolve nicely.

I find some of my patients get aggressive with scrubs! I have seen dyschromia in the pattern of a scrubbing technique when scrubs are too harsh! It's hard to go overboard with sugar because it naturally dissolves and the abrasive quality goes with it. The added bonus that most people do not realize is that glycolic acid, alpha-hydroxy acid or chemical exfoliant, is also derived from sugar. This means there is an added bonus of a little chemical exfoliation in this process. Lastly, sugar does tend to hold onto moisture and hydrate as it exfoliates.

Are there any ways to make antiperspirants last longer?



The most important way to make antiperspirants last longer or work more effectively is to apply them at night. They actually take time to take effect and will be far more effective the following day by having the opportunity to form the precipitates needed to physically block the sweat ducts.


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