Antihydral (Methenamine) for palmar hyperhidrosis - A guide from a 6+ years user
So, hello all, I'm 22 years old and I have severe palmoplantar hyperhidrosis. I've been using Antyhidral for my hands since I was 16 and it is the most effective treatment I've used so far, at least as far as "not sweating" goes. Since I don't hear much about it in this sub (weird considering the relative popularity of Antihydral here in Brazil), I decided to talk about this treatment option here.
1 - What is Antihydral?
Antihydral is a whiteish thick cream composed of 13% Methenamine, an old medication used to treat urinary treat infections. In case you're allergic (or want to make it at home idk) the excipients are talc, water, zinc oxide, white clay, food coloring E172 (Iron Oxide), Glycerol and carmellose sodium. It's made by Robugen in Germany, which means I have to import it from Germany or buy from someone who imported it. To my knowledge they do not sell it outside of Germany. No one knows exactly how it works and the research I could find on it and hyperhidrosis is usually really old (and mostly German).
2 - How to use Antihydral
Apply a thin layer (probably thinner than the photo) of the cream on hands or feet before bedtime, wash it off in the morning.
The effects appear usually within 3-10 days, lasting also for about that amount of time after you stop using it. After you're satisfied with the results/side effects (which I'll explain soon), you can begin to use it every other day, or every two days, whatever works for you. For me, after six years, I'm more like "shit I'm starting to sweat again, better use Antihydral for a few days" and so on. As I said, the effects last up to 10 days. The more days you use it, the more "not sweaty" days you get after stopping.
Now maybe you're thinking: "but won't my sweat wash the cream off anyway?" In short, yes. Specially on the first days when you're still sweating a lot, you will sweat, some cream will come off onto your bed sheets and whatnot (don't worry, they come off with water). This is not ideal so on the first days of my treatment I slept with a fan in front of my hands so I wouldn't sweat the cream off. As you stop sweating within a few days, this stops being a problem.
3 - Problems, side effects and how to avoid them
Methenamine in your skin (and body) reacts producing formaldehyde. Yes, formaldehyde, the carcinogen. Now this is probably why it works in the first place, given that formaldehyde also works as a potent antiperspirant (Rollinson JR, 1971, and my sister with hyperhidrosis working in her lab with formaldehyde one day spilling it on her hands) (also please don't use pure formaldehyde anywhere on your skin).
That said, Antihydral/methenamine is *probably* safe. Because the concentrations of formaldehyde are very low and its use is only topical. In fact, there is no research linking methenamine use (oral or topical) to any kind of cancer or severe health conditions. BUT, there also is no research saying otherwise. As I said, research on methenamine, specially methenamine and hyperhidrosis is very very scarse.
So let's go to the more practical short-term obvious problems:
Your skin is going to get dry. I mean dry. Seriously, really dry. So much so that it can begin to get really flaky, and it can be rough as sand paper. Also some people's hands get yellowish but don't worry, that passes with a few months of treatment.
There's not much you can do if your skin gets yellow. It probably will pass within a few months of treatment so don't give up.
As for the driedness..
My actual hands now , not that bad actually
You will have to moisturize. A lot. And trust me, normal hand moisturizers won't do. I use Cetaphil for very dry/sensitive skin. Now how did I come across this product? My stepmother's son has a skin condition that makes his skin very very dry (kinda like anti-hyperhidrosis). So I tried his moisturizer and it worked (at least better than the other ones). What I'm trying to say is: you'll need a very good moisturizer, so good that only people with rare skin conditions have to use them. And of course, they'll not be the cheapest ones to get.
This is the main trick with Antihydral, you're constantly trying to balance three factors:
1 - Not using too much so your skin don't become sandpaper
2 - Not moisturizing too much so your skin don't get sticky and gross
3 - Not using it too little and continue sweating
Here's another side effect that might not be so fun: Your skin will get wrinkly really easily in contact with water:
My hands after washing the dishes
Sometimes it will wrinkle so much it can begin to hurt a little. But to be honest, this side effect is so harmless to me at least, I don't even think about it. It just there, be advised.
Also in the first months of Antihydral use, my hands got quite itchy. For that, just moisturize and don't scratch it too hard.
4 - Obligatory don't use Antihydral if:
Don't use Antihydral if you're allergic to any of its components (see section 1) or formaldehyde, nor if you're pregnant or breastfeeding. Don't use Antihydral if you have other skin conditions that might be affected. As always, talk to your doctor.
5 - How to get Antihydral
In short, Amazon, Ebay (or equivalent thereof in your country), it really varies with your location so you'll have to do some Googling. Also search for European stores and see if they ship to your country. As I said, here in Brazil there are a ton of online resellers, but I'm not sure in other places.
6 - Final words
So this is a little of what I've learned from 6 years controlling my HH with Antihydral. It's far from a perfect treatment, but it works. The question is: will the side effects be a bigger problem for you than hyperhidrosis? That's really personal. I for one, prefer having sandpaper hands than sweaty hands.
If you have any other questions, feel free to post it in the comments, or DM me, etc
Hope I helped someone with this, bye!