Athletes, coaches, trainers, team physicians, physical therapists, and even the “weekend warrior” are faced with problems such as:

• inflammation
• muscle spasms
• fungal infections of the skin and nails (athlete’s foot, jock itch, and onychomycosis)
• hemorrhoids
• excessive perspiration

Our compounding specialists can help these problems and more, with customized medications that contain the most appropriate ingredients in the best vehicle to most efficiently provide the needed drug to the affected area. Please contact our compounding pharmacist for more information or to discuss “problem-solving” therapies.

Hyperhidrosis therapy

Excessive perspiration is a concern for many athletes, as well as members of dance teams and marching bands. Numerous topical treatment options exist.

Primary hyperhidrosis (excessive perspiration) is a physically and emotionally distressing condition which involves mainly the palms, soles, and axillae. Oral anticholinergic agents and beta-blockers may be effective for controlling or reducing profuse sweating, but also carry significant side effects. Topical therapies may be the most practical and most common treatment for hyperhidrosis, but many agents that have proven useful in clinical trials are not commercially available.

Placebo-controlled trials have shown that topically applied 20% aluminum chloride hexahydrate significantly reduces the symptoms of hyperhidrosis in 60%-100% of patients. Skin irritation can be minimized with 1% hydrocortisone cream or by compounding 20% aluminum chloride in a 4% salicylic acid gel base, instead of in anhydrous alcohol base (as is the commercial product Drysol®).

Luh and Blackwell of the Dept. of Internal Medicine, University of Texas Medical Branch at Galveston describe a healthy, active 27-year-old male resident physician who had excessive facial sweating with minimal exertion or stress. The sweating was especially pronounced on the forehead, nose, and upper lip. Daily topical application of a 0.5% glycopyrrolate solution to the face and forehead significantly reduced facial sweating after the first treatment, without any discomfort to the skin. No loss of efficacy was seen after multiple face washings. Facial hyperhidrosis recurred after withdrawal of the glycopyrrolate for 2 days, confirming its therapeutic effect. Two years later, he continues to use glycopyrrolate as needed.

Mayo Clin Proc1 986 Dec;61(12):951-6

South Med J 2002 Jul;95(7):756-8

Ann Pharmacother 1995 May;29(5):489-92

Intl J Pharm Comp 2001 Jan/Feb;5(1):28-9

Hemorrhoids are particularly problematic for catchers, coaches, and others who are regularly in a squatting position. Treatment often involves use of a novel dosage form known as the “rectal rocket”, a suppository that permits simultaneous internal and external application of anti-inflammatories, anesthetics, antibiotics, or other medications.

Pregame rubs can be compounded to contain substances such as emu oil and anti-spasmodic drugs. Emu oil is a moisturizer that can improve healing of injured skin.

Plast Reconstr Surg 1998 Dec;102(7):2404-7