Safety considerations
No significant safety concerns have been found so far. This, of course, does not guarantee that you are not going to be the first to encounter one.
The following issues are currently under consideration. Your questions and suggestions are welcome. Please feel free to submit your message using any of our contact tools.
1 Drug use
We stay away from new or problematic drugs, using only field-proven non-prescriprion products, namely undecylenic acid, clotrimazole, miconazole, tolnaftate (Schering-Plough Tinactin, or the like), terbinafine (Lamisil of Novartis Pharmaceuticals, also sold by this company under the older brand name DesenexMax, not to be mixed with other Desenexes).
Some substances are believed to be absorbed much faster in armpits, than through the "normal" skin - we can only wonder about vagina, or places between fingers and toes, where antifungal medicines are often applied. Anyway, the following calculations may bring at least some peace of mind.
Topical LamisilAT cream contains 1% of terbinafine, and, even using it very liberally, one can hardly consume a 24 g tube in 1 week of armpits treatment. This gives, say, 30 mg of active ingredient per day, or 210 mg per course.
Terbinafine is also produced in a prescription-only form (Lamisil), as 250 mg tablets, for curing fungal infections of nails. Systemic treatment lasts from 6 (for fingernails) to 12 (toenails) weeks, one tablet per day. So, in overall a patient consume 250 mg daily (8 times more than it is applied to the skin in case of topical treatment), and from 10 to 20 g per course.
The only oral form of clotrimazole found in governmental databases is Mycelex Troches (or lozenges). This is not a systemic drug. Clotrimazole is supposed to pass through gastrointestinal tract, being only partially absorbed to the body. Each troche contains 10 mg of clotrimazole. The typical dose is 5 troches a day for 14 days. This makes 50 mg daily, 700 mg altogether. Let’s suppose that in topical use we bring to the skin the same 30 mg a day, 420 mg per two weeks course.
Tolnaftate and miconazole are for topical use only. Worst side effect reported on tolnaftate is skin irritation. Miconazole may also cause rapid heartbeat. Find out what is high blood pressure range
Safety data are easy to misinterpret. Good example is ethylene glycol, commonly used as car antifreeze. If you request information regarding toxicity of this substance, you’ll think it’s a terrible poison, so huge the threat seems to be. In fact, ethylene glycol is very little toxic. An adult human must drink a glass of it to die. The problem is (1) that antifreeze is found in large quantities in obscure places, and (2) kids and pets like it because it is sweet to taste.
Undecylenic acid is labeled highly toxic in cosmetology, and low toxic in medicine. Although officially it is for topical use only, it is said to cause fever, headache, nausea and vomiting. The most probable explanation is that the folks suffering from gastrointestinal candidiasis inofficially eat undecylenic acid with tablespoons. A dose of 20 g per day is believed to be safe. By the way, undecylenic acid is also approved as a pesticide for cats and dogs.
Drug profiles now found in many places on the Web often look copycatted from each other, and, when it gets to the side effects, are not specific on how the information has been received. Ubiquitous horror stories like rapid heartbeat after vaginal miconazole use, or blistering from clotrimazole (hopefully occurred somewhere else), might have been reported only once. Some observations may also have to do with heavy doses typical for AIDS-related administration of drugs.
There are few universal precautions we follow: perusing drugs manuals and other sources, paying attention to minor details like drying the skin before applying the cream, and trying any medicine on a small spot first.
2 Special conditions
Since topical fungal infections are not life threatening, it is not known if the medicines we use are safe during pregnancy and breastfeeding (even though some of them are proven to be harmless on mice, and are administered to young children).
It is also not advisable to treat your armpits when you are taking another medication, although only minor interactions of this kind have been reported.
3 Other infections
Once the primary odor-producing factor has been exterminated, some other microorganisms may take this opportunity and occupy the niche. Nothing is certain (and little is certainly good or bad) in this area. Only time can tell how stable the odorless condition achieved through medication can be, and what other conditions can arise from it.
Phenomena like presumable Candida albicans proliferation in the gastrointestinal tract when competing bacteria got suppressed with antibiotics are rather rear. To the best of our knowledge Coryneform bacteria inhabiting armpits are not considered to be our symbionts. We could not find anything particularly good about them, except for their ability to sell antiperspirants and deodorants. Historically we humans have cleaned our skins from many perils. Armpit malodor producers may very well become another one.
We keep looking for reliable evidences that now, or at any moment in the past there are, or were people susceptible to armpit malodor, but living without it for a while. We are also trying hard to create such evidences.
Before medication it makes sense to save "mugshots", or backup copies of your armpit biocenosis on shirts or cloth pads. Safety measures taken after medication are: checking the odor several times a day, checking the skin condition (visually) at least once a day, and avoiding surfactants on armpits.
4 Antimicrobial resistance
The following "definition" is borrowed from Antimicrobial Resistance Glossary of federal governmental Centers for Disease Control and Prevention
Antimicrobial resistance is the result of microbes changing in ways that reduce or eliminate the effectiveness of drugs, chemicals, or other agents to cure or prevent infections.
First of all, it make sense to mention that mutagenic properties of drugs are now routinely tested. Tests results are published by drug producers, and approved by FDA. We have not found any evidences that the drugs we use have ever shown mutagenic effect on microbes (or laboratory animals).
With that in mind we try to limit a number of medications even for experimental purposes, make each of them as complete as possible, and exclude transmission of microorganisms after treatment to other persons.