Iontophoresis for hyperhidrosis

NewsBot · Dec 3, 2013

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Efficacy and safety of tap water iontophoresis for palmoplantar hyperhidrosis
Talat Masood Akbar, Mahmood A. Saqib, Sundas Fahim, Mohammad Nasir, Haroon
Nabi
Journal of Pakistan Association of Dermatologists 2013;23 (3):304-309.

Objective To evaluate the efficacy and safety of tap water iontophoresis (TWI) for the
treatment of palmoplantar hyperhidrosis in our local setting.

Patients and methods Thirteen patients of idiopathic palmoplantar hyperhidrosis were enrolled
in the study from the Department of Dermatology, Lahore Medical and Dental College/Ghurki
Hospital and Skin Clinic, Gulberg, Lahore from May 2009 to August 2012. Two patients
dropped out, and the study was completed by eleven patients. The patients were treated with
TWI three times a week for six weeks and followed up at twelve weeks. Each session lasted for
20 minutes, with the polarity being reversed after 10 minutes. The results were assessed by the
hyperhidrosis disease severity index, improvement of sweating on a scale of I to IV and the
starch-iodine test. Any adverse events were noted.

Results All the patients responded well to the treatment with minimal discomfort.

Conclusion Tap water iontophoresis is a safe, effective, inexpensive and affordable treatment
modality for palmoplantar hyperhidrosis. It improves quality of life significantly during
treatment.
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Admin2 · Dec 3, 2013

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NewsBot · Mar 24, 2014

Compliance with tap water iontophoresis in patients with palmoplantar hyperhidrosis.
Ozcan D, Güleç AT.
J Cutan Med Surg. 2014 Mar 1;18(2):109-13.

Background:patients tend to be noncompliant with tap water iontophoresis (TWI), which is an effective treatment option for palmoplantar hyperhidrosis.

Objective:To investigate compliance with TWI in patients with palmoplantar hyperhidrosis and identify the factors limiting its utility.

Methods:The medical data of 22 patients treated with TWI for palmoplantar hyperhidrosis were collected. A telephone inquiry questioning overall satisfaction with the treatment and the reasons for discontinuation was conducted.

Results:Sixteen patients completed the initial treatment period, and all responded well to the therapy. Eight patients started on the maintenance treatment, five of whom gave up before completing five sessions. The reasons for discontinuation were a lack of time in 12 patients, switching to home therapy in 3 patients, and side effects in 1 patient.

Conclusion:patients with palmoplantar hyperhidrosis are noncompliant with TWI, mainly due to a lack of time. They should be well informed before therapy and be encouraged to have a home device for maintenance.
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NewsBot · Mar 15, 2016

Simple user-made iontophoresis device for palmoplantar hyperhidrosis.
Nagar R, Sengar SS.
J Cutan Aesthet Surg 2016 Mar 15];9:32-3. (full text)

Iontophoresis is defined as passing of an ionized substance through intact skin by application of direct electric current. Tap water iontophoresis is reliable and effective method for treatment of palmar and plantar hyperhydrosis when practiced with appropriate technique and timing.One of the major setback for using iontophoresis is that the apparatus is expensive and is not readily available.A simple user-made Iontophoresis device have been described here, which could be easily constructed and used at home.
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NewsBot · Feb 3, 2017

Tap water iontophoresis in the treatment of pediatric hyperhidrosis.
Dagash H et al
J Pediatr Surg. 2017 Feb;52(2):309-312

AIM OF THE STUDY:
The treatment options for localized hyperhidrosis include antiperspirants, anticholinergics, iontophoresis, botulinum toxin and surgery. Tap water iontophoresis (TWI) involves immersing the affected area in tap water and passing a small electrical current through the area. Our aim was to assess the success of this therapy in a pediatric cohort.
METHODS:
Retrospective case note review of all patients younger than 18years who underwent TWI between 2002 and 2015. Demographic data, number of treatment sessions, side effects and overall success were analyzed. Individuals undergo 7 treatments over 4weeks. A positive outcome was determined as an improvement in symptoms. Pre- and posttreatment hyperhidrosis disease severity scale (HDSS) was measured. Data are presented as mean (range). Statistical analysis was by paired t-test. A P value of <0.05 was regarded as significant.
RESULTS:
There were 43 patients (30 females) with a mean age of 15 (8-17) years. Palmar and/or plantar hyperhidrosis (PPH) was present in 39/43 (91%) patients. Axillary hyperhidrosis (AH) was present in 19/43 (44%) patients. All patients (with the exception of one) underwent 7 sessions (5-7). Side effects included paresthesia (88%), pruritus (26%), pain (26%), erythema (14%), dryness (12%) as well as vesicle formation and abrasions in one patient (2%). A positive outcome was found in 84% (36/43) of patients. There was a significant reduction in mean HDSS (pre 3.5 vs. post 2; P=0.0001).
CONCLUSION:
TWI is a safe and effective modality of treatment for both PPH and AH in the pediatric population, with minimal side effects. Pediatric surgeons should offer this treatment option before considering more invasive surgical procedures.
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NewsBot · Jun 18, 2018

Proposed mechanism of action of tap water iontophoresis for
treatment of hyperhidrosis
Griffen Dr. Blaine D
Gogent Medicine

Tap water iontophoresis is commonly used to treat hyperhidrosis, yet the mechanism of
action for this treatment remains unknown. Here I propose a plausible mechanism of action
based on the biology of the eccrine sweat gland, reported patterns in iontophoresis effectiveness,
and known dynamics of small particles in fluid systems. Specifically, I propose that
iontophoresis works via the production of a colloid formed between the products of dark (mucin)
and clear (aqueous solution) cells, and the jamming of nanomineral particles inside the lumen
and/or the duct of the sweat gland, creating a blockage that temporarily prevents further sweat
production or secretion. I further outline several feasible tests of this hypothesis.
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NewsBot · Jan 8, 2022

Comparison of 10 versus 20 sessions tap water iontophoresis efficacy in the treatment of palmoplantar hyperhidrosis.
Vural AT, Özcan D, Güleç AT
Journal of Cosmetic Dermatology, 04 Jan 2022,

Background
Tap water iontophoresis (TWI) is an effective treatment option for palmoplantar hyperhidrosis (HH). However, the optimal number and frequency of TWI sessions to control profuse sweating are unclear.
Objective
To compare the efficacy of 10 and 20 sessions of TWI in patients with palmoplantar HH and determine the adequate number of sessions to achieve a favorable clinical response.
Methods
Eighty patients treated with TWI for palmoplantar HH were included. The alteration in sweating intensity considering the mean value of gravimetric measurement and mean visual analog scale (VAS) scores after the 10th and 20th session of TWI were calculated. The difference between performing 10 and 20 sessions of TWI in providing improvement of HH was analyzed. We also conducted a telephone-based inquiry to determine the patients' outcome.
Results
The reduction in sweating intensity was significant both after the 10th (p < 0.001) and 20th (p < 0.001) sessions when compared with the basal level considering gravimetry and VAS. When the mean sweating intensity after the 10th and 20th sessions were compared, no difference was observed gravimetrically (p = 0.03); the difference between the mean score of VAS after the 10th and 20th sessions (p < 0.001) was significant. Eleven and nine patients not considering a maintenance or an alternative treatment had lower and same sweating intensity as compared with the baseline, respectively.
Conclusion
Ten TWI sessions within two weeks for managing palmoplantar HH are adequate to achieve a clinical response. However, the patients are more satisfied when they receive 20 sessions instead of 10 sessions of TWI.
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