Iontophoresis is used as a treatment for palmar and plantar hyperhidrosis, or hyperhidrosis that affects the hands and the feet. It is defined as the introduction of an ionized substance through intact skin by the application of a direct current. Scientists are not yet sure why, but when iontophoresis is applied regularly to the hands and feet, the sweating associated with hyperhidrosis is reduced. It was first discovered to be a helpful treatment for hyperhidrosis in 1936 when a man by the name of Ichihashi used iontophoresis with various solutions of histamine, formaldehyde and other substances. He found that sweating on the palms of his subject’s hands was reduced. Later in the early 1950’s another pair of scientists named Bouman and Gruenwald Lentzer published a paper that stated that iontophoresis was an effective treatment and that an ionized substance, or medication, did not need to be added to water for it to have a positive effect on sweat reduction. Further studies revealed that iontophoresis works well, and that about 85% of people who use it see improvement.
Iontophoresis is a good way to manage hyperhidrosis at home. Most people begin using iontophoresis at their doctor’s office and progress to at-home treatments after familiarizing themselves with the process. There are two machines cleared by the FDA that patients can use at home, these are the R.A. Fischer and Hidrex USA. There are also other brands with good reputations that can be safely used at home. Each machine has its own set of instructions, but the general process is similar. Here are instructions on how to perform iontophoresis at home using the Fischer unit:
- Fill the two trays with room temperature water up to the electrodes.
- Use the cords that were supplied with the machine and connect the trays to the unit’s output. Make sure the machine is off while doing this.
- Before using the equipment make sure the patients has no jewelry on and all cuts are covered with vaseline or a similar substance.
- With the machine off, have the patient place each hand in one tray. The water should reach just above the tops of the hands. The patients should keep their hands in the tray for the entire treatment time. If the patients removes their hands or touches the electrodes the may feel a slight shock. They should rotate their hands around the electrode as time goes on if they feel the skin close to the electrode becoming irritated.
- Turn the machine on. Begin with the intensity knob at 0 and gradually increase the amperage until it is between 15 to 18 mA. Treat at this level for 10 minutes.
- Once the 10 minutes are up slowly decrease the current flow to zero.
- When the meter reads zero and the active light shuts off, switch the direction of the flow. Repeat steps four through six for another 10 minutes. When done, the patient should have been treated for 20 minutes all together, with the current flow going in opposite directions for 10 minutes each.
The same procedure can be followed when treating feet. It is important to remember that for treatment to be effective, patients need to be treated every two to three days for the first five to ten sessions. Then patients can spread treatments out to once a week or once every couple weeks. If someone finds that iontophoresis is not working well for them, there are things that can be done to make iontophoresis more effective. The process for other iontophoresis units will be similar, but not exactly the same. It is important to first learn how to use a personal unit with the assistance of a medical professional. Some people have asserted that iontophoresis makes sweating worse. No studies have found that this occurs, but for those who experience it there is comforting news. Even if sweating gets worse after initiating iontophoresis it almost always improves if treatments are continued.
It is important to make sure people with pacemakers do not attempt iontophoresis, as it can affect a pacemaker ability to function. Some irritation is normal, especially along the water line. Hydrocortisone cream can help as well.
- Stolman, L. P. (2008). Hyperhidrosis Medical and Surgical Treatment. Eplasty, 8(22). Retrieved October 9, 2018.