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Iontophoresis for hyperhidrosis

IONTOPHORESIS FOR HYPERHIDROSIS

What are the aims of this leaflet?

This leaflet has been written to help you understand more about iontophoresis for hyperhidrosis. It tells you what iontophoresis is, what the treatment process involves, the potential side effects and where you can get more information.

What is hyperhidrosis?

Hyperhidrosis means excessive sweating. It can be localised or affect the whole body.

What is iontophoresis?

Iontophoresis (pronounced eye-on-toe-for-ee-sis) is a safe and effective treatment that can be used to reduce excessive sweating (hyperhidrosis) of the hands, feet and underarms.

What does the treatment process involve?

It involves using an iontophoresis machine to pass a weak electrical current through the affected areas of the skin by immersing them in either trays filled with water or through water soaked sponge underarm pads. The current is passed one way for a fixed time and then reversed for the same amount of time. Iontophoresis can only be used for hyperhidrosis of the hands, feet and armpits.

Are any medications used during the treatment process?

Generally, tap water is used. However, in some specialist centres an aqueous glycopyrrolate solution is added into the water filled trays. This drug works by decreasing the body’s secretions at the treatment site. Side effects of glycopyrrolate are uncommon when absorbed through the skin but could include:

  • bruising or blisters if a high intensity of current is required
  • a sensation of mild burning if the electrode is touched
  • a mild electric sensation during the treatment when removing your hands or feet from the trays
  • moderate thickening of the treated skin
  • itchiness of the treated skin

These side effects regarding glycopyrrolate can be discussed in further detail with your clinician.

How does it work?

It is not known exactly why iontophoresis is successful and there are various theories including:

  • The current and mineral particles in the water act together to thicken the outer layer of skin, thereby blocking the flow of sweat.
  • The current may disrupt normal nerve transmission, which prevents the sweat duct from functioning.
  • Iontophoresis decreases the pH value in the sweat gland, which makes it more acidic and reduces the amount of sweat produced.

Can anyone receive treatment?

You are not suitable to undertake iontophoresis treatment if:

  • you have a cardiac pacemaker or similar device
  • you have metal implants in the flow of the current
  • you are epileptic or suffer from seizures
  • you are pregnant.

The lower age limit for iontophoresis is 5 years, however performing treatments on under 12's needs to be agreed with the doctor.

Does it work for everyone?

After completing the initial recommended treatment schedule, up to 85% of people will find relief from their symptoms for the hands and feet.  This is reduced to a 70% success rate for the underarms. 

Will it cure my sweating?

No. Unfortunately the effects are only temporary and the treatment will need to be ongoing whilst you continue to have symptoms of hyperhidrosis. You will require a top-up treatment when the affected areas start to become clammy again before the sweating fully begins.  

What does the treatment schedule involve?

The initial treatment schedule usually involves 7 treatment sessions over a 4-week period. After this, if the treatment is successful then you will find temporarily relief from your symptoms. You will then need top-up sessions as required on a weekly to monthly basis.

How long does each session take?

Each session lasts for 20-30 minutes depending on the area to be treated.

Is it painful?

No, the treatment should not be painful. You will be expected to feel a tingling ‘pins and needles’ sensation at the treatment site.

What are the potential side effects?

Some people can experience:

  • bruising or blisters if the intensity of the current is too high.
  • a sensation of mild burning if the electrode is touched.
  • a mild electric shock sensation if the circuit is broken during the treatment by removing your hands or feet from the trays.
  • moderate thickening of the skin if the treatment sessions are too frequent.
  • itchiness of the treated area after treatment.

Where can I receive iontophoresis treatment?

Most dermatology departments are able to offer a trial of the treatment through a nurse-led clinic. This enables you to see if the treatment works successfully before you purchase your own iontophoresis machine for home use. The treatment then can be can be carried out in the privacy of your own home without needing any medical supervision or anyone to operate the machine for you. You can find various iontophoresis machine suppliers online.

Where can I find out more about iontophoresis treatment?

If you want to know more about iontophoresis you should speak to your dermatologist or dermatology specialist nurse.

Web links to further information:

Hyperhidrosis patient information leaflet:

http://www.bad.org.uk/for-the-public/patient-information-leaflets/hyperhidrosis

http://dermnetnz.org/procedures/iontophoresis.html

http://patient.info/health/excessive-sweating-hyperhidrosis

Links to patient support groups:

Hyperhidrosis Support Group

www.hyperhidrosisuk.org
For details of source materials used please contact the Clinical Standards Unit (clinicalstandards@bad.org.uk).

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel

BRITISH ASSOCIATION OF DERMATOLOGISTS
PATIENT INFORMATION LEAFLET
PRODUCED APRIL 2016
REVIEW DATE APRIL 2019

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