Do you suffer from excessive sweating? Have you been diagnosed with a condition called hyperhidrosis? A procedure called iontophoresis, which is commonly used in physical therapy, could help relieve hyperhidrosis symptoms with very few side effects. It is a type of non-invasive treatment that uses electrical stimulation to deliver medication across the skin. Keep reading to get answers to all your questions about iontophoresis.
What is iontophoresis in physical therapy?
Iontophoresis involves passing an electrical current through a body part that is submerged in water. The treatment involves soaking the skin in tap water, normal saline (salt water), or a solution containing a medication. It is a safe, effective, and relatively inexpensive treatment that is most commonly used to treat hyperhidrosis (persistent excessive sweating), but it can also be used to treat some other conditions like sports injuries and some cancers.
How does tap water iontophoresis work?
The current is applied to the affected body part, such as the hands, feet, or armpits. The application of the electrical current generates charged or ionized particles in the tap water or medication solution, which are able to cross the skin barrier. This enhances the delivery of drugs through the skin. It also reduces sweating by temporarily blocking the sweat glands.
The exact mechanism of action of iontophoresis treatment is not well understood. However, researchers believe that sweat forms when there is an electrical gradient in the sweat gland, produced by a type of nerve activity. Iontophoresis devices reduce sweat production by changing the electrical gradient. It is also postulated that the charged particles physically block the sweat ducts in the stratum corneum layer of the skin. The electrical current can also potentially disrupt normal nerve activity. Scientists have also theorized that the hydrogen ions that accumulate cause the pH in the sweat glands to drop, which leads to a reduction in sweating.
What is iontophoresis used for?
Tap water iontophoresis is mainly used to treat hyperhidrosis, a condition in which there is excessive sweating in focal areas of the body such as the palms and soles, which occurs even in the absence of heat or exercise. Hyperhidrosis can be an embarrassing and troublesome condition to live with. Iontophoresis can help control the symptoms. In addition to the hands and feet, it can also be used in the axilla (armpit) but is somewhat less effective here. Additional uses of iontophoresis treatments include sports injuries and certain types of cancers.
What medication is used for iontophoresis?
Various medications can be added to the water in the iontophoresis device, such as:
- Botulinum toxin A (Botox) or glycopyrronium to reduce sweating.
- Lignocaine to anesthetize an area of skin.
- Antifungal medicine to treat toenail fungal infections (onychomycosis).
- Silver ions to get rid of infections caused by resistant microorganisms.
- Anti-inflammatory medicine to treat conditions such as tendonitis or bursitis.
Iontophoresis devices enhance drug delivery because the electrical current helps the medication molecules cross the skin barrier.
Who can use the iontophoresis device?
Most people can use iontophoresis devices safely. However, people with a heart condition who have implanted pacemakers in place or those with metal implants should not use these devices. Iontophoresis treatments are also not recommended in pregnant women. A patient with a history of seizures (epilepsy or convulsions) may not be able recommended to undergo these treatments due to safety issues.
Is the treatment painful? Does petroleum jelly help?
Iontophoresis treatment is not painful. The current is not strong enough to cause an electric shock. Most people describe iontophoresis as a feeling of pins and needles or mild tingling sensation in the skin. Petroleum jelly can be applied at the water line and to any small wounds, cuts, or scratches to reduce discomfort and irritation.
Hyperhidrosis treatments with iontophoresis are usually performed at a doctor's office. However, they can also be performed at home if you purchase an iontophoresis device. When performing the treatment at home, it can be useful to add a teaspoon of baking soda to the water to regulate the pH and improve the effectiveness of the treatment.
How do I prepare for iontophoresis?
There is no special preparation needed before the procedure. During the initial consultation, you should give your healthcare provider your complete health information to ensure that iontophoresis treatment can be performed safely.
What happens during iontophoresis?
An iontophoresis device is a battery powered machine that is easy to use. For the treatment of palmar hyperhidrosis (excessive hand sweating), the hands are placed in a shallow tray that contains electrodes. When the iontophoresis device is switched on, a current passes through the water. The amount of current can be adjusted based on the patient's tolerance and the amount of tingling sensation experienced. Each treatment usually lasts 20-30 minutes. Treatment sessions are repeated every 1-3 days. Once a response is obtained, the frequency of iontophoresis treatments can be reduced to once per week to maintain the results.
Iontophoresis for hyperhidrosis (sweat glands)
You are probably wondering - is the treatment going to cure my sweating condition? Most patients need several treatment sessions in a dermatology office before they notice a difference in their hyperhidrosis symptoms. For some patients, regular treatments are needed to keep the hyperhidrosis under control. Your doctor may recommend that you buy a machine for home use if this is the case.
Iontophoresis for sports injuries
People with a variety of sports injuries can benefit from iontophoresis. The procedure involves adding anti-inflammatory drugs to the water and placing the injured body part in the iontophoresis device. For example, if you have heel pain, your doctor will place your feet in the machine. Your doctor will then apply mild electric currents from the electrodes for 10-15 minutes. The charge from the current helps the medicine penetrate better. You may need several sessions per week while your injury heals.
Iontophoresis cancer treatment
Although the most common use of iontophoresis is for the treatment of hyperhidrosis, it is also a method of delivering cancer drugs in patients with some types of malignancies. The procedure has shown promise in certain cancers like retinoblastoma (a cancer of the eye), bladder, pancreatic, and skin cancers. Some of the anti-cancer medicines that can be delivered via iontophoresis devices include 5-FU, cisplatin, and imatinib.
How effective is iontophoresis?
Data from studies has shown that up to 85% of patients experience noticeable improvement in palmar hyperhidrosis within 2-4 weeks of starting iontophoresis treatments. One study found that tap water iontophoresis improves sweating in patients by 78% in the soles and 75% in the axilla after about 3 weeks of treatment.
Tap water iontophoresis is the most common method of treatment. However, a doctor may recommend using normal saline (salt water) or adding anticholinergic medicines like glycopyrronium to the water if plain tap water is not effective for a patient.
Risks and common side effects of iontophoresis
In general, iontophoresis therapy is a safe treatment for people who are in otherwise good health. You should follow the manufacturer's guidelines when using an iontophoresis machine at home. You should avoid directly touching the electrodes in the tray because this can give you a mild electric shock.
The most common side effect of the treatment is mild redness and skin irritation in the treated sites. Occasionally, small vesicles (blisters) can develop. Some people may get dry or cracked skin (dermatitis) after iontophoresis treatments of the hands and feet. These effects usually resolve in 2-3 days. The application of moisturizers or emollients several times a day can help with symptoms. Topical steroid medications can also be used if a patient has these side effects.
When anticholinergic medications are added to the iontophoresis treatment, side effects like dry mouth and dry eyes can occur due to absorption of the drug into the body.
Finding a provider
The MeTime app makes it easy to find qualified healthcare providers in your area. You can click and upload pictures and have suggestions sent directly to you. Interested in finding out if iontophoresis could help you? Try the MeTime app now!
