Iontophoresis
Iontophoresis uses a simple device to treat
excessive sweating of the hands (palmar hyperhidrosis) and feet (plantar hyperhidrosis).
It is particularly useful for people who’ve tried prescription strength antiperspirants
but find that they need a stronger treatment. Used correctly and adjusted
to individual situations, iontophoresis has proven to have a very high success rate (83% according to the American
Academy of Dermatology) for people with sweaty palms and sweaty feet.
Iontophoresis uses water to conduct a mild electrical current through the skin’s surface. It’s not entirely understood how or why iontophoresis works, but it’s believed that the electric current and mineral particles in the water work together to microscopically thicken the outer layer of the skin, which blocks the flow of sweat to the skin’s surface. Once this sweat output is blocked or interrupted, sweat production on the palms and soles is, often suddenly and dramatically, "turned off".
How to Use Iontophoresis Effectively
During iontophoresis, patients sit with hands or feet, or both, immersed in shallow trays filled with water for a short period of time (20 to 40 minutes) while the device sends a mild electrical current through the water. The process is repeated every other day for five to ten days or until sweating is reduced to a comfortable level. Once the desired dryness has been achieved, patients are switched to a maintenance schedule, ranging from once per week to once every four weeks, depending on the individual. To maintain dryness, iontophoresis must be repeated as soon as sweating begins to return.
Sometimes, tap water in certain geographic locations may be too soft for iontophoresis to work. That is, it doesn’t contain many minerals or electrolytes (tiny particles that help the electric current travel through the water and into the skin). Adding about a teaspoon of baking soda to the trays of water will take care of this.
If iontophoresis with plain tap water or tap water with baking soda doesn't produce the desired dryness, a prescription medicine called an anticholinergic may be added to the water. In the majority of cases this works and causes the palms and soles of the feet to stop sweating.
Women who are pregnant, people with pacemakers, or substantial metal implants (such as joint replacements), cardiac conditions, or epilepsy should not use iontophoresis. All jewelry should be removed before iontophoresis. If excessive dryness of the skin occurs, moisturizers are recommended. Skin abrasions, cuts, and hang nails should be covered with Vaseline or a similar barrier before iontophoresis to prevent skin irritation. If the skin along the "water line" becomes irritated due to iontophoresis, Vaseline should be applied to that area before each treatment. To relieve skin irritation that has already occurred, a simple 1% hydrocortisone cream is recommended. Patients are often concerned about getting an electric shock during iontophoresis but the current used is not strong enough to cause harm. It can startle you, however, so your doctor will teach you how to avoid such shocks. Iontophoresis is not usually recommended for excessive underarm sweating (axillary hyperhidrosis) because the skin in the armpits is likely to be irritated by the process and because it is prohibitively difficult to perform iontophoresis on the underarms.
Successful iontophoresis requires a learned technique so it's very important that you find a healthcare professional who can coach you through the correct usage of iontophoresis in his or her office. If you and your doctor decide that iontophoresis is a good treatment choice for your situation, your doctor can write you a prescription for a home-use iontophoresis machine. In the United States, experts recommend the iontophoresis machine available through R.A. Fischer Company. This machine costs under $1,000 and can be even be shared by multiple people in the same family. Recently, RA Fischer introduced a rental program so people can try out their device before purchasing. This makes a lot of sense and is easy on the wallet too! Contact Bill Schuler at R.A. Fischer Company at (800) 525-3467 to discuss this option.
Speaking of costs, other, less expensive, over-the-counter devices like Drionic or the homemade device some have tried have been found to yield unsatisfactory results. So while it may appear that you are saving money, if you don't get the results you need, then it really was money wasted. In addition to the R.A. Fischer device, others are available outside the US. While it is not as familiar to us here at the IHHS, in particular we hear great things about the Hidrex device. We have also been impressed with their background research and the devices' ease of use. Made in Germany, you can find out more at the manufacturer's website: www.Hidrex.de. Anotheriontophoresisdevice on the market is the Idromed. This is a snazzy looking device, and we'd love to hear from you if you have tried it. The Idromed is available at www.drhoenle.de.
To help with the process of obtaining reimbursement from a U.S. health insurance organization for the purchase of a home-use iontophoresis machine from the R.A. Fischer Company, ask your doctor to complete this Medical Insurance Claim Statement Form and to submit it for you.
Next Steps
Have you talked to your doctor about excessive sweating? If not, now is the time! Learn more about how you and your doctor can work together to find the right treatment, or combination of treatments, to manage your hyperhidrosis.
Have you tried antiperspirants and iontophoresis, and still feel like your quality of life is suffering due to excessive sweating? Learn more about how Botox injections can help.
And remember, because hyperhidrosis is a serious medical condition, you deserve insurance coverage and reimbursement for your doctor’s visits and treatments! We’ve got tips to help you navigate the health insurance realm and receive coverage.