Treatment Of Excessive Sweating (Hyperhidrosis) With Iontophoresisis

Iontophoresis is a safe and accepted way of reducing excessive sweating. It is generally used to treat hyperhidrosis of the hands (palmar hyperhidrosis) and feet (plantar hyperhidrosis) although it can sometimes be used to treat the armpits too. The exact mechanism of action of iontophoresis is still not entirely clear. However, it seems to block and/or disrupt sweat production and secretion effectively.

What to expect during treatment

Treatment involves immersing the hands or feet in shallow baths which are attached to the iontophoresis machine by electrical leads. The machine is battery operated and you control the power yourself. When you develop a tingling sensation, the current is stabilised and you remain with your hands or feet in the baths for around 10 -15 minutes. It is very unlikely that you will hurt yourself during the procedure as the electric current used is very small.

Treatment can be performed with either glycopyrronium bromide solution or with tap water. Glycopyrronium bromide iontophoresis is associated with a higher success rate.

During the early stages of treatment, some patients may find it difficult to tolerate the tingling sensation associated with some levels of current. If this occurs, the machine can be turned down. With repeated sessions tolerability usually improves. Other minor side-effects that can sometimes occur include vesiculation (small blisters), redness and dryness of the skin. These side-effects are easily treatable and also tend to settle with time.

Potential contraindications to treatment

Whilst iontophoresis is not associated with any serious complications, treatment is best avoided if you fall into one of the categories listed below:

• Pregnant and / or breastfeeding
• Patients with a cardiac pacemaker or similar device
• Patients with metal orthopaedic implants. Depending on the size and position of the implant, it can potentially divert the electric current. The current does not go above the neck, so earrings, dental braces and fillings do not cause a problem
• Patients with abnormal or loss of sensation in their hands and feet (peripheral neuropathy)

Iontophoresis with glycopyrronium bromide solution is best avoided in patients who have the following conditions:

• Glaucoma
• Obstructive uropathy
• Ulcerative colitis

How long will it last?

Iontophoresis is not a permanent solution to the problem. If treatment is successful then you will be offered the option to buy your own machine so that you can continue the treatments at home. With regular maintenance therapy, you should be able to reduce your sweating considerably.