Iontophoresis has been used to treat excessive sweating on the hands and feet since the 1940s. Recently there have been device improvements to make the treatment more effective for other body areas, too. It is not fully understood how iontophoresis works to decrease palmar or plantar hyperhidrosis. During iontophoresis, a medical device is used to pass a mild electrical current through water and into the skin’s surface. There is often a significant tingling sensation associated with usage of the machines. The current can be adjusted, and this impacts the effectiveness of iontophoresis as well as the painful sensation associated with the electrical current. It is very difficult to quantitate sweating, and therefor there have not been any prospective studies that evaluate the success rates or patient satisfaction associated with these machines. Iontophoresis tends to be most successful in patients with mild to moderate sweating, usually in severe cases the overall reduction in sweating is inadequate to effectively improve quality of life. Iontophoresis is often recommended for people who have tried using aluminum chloride products but have not received adequate reduction of sweating.
Treatment requires placing the hands or feet into a tray of water while an electrical current passes through the trays. Typically treatments should last for 30 minutes and should be done at least three times per week. If there is a significant reduction in sweating after several weeks of use, then treatment frequency can gradually be reduced, however to maintain relief of sweating, maintenance use will be required. To be successful iontophoresis requires a very motivated patient because of the requirement for ongoing life-long treatments. Iontophoresis even when successful is not a permanent cure for the problem, but can effectively improve the problem provided treatments are kept up. As a result, we find many people get discouraged over time and seek a permanent solution such as ETS.
There are several devices available for home use. The Drionics machine is a simple relatively inexpensive battery operated device that costs under $200. RA Fischer manufactures a more sophisticated device that is FDA approved for treating hyperhidrosis. The MD2 is a digital machine that costs about $975.
Before starting iontophoresis treatments it’s imperative to check with the manufacturer regarding proper use of the device, any personal contraindications or physical restrictions that could impact results