Iontophoresis

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Tap water iontophoresis

Definition
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  • In the case of hyperhidrosis pedum et manuum, the hands and/or feet are bathed in tap water with a weak direct current (approx. 10-20 mA at 1-2 kOhm). The method is suitable for treatment at home.
  • Iontopheresis is also successfully used in psoriasis, especially in the palmoplantar form of psoriasis.

General definition
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Direct current is used for hyperhidrosis and medium frequency alternating current is used for psoriasis.
  • Direct current device: The device of choice for its effectiveness, especially in severe hyperhidrosis.
  • Pulsed direct current device: method of choice for children and sensitive persons. No need for slow up regulation, no tingling sensation. Local irritations and risks of improper handling (e.g. electric shocks) are greatly reduced. A disadvantage is the reduced effectiveness.

Indication
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Implementation
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  • Hyperhidrosis: Put your hands or feet in a plastic tub filled with tap water (not deionized water!) so that the skin areas to be treated are just covered. Remove all metal parts before treatment! Slowly increase the current (hands up to 10-15 mA, feet up to 15-20 mA). The required current varies and depends on the individual sweat secretion, the patient should only feel a slight tingling sensation! Duration per session: 10 minutes (longer sessions do not produce any additional effect!). Initially 1 time per day, at least 3 times per week. Followed by maintenance therapy with approx. 1-2 sessions/week. Normhidrosis is reached on average after 10 sessions. In case of 25 unsuccessful sessions, discontinuation, as no more therapy success can be expected. Additives such as NaCl or ammonium chloride tend to reduce the effectiveness and may increase local side effects.

    Notice! Do not treat hands and feet at the same time, as this will change the current flow!

  • Psoriasis: Treat hands and/or feet 2 times 10 minutes or 1 time 20 minutes daily. As in hyperhidrosis, the current is slowly increased until a tingling sensation occurs.

Undesirable effects
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Tingling, discomfort, burning, skin irritation, electric shocks.

Contraindication
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  • Absolute: Metal implants (e.g. pacemakers). Relative: Open skin areas, rhagades.
  • Pregnancy, poor circulation, tetany, malignant tumours, varicose veins, Parkinson's disease, epilepsy

Note(s)
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Devices can be obtained from:
  • Hidrex GS (direct current, 30 mA, max. 60 V) and Hidrex PS (pulsed direct current 60 mA, 18 or 24 V) as home or practice therapy devices at Hidrex GmbH (Biomedizinische Technik, Uellendahler Str. 488, 42109 Wuppertal).
  • Iontex III S practice therapy device (25 mA, 54 V) or Iontex III home therapy device (25 mA at 36 V) at Kimetic GmbH Medizintechnik (Postfach 1350, 71254 Ditzingen).
  • Ionto PSO: Ionto-Comed GmbH; Boschstr 5; 76344 Eggenstein.

Literature
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  1. Anliker MD, Kreyden OP (2003) Tap water iontophoresis. Curr Probl Dermatol 30: 48-56
  2. Marasini B, Conciato L (2001) Iontophoretic evaluation of vascular reactivity to acetylcholine in patients with primary Raynaud's phenomenon and systemic sclerosis. Clin Rheumatol 20: 451-452
  3. Moraru E, Auff E, Schnider P (2002) Hyperhidrosis of the palms and soles. Curr Probl Dermatol 30: 156-169
  4. Murphy R, Harrington CI (2000) Treating hyperhidrosis. Iontophoresis should be tried before other treatments. BMY 16: 702-703
  5. Reinauer S et al (1995) Pulsed direct current iontophoresis as a new treatment option. dermatologist 46: 543-547
  6. Schauf G et al (1994) Modification and optimization of tap water iontophoresis. Dermatologist 45: 756-761
  7. Togel B, Greve B, Raulin C (2002) Current therapeutic strategies for hyperhidrosis: a review. Eur J Dermatol 12: 219-223

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Last updated on: 29.10.2020