Iontophoresis – Page 3 – Hyperhidrosis Research . org

January 24, 2019

Topical Treatment of Primary Focal Hyperhidrosis, Part 1.

Topical Treatment of Primary Focal Hyperhidrosis, Part 1.

Int J Pharm Compd. 2019 Jan-Feb;23(1):23-31

Authors: Zur E

Abstract
Primary focal hyperhidrosis is idiopathic, localized, uncontrollable, excessive, and unpredictable sweating beyond what is necessary to regulate body temperature. Primary hyperhidrosis is thought to affect approximately 2% to 3% of the population, and its effect on a patient’s quality of life is very significant. Primary focal hyperhidrosis can be managed using various therapeutic options, including drugs (topical and systemic), nonsurgical interventions (e.g., iontophoresis, botulinum toxin injections), and surgery. This article, which is presented in 2 parts, is a comprehensive review of the topical, evidence-based treatments of primary focal hyperhidrosis, and it covers the following active pharmaceutical ingredients: aluminum salts, methenamine, glycopyrronium salts, oxybutynin chloride; the latter 2 ingredients will be discussed in part 2 of this article. This article discusses the evidence-based data that exists from clinical trials that support the use of topical medications to treat the pathology from efficacy and from a safety point of view. This review also discusses compounding considerations for professionally and safely compounding various topical preparations. In addition, a range of relevant formulas are attached to the article and can be used by compounding pharmacists.

PMID: 30668532 [PubMed – in process]

January 18, 2019

A Retrospective Analysis of the use of Tap Water Iontophoresis for Focal Hyperhidrosis at a District General Hospital: The Patients’ Perspective.

A Retrospective Analysis of the use of Tap Water Iontophoresis for Focal Hyperhidrosis at a District General Hospital: The Patients’ Perspective.

J Dermatolog Treat. 2019 Jan 16;:1-9

Authors: Gollins CE, Carpenter A, Steen C, Bulinski H, Mahendran R

Abstract
Tap water iontophoresis as a treatment for focal hyperhidrosis, is given as an initial series of treatments in hospital followed by home maintenance treatments. Our study assessed quality of life and perception of hyperhidrosis with the use of iontophoresis. All patients treated with iontophoresis at our hospital from 2012 – 2017 were retrospectively assessed (n = 82, mean age 34 years; 60% female). 50 of the 82 patients (mean age 34 years; 60% female) had a pre-treatment DLQI (mean 12.6). Twenty three of these patients (mean age 33 years; 60% female) had a paired pre- and post-treatment DLQI recorded. The average DLQI pre-treatment was 14.1 and post-treatment was 2.2. Therefore, the average reduction (improvement) was 11.9 (p < 0.05). 38 of the 82 patients (46%) completed a telephone interview (mean age 35 years; 65% female). Of this cohort, 24 had an improvement in HDSS following treatment, and the remaining 14 patients had no change. 9 patients (24%) bought their own iontophoresis machine. In these patients, there was a higher average improvement in HDSS (1.8), compared to the total interviewed cohort (1.0). In conclusion tap water iontophoresis can result in a significant improvement in perceived severity of hyperhidrosis and quality of life.

PMID: 30646797 [PubMed – as supplied by publisher]

December 12, 2018

A Pocket-Friendly and Sustainable Iontophoresis Apparatus for Palmoplantar Hyperhidrosis: Advancement over a Previously Described Homemade Design.

A Pocket-Friendly and Sustainable Iontophoresis Apparatus for Palmoplantar Hyperhidrosis: Advancement over a Previously Described Homemade Design.

J Cutan Aesthet Surg. 2018 Jul-Sep;11(3):153-156

Authors: Jain S, Dey VK, Agrawal N

Abstract
Introduction and Objectives: Tap water iontophoresis is a promising therapy for palmoplantar hyperhidrosis. Non-affordability and nonavailability of the marketed device restrict its usage for many patients hailing from villages or small cities.
Materials and Methods: In an article named “A simple user-made iontophoresis device for palmoplantar hyperhidrosis” published previously in this journal, a simple inexpensive homemade device that runs on 12 V direct current battery was described. We made a small modification by using a 220-12 V alternate current to direct current semiconductor diode-based transformer for the current supply.
Results: The added innovation made the device lightweight, cheaper, and usable with domestic electric supply at home/clinic. Sustained supply of current at same voltage without dip and non-requirement to change/replace battery are added advantages. Cost of the whole assembly is ₹310. Working and clinical efficacy of our device were comparable to the commercially available apparatus as reported by 13 patients who received thrice a week of 15min sessions with our device. Mild electric pricking sensation was felt by all patients. Four of thirteen reported that pricking sensation was a bit more with our device as compared to the marketed device. No calibration for intensity is available in our device.
Conclusion: This simple to assemble and inexpensive device makes iontophoresis applicable in many needy patients with similar efficacy and few limitations compared to expensive marketed devices.

PMID: 30533993 [PubMed]

November 11, 2018

[Hyperhidrosis-aetiopathogenesis, diagnosis, clinical symptoms and treatment].

[Hyperhidrosis-aetiopathogenesis, diagnosis, clinical symptoms and treatment].

Hautarzt. 2018 Oct;69(10):857-869

Authors: Wohlrab J, Kreft B

Abstract
Although primary hyperhidrosis is a common disease, secondary symptomatic hyperhidrosis is rather rare. Primary hyperhidrosis is a complex neuropathic dysregulation with a genetic predisposition and is diagnosed when patients show pathologic sweating patterns and excessive sweating for at least 6 months and fulfill at least four of the following criteria: affected areas are axillae and/or palms and/or soles and/or forehead; symmetry; no night sweating; at least once a week; onset before the age of 25; positive family history; negative impact on daily activities. Frequently used therapies are topical aluminum salts and anticholinergics, iontophoresis in water, and intracutaneous botulinum toxin. Anticholinergics are also used as systemic treatment. Surgical procedures are used as a last result. Furthermore procedures using thermolysis have been developed.

PMID: 30218113 [PubMed – in process]

November 11, 2018

Hyperhidrosis: Management Options.

Icon for American Academy of Family Physicians

Hyperhidrosis: Management Options.

Am Fam Physician. 2018 Jun 01;97(11):729-734

Authors: McConaghy JR, Fosselman D

Abstract
Hyperhidrosis is excessive sweating that affects patients’ quality of life, resulting in social and work impairment and emotional distress. Primary hyperhidrosis is bilaterally symmetric, focal, excessive sweating of the axillae, palms, soles, or craniofacial region not caused by other underlying conditions. Secondary hyperhidrosis may be focal or generalized, and is caused by an underlying medical condition or medication use. The Hyperhidrosis Disease Severity Scale is a validated survey used to grade the tolerability of sweating and its impact on quality of life. The score can be used to guide treatment. Topical aluminum chloride solution is the initial treatment in most cases of primary focal hyperhidrosis. Topical glycopyrrolate is first-line treatment for craniofacial sweating. Botulinum toxin injection (onabotulinumtoxinA) is considered first- or second-line treatment for axillary, palmar, plantar, or craniofacial hyperhidrosis. Iontophoresis should be considered for treating hyperhidrosis of the palms and soles. Oral anticholinergics are useful adjuncts in severe cases of hyperhidrosis when other treatments fail. Local microwave therapy is a newer treatment option for axillary hyperhidrosis. Local surgery and endoscopic thoracic sympathectomy should be considered in severe cases of hyperhidrosis that have not responded to topical or medical therapies.

PMID: 30215934 [PubMed – in process]

November 11, 2018

Tap water iontophoresis in the treatment of pediatric hyperhidrosis.

Tap water iontophoresis in the treatment of pediatric hyperhidrosis.

J Pediatr Surg. 2017 Feb;52(2):309-312

Authors: Dagash H, McCaffrey S, Mellor K, Roycroft A, Helbling I

Abstract
AIM OF THE STUDY: The treatment options for localized hyperhidrosis include antiperspirants, anticholinergics, iontophoresis, botulinum toxin and surgery. Tap water iontophoresis (TWI) involves immersing the affected area in tap water and passing a small electrical current through the area. Our aim was to assess the success of this therapy in a pediatric cohort.
METHODS: Retrospective case note review of all patients younger than 18years who underwent TWI between 2002 and 2015. Demographic data, number of treatment sessions, side effects and overall success were analyzed. Individuals undergo 7 treatments over 4weeks. A positive outcome was determined as an improvement in symptoms. Pre- and posttreatment hyperhidrosis disease severity scale (HDSS) was measured. Data are presented as mean (range). Statistical analysis was by paired t-test. A P value of <0.05 was regarded as significant.
RESULTS: There were 43 patients (30 females) with a mean age of 15 (8-17) years. Palmar and/or plantar hyperhidrosis (PPH) was present in 39/43 (91%) patients. Axillary hyperhidrosis (AH) was present in 19/43 (44%) patients. All patients (with the exception of one) underwent 7 sessions (5-7). Side effects included paresthesia (88%), pruritus (26%), pain (26%), erythema (14%), dryness (12%) as well as vesicle formation and abrasions in one patient (2%). A positive outcome was found in 84% (36/43) of patients. There was a significant reduction in mean HDSS (pre 3.5 vs. post 2; P=0.0001).
CONCLUSION: TWI is a safe and effective modality of treatment for both PPH and AH in the pediatric population, with minimal side effects. Pediatric surgeons should offer this treatment option before considering more invasive surgical procedures.
LEVEL OF EVIDENCE: IV: Retrospective study.

PMID: 27912978 [PubMed – indexed for MEDLINE]

November 11, 2018

Plantar Hyperhidrosis: An Overview.

Plantar Hyperhidrosis: An Overview.

Clin Podiatr Med Surg. 2016 Jul;33(3):441-51

Authors: Vlahovic TC

Abstract
Plantar hyperhidrosis, excessive sweating on the soles of feet, can have a significant impact on patients’ quality of life and emotional well-being. Hyperhidrosis is divided into primary and secondary categories, depending on the cause of the sweating, with plantar hyperhidrosis typically being primary and idiopathic. There is an overall increased risk of cutaneous infection in the presence of hyperhidrosis, including fungal, bacterial, and viral infections. This article discusses a range of treatment options including topical aluminum chloride, iontophoresis, injectable botulinum toxin A, glycopyrrolate, oxybutynin, laser, and endoscopic lumbar sympathectomy. Lifestyle changes regarding hygiene, shoe gear, insoles, and socks are also discussed.

PMID: 27215162 [PubMed – indexed for MEDLINE]

November 11, 2018

A Simple User-made Iontophoresis Device for Palmoplantar Hyperhidrosis.

Icon for Medknow Publications and Media Pvt Ltd

A Simple User-made Iontophoresis Device for Palmoplantar Hyperhidrosis.

J Cutan Aesthet Surg. 2016 Jan-Mar;9(1):32-3

Authors: Nagar R, Sengar SS

Abstract
Iontophoresis is defined as passing of an ionized substance through intact skin by application of direct electric current. Tap water iontophoresis is reliable and effective method for treatment of palmar and plantar hyperhydrosis when practiced with appropriate technique and timing. One of the major setback for using iontophoresis is that the apparatus is expensive and is not readily available. A simple user-made Iontophoresis device have been described here, which could be easily constructed and used at home.

PMID: 27081247 [PubMed]

November 11, 2018

Plantar hyperhidrosis: A review of current management.

Plantar hyperhidrosis: A review of current management.

J Dermatolog Treat. 2016 Nov;27(6):556-561

Authors: Singh S, Kaur S, Wilson P

Abstract
AIM: To critically appraise current literature regarding the management of plantar hyperhidrosis in the form of a structured review.
METHOD: A literature search was conducted using various databases and search criteria.
DISCUSSION: The literature reports the use of conservative, medical and surgical treatment modalities for the management of plantar hyperhidrosis. However, long-term follow-up data are rare and some treatment modalities currently available are not fully understood.
CONCLUSION: There is a considerable dearth in the literature on the management of plantar hyperhidrosis. Further study in larger populations with longer follow-up times is critical to access the long-term effects of treatment. Nonetheless, iontophoresis, botulinum toxin injection and lumbar sympathectomy are promising treatment modalities for this disorder.

PMID: 27053510 [PubMed – indexed for MEDLINE]

November 11, 2018

Iontophoresis for palmar and plantar hyperhidrosis.

Iontophoresis for palmar and plantar hyperhidrosis.

Dermatol Clin. 2014 Oct;32(4):491-4

Authors: Pariser DM, Ballard A

Abstract
Iontophoresis is a safe, efficacious, and cost-effective primary treatment of palmar and plantar hyperhidrosis. Decades of clinical experience and research show significant reduction in palmoplantar excessive sweating with minimal side effects. To get the best results from iontophoresis, health care professionals need to provide education on the mechanism of action and benefits, evidence of its use, and creation of a future patient-specific plan of care for continued treatments at home or in the physician’s office. Iontophoresis may be combined with other hyperhidrosis treatments, such as topical antiperspirants and botulinum toxin injections.

PMID: 25152342 [PubMed – indexed for MEDLINE]