Iontophoresis (Drionic) - Electric Devices
The use of electricity in medicine dates back centuries. Since 1952 iontophoresis has been used for the treatment of palmar and plantar hyperhidrosis. Iontophoresis involves the use of electrical current to deliver ionized matter through the skin. The exact mechanism of action is still unclear but it is thought that the interaction between the electric current, pH and ionic movement found in tap water possibly creates a prolonged interruption in sweat gland function, conduction, and perhaps by inducing some sort of blockage in the sweat gland pores which in turn obstructs sweat flow and secretion.
So far hystolgical studies did not show any plugging of the pores or impairing of electrochemical gradient of sweat secretion in those individuals. Commercial iontophoresis devices have been available since the 1980's for home use in the treatment of hyperhidrosis.
This is one of the alternative methods that a patient can try for the treatment of palmar and plantar hyperhidrosis. Applications may vary but typically it has to be used a few times a week for periods of up to 30 minutes. The device provides a direct current of 15 to 20 mA. Achieving euhidrosis (Normal Sweating) is difficult to obtain. Maintenance frequency can vary between one person and another. It is very difficult to obtain definite control of the sweating and different investigators suggest changes of the electric current direction, or the intensity. So far very few studies with a very small number of patients have shown limited success. Adverse affects of iontophoresis are generally minimal. They include irritation, dryness and peeling of skin, vesicals in the short but not long term, redness, burning and stinging sensation that usually resolves on cessation of therapy.
Recently instead of tap water in the iontophoresis devices researches started to use anticholinergic solutions to increase the effect of the iontophoresis machine. So far not to many studies confirmed the superiority of this treatment which can cause the same side effects as mentioned above. Dry type of iontophoretic devices were also tried but so far very limited clinical evidence is available.
There are two main devices in the market now. The most commonly used is the Drionic (General Medical Co., Los Angeles, California - www.drionic.com). Another device is made by The Fischer MD-1a (R.A. Fischer Co., Northridge, California - www.rafischer.com). Those devices have also an axillary pad for the treatment of axillary hyperhidrosis.
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