- Best Results5-10 sessions
- Treatment RecoveryNA
- Procedure Time5-12 minutes
- Skin SpecialistNurse Practitioner
- Duration of Results1-4 days
- AnaestheticNA
- Back to WorkNA
- Cost$
Iontophoresis for Excessive Sweating
Iontophoresis treatment for excessive sweating can be successful in up to 80% of cases. This is a safe treatment for sweating of the hands & feet. Iontophoresis uses water to conduct a tiny electrical current. This reduces sweat production. Most patients will require several treatments to see if iontophoresis works for them.
FactsFacts on Iontophoresis for Excessive Sweating
- This treatment is ideal for excessive sweating of the hands & feet
- The success rate varies between 60-80%
- It works by blocking sweat glands with minerals passed thru an electrical current via an iontophoresis machine
- Treatments take a few minutes to perform
- Addition of topical glycopyrrolate increases efficacy
- 2 to 3 sessions are performed weekly
- Iontophoresis sessions can be reduced once sweating is minimised
What is iontophoresis?
Iontophoresis is the next step for patients who suffer from excessive sweating of the hands & feet who do not respond to antiperspirants. This treatment has been in use for many decades and can be effective in up to 60-80% of palmar & plantar hyperhidrosis- sweating of the hands and feet.
Iontophoresis uses water to conduct a mild electrical current to the sweat gland unit. Over time the sweat glands reduce production of sweat. This treatment temporarily blocks sweat production.
How does iontophoresis work?
Many theories have been postulated over the decades about how this treatment works. We initially thought that iontophoresis blocked the sweat gland with keratin, causing a plug at the surface of the eccrine (sweat) unit. This has been dispelled. We now think that iontophoresis works by passing charged particles into the sweat gland, causing it to reduce sweat production.
For scientists & chemistry majors out there- iontophoresis may transfer ions to cause a chemical change within the eccrine units to increase the threshold for sympathetic nerve impulse, essentially changing the cellular secretory physiology of the sweat gland.
What types of sweating can be treated with iontophoresis?
This treatment is best suited for sweating of the hands & feet- palmar and plantar hyperhidrosis. Typically, 60-80% of patients who suffer excessive sweating in these areas respond to this treatment. Once sweating stops, iontophoresis treatments can be reduced. In some cases, patients only need to perform the procedure once every 12-14 days.
Underarm sweating or axillary hyperhidrosis can also respond to iontophoresis, however the use of underarm pads is needed. Iontophoresis in this area has a lower success rate compared to sweat stopping treatments.
Does iontophoresis work for excessive underarm sweating?
Excessive underarm sweating may respond to iontophoresis with the use of special underarm pads. The success rate for iontophoresis in this area is not as good as the hands and feet. Other treatments such as anti-sweat injections have a much higher success rate. Sweat stopping treatments for the treatment of underarm sweating is now on the PBS, and claimable through Medicare.
View our Treatment Gallery
How is iontophoresis performed?
There are several ways to perform iontophoresis. This depends on several factors including- location of sweating, the type of machine used, severity of sweating & previous response and failures. In general iontophoresis is carried out in the following way:
Patients use either the two hands technique, two feet method or one hand one foot. The sweaty areas are immersed in either water or a solution containing ions and chemicals. In Brisbane, we generally use tap water due to the high mineral content.
- A mild electrical current is sent thru the water for 15-30 minutes
- This process is repeated every two to three days for 8-10 sessions
- In some cases salt or sodium bicarbonate is added to increase the ionic strength
- Once sweating decreases, patients go on to a maintenance schedule of one to three sessions per week
Tap water iontophoresis has a success rate of around 50%. Glycopyrrolate has a success rate of around 80+%
Is the treatment painful?
It is well tolerated. The level of current is adjusted so that a slight tingle is felt. This tingle is maintained for a set amount of time, usually 5 to 14 minutes.
Recent devices have built in safety to eliminate the shock when the circuit is broken. This occurs when you suddenly lift one hand or foot from the solution.
Has iontophoresis got any side effects?
It is well tolerated. The level of current is adjusted so that a slight tingle is felt. This tingle is maintained for a set amount of time, usually 5 to 14 minutes.
Recent devices have built in safety to eliminate the shock when the circuit is broken. This occurs when you suddenly lift one hand or foot from the solution.
Has iontophoresis got any side effects?
Sometimes side effects can be seen during iontophoresis treatments, however are not severe enough to lead to discontinuation. Most can be prevented or treated effectively.
Open cuts on the hands and feet should be covered with Vaseline to reduce discomfort during iontophoresis. Starting with a low voltage will reduce any ‘shocking experiences.”
Side effects such as redness along the water line can be seen in 10% of patients, and often fades within a day or two. In a minority of cases ‘bubbles’ of the skin (thought to be blocked sweat glands) can be seen, and usually resolve by themselves. Other rare and transient side effects include dryness of the skin & skin irritation. Using a mild steroid cream as well as a moisturiser can reduce the severity of this side effect.
What other treatments are there if iontophoresis is ineffective?
Iontophoresis is effective in over 80% of cases. For resistant cases, your dermatologist can-
- Combine tablets for sweating as well as iontophoresis
- Add sodium bicarbonate to the iontophoresis mix
- Using antiperspirants with iontophoresis
- Combine chemicals with tap water (glycopyrrolate solution)
- Using special creams with iontophoresis
Other treatments to help patients with excessive sweating of the hands and feet include Botox injections. For patients who suffer from palmar hyperhidrosis who do not respond to all forms of iontophoresis, ETS or endoscopic thoracic surgery can be of benefit.
Note: Anti-sweat injections are claimable via Medicare only if it is used to treat severe excessive sweating of the armpits/ underarm sweating. It is not PBS listed for treating excessive sweating of the hands & or feet.
Where can I purchase an iontophoresis machine?
Devices can be purchased online. They range from 400 to 1100 dollars. More expensive devices like the Idromed are not necessarily better. Even though it is German engineered, there are batches that are inherently faulty.
Dermadry or Fisher are other brands. My advice is not to purchase a device until you know that iontophoresis works for your pattern of sweating.
Book a consultation with Emily Fenton, nurse practitioner at Skinfluence Clinic in Brisbane as she performs iontophoresis.
Who is suitable for iontophoresis?
Most patients are suitable candidates, including children. Iontophoresis is a very safe treatment; however certain exclusions do apply. These include-
- Pregnant women
- People with pacemakers
- Patients with metal implants in the path of the current, eg. Joint replacements
- Patients who suffer for epilepsy
As a guide, children over the age of 7 will tolerate iontophoresis. The current produced by devices are akin to a tingle, not an eclectic shock.
Davin’s Viewpoint on Iontophoresis for Excessive Sweating
Iontophoresis is the next step if antiperspirants don’t work. Ionto is best suited for excessive sweating of the hands & feet, however it can also be used for excessive sweating of the underarms. The success rate for iontophoresis is in the order of 80%. Most commonly we start with tap water with a pinch of sodium bicarbonate. Brisbane has hard water with many minerals, so the addition of salts is minimal.
If this fails, your dermatologist can compound chemicals to further block sweating. The addition of glycopyrrolate to the solution is more effective than tap water alone and will result in remission rates of up to 2 weeks following iontophoresis (most commonly a few days).
Botox injections can be used on the hands; however this treatment is best suited for excessive underarm sweating as it is covered under Medicare. Injections to the hands & feet can be effective in up to 90% of patients, however it only lasts 3-4 months, and it is not covered under the PBS, unlike its use for underarm sweating. Botulinum toxin can also be used in solution, this treatment is academic & not practical due to the costs- over $1000 for 2 litres of solution.
If patients fail iontophoresis, ETS or endoscopic thoracic sympathectomy is the next step, and an opinion from a Vascular Surgeon is valued.
