Hyperhidrosis of palms, soles, armpits - Dr. Zatrok’s blog

Hyperhidrosis of palms, soles, armpits

Many people suffer from the symptoms of excessive sweating (known in medical terms as hyperhidrosis). Without any particular cause – such as very warm weather, or stress, etc. – “they are dripping water”. If you are affected by it, then you also must be struggling a lot with this problem. You can try an army of cosmetics, medicines, more recently, Botox injections, and even undergo surgery. However, these really work for few people. Today, they begin to “rediscover” the tap water iontophoresis. The method has been applied for nearly 50 years, but only nowadays have the devices become really effective. So much so that according to the latest studies, already more than 90% of those who have received treatment have experienced a beneficial effect. Let’s take a closer look at the method.

What is hyperhidrosis?

Some people’s sweat glands are unduly excessively active and for unknown reasons, they produce a continuous and large amounts of sweat. This phenomenon is abnormal sweating or hyperhidrosis, which affects around 5% of the world’s population.

Sweating is a “normal” and necessary function which is of great importance in the regulation of body temperature. There are millions of sweat-producing glands in your body. Warm weather, exercise, stress, infectious diseases, and consuming strong-flavoured (e.g. hot and highly spiced) foods activate your sweat glands and increase sweat production (sweating).

The most accepted view is that abnormal sweating is a consequence of the hyperactivity of the sympathetic nervous system, which causes the sweat glands to continuously produce sweat. Patients with hyperhidrosis sweat 4-5 times more than average. The amount of sweat significantly exceeds what the body needs to maintain and control the body temperature.

In essence, the sweat glands of people with hyperhidrosis are always “switched ON”, and do not require a trigger to activate them, such as a rise in body temperature while exercising.

hyperhidrosis or excessive sweating of palms, soles or armits

Forms of abnormal sweating

Primary hyperhidrosis is most often a hereditary disease, i.e., it shows family accumulation. According to research findings, it is related to excessive activity of the sympathetic nervous system. The nerves running to the sweat glands are malfunctioning, sending signals to the sweat glands to secrete excessive amounts of sweat, even if there is no reason to do so. Even at rest and in cool weather, the sweating is so strong that a “healthy-ish” person can only experience it in the heat of the sauna.

Primary hyperhidrosis usually appears as early as childhood. In most cases, sweating is strongest in a defined area of the body, such as the palms, soles, armpits, less often the head, face, and neck. Rarely, several areas can be affected at the same time.

Although excessive sweating is not a life-threatening condition, it can also have a serious impact on everyday life, learning, work, and relationships. The problem can lead to mental problems, depression, and isolation.

Secondary hyperhidrosis can also be caused by a disease or a side effect of a medicine. However, this usually affects the whole body. In such a case, identifying and eliminating the root cause(s) is the method of treatment.

Treatment of abnormal sweating

Although there is no cure that would permanently eliminate the phenomenon, but there are a number of treatments available to relieve the symptoms. These include antiperspirant cosmetics and prescription oral and topical medications, as well as tap water iontophoresis.

Tap water iontophoresis for the treatment of palmar and plantar hyperhidrosis can be traced back to the 1940s. Since the introduction of the method, the technology has been constantly evolving, resulting in a significant improvement in its efficiency. Therefore, today, tap water iontophoresis is one of the safest, easiest, and most effective ways to treat hyperhidrosis. With the devices available today, treating excessive sweating is easy, fast and risk-free even at home.

The International Hyperhidrosis Society, that is, the professional organization of physicians treating pathological sweating has long recommended this treatment as first choice treatment option. It is effective even if all other usual treatment attempts (cosmetics, medications, Botox, acupuncture, etc.) have failed.

The treatment is safe, needle-free and drug-free. A mild, pulsating electric current is passed through the skin of the problem area. Treatment with a current of appropriate frequency and intensity “separates” the connection between the sweat glands, and the vegetative nerves that provide them with incorrect instructions. This eliminates sweating generated by malfunctioning neural activity. A two-week cure eliminates sweating for weeks, or at least significantly reduces it. What is important: it is almost always successful!

sweat glands before and after treatment

What is tap water iontophoresis and how does it work?

To better understand iontophoresis, let’s interpret the word itself.

  • Ion = electrically charged molecule
  • Phoresis = a process in which charged particles migrate in electrolyte fluids acting as conductors, under the influence of an electric direct current.
    Positive ions (cations) migrate toward the negatively charged cathode, while negative ions (anions) migrate toward the positive side, i.e., the anode.
  • Iontophoresis = movement of ionized (electrically charged) particles by means of electrical current

Iontophoresis is a form of electrotherapy during which a mild electrical current is passed through the affected area (hands, feet or armpits). The current “carries away” the electrically charged particles in water and delivers them to the body.

According to the most accepted theory, this inhibits the sympathetic neural signal transmission, and this quasi “turns off” the sweat glands. It neutralizes the signal between the nerve and glands, thereby reducing or completely inhibiting the formation of sweat in the treated area. Other theories suggest that the iontophoresis causes blockage of the sweat gland – during treatment, the deposition of ions creates a temporary “plug” in the sweat glands.

After all, it doesn’t matter which way, but with treatment you can achieve excellent results.

Important information before treatment of sweating

  • Apply iontophoresis treatment only if there are no contraindications to it. These are the same reasons to be considered for other electrotherapy treatments, too. Follow the device manufacturer’s instructions and recommendations.
  • It is important to know that in the course of the iontophoresis, you may feel a mild tingling sensation.
  • You should also know that the electric current used during iontophoresis is not strong enough to cause any damage.
  • Do not use iontophoresis during pregnancy, if you have a pacemaker, heart disease or epilepsy. If you are unsure, ask your doctor’s opinion.
  • Remove jewellery, rings, and bracelets before iontophoresis treatment.
  • If there is a wound or scratch on your skin, apply Vaseline to the affected skin area before treatment, this will protect the wound from getting soggy from soaking in water. Vaseline inhibits the iontophoresis process, so apply it only where and to the extent necessary.
  • Treatment may cause mild redness of the skin. It will disappear in a few minutes. If not, ask your doctor what to do.
  • If it dries your skin excessively, use a moisturizing body lotion after treatment.

What does effectiveness depend on?

Mainly on the current form used by the device. You can expect the best results from devices specially made for the treatment of abnormal sweating.

The most effective treatment is provided by devices that use the so-called pulsed current (continuous alternation of current / pause).

Home electrotherapy devices are available that provide “conventional” constant current iontophoresis in addition to analgesic TENS (nerve stimulation) and muscle stimulation (EMS) programmes. Such devices are mainly intended for the treatment of joint complaints. They are 30-40% less efficient in the treatment of sweating than devices that provide a pulsed current.

Dermadry’s tap water iontophoresis deviceDermadry tapwater iontophoresis unit for treatment of excessive sweating

  • this device was developed as an effective way to treat abnormal sweating
  • separate programmes are available to treat sweating in the palms, soles (hands and feet sweating, i.e., palmoplantar hyperhidrosis) and armpits/underarms (underarm sweating, that is, axillary hyperhidrosis).
  • simple operation, 15-30 minutes treatment time per day
  • after 2 weeks of treatment, 93% success rate, sweating normalizes or disappears completely
  • for home use, cosmetologists, or dermatology clinics
  • its price is around €400
  • Click here or on the image to buy it

What kind of water should you use?

Normal tap water is required for the treatment!

Water quality may vary from one settlement to another. If the water is too soft, the iontophoresis may not have an optimal effect. Soft water does not contain enough minerals or electrolytes (tiny electrical particles). Use unsoftened water or add a teaspoon of baking soda to the water used.

According to some clinicians, salt water has a stronger therapeutic effect. If you are “not satisfied” with the normal tap water available at your place, add a quarter teaspoon of table salt to the water and carry out the treatment.

Although purchasing a device specifically designed to treat excessive sweating may seem expensive, but you can quickly see through that because the device “lasts” for many years, (even decades), you can treat sweating without additional costs. Excessive sweating often “runs through” the entire family, meaning almost every family member is affected. The iontophoresis device can be used by all members of the family.

Treatment of hands and feet sweating by iontophoresis

The treatment itself is carried out in the same way with both the pulsed current and the conventional iontophoresis devices. Let’s take a look at the steps.

Treatment of excessive sweating of palms and soles

  • Take out the device, the iontophoresis kit, two plastic trays (the size that your hands or feet fit right in).
  • Fill the containers with half a centimetre of water. Just touch the water with your hands or feet (do not immerse)!
  • Connect the electrodes to the cables, and plug the latter to the device.
  • Place one electrode and a towel in one tray and the others in the other one.
  • Stand on it with both feet, or place both of your hands on the towels.
  • Activate device (start the “hands” or “feet” programme/profile). Run the iontophoresis programme with a current that you can tolerate but does not cause you pain.

Treatment of underarm sweating by iontophoresis

Treatment of excessive sweating of armpits

  • Connect the electrodes to the cables, and plug the latter to the device.
  • Soak the sponge cases (underarm pockets) in water, insert electrodes, insert cables, plug the cables into the device, plug AC adapter, select the “underarm” programme and place one (electrode containing pocket) in your right armpit and the other in your left armpit.
    Press your arms against your armpits/trunk until the end of the treatment.
  • Activate device (start the “underarm” programme). Run the iontophoresis programme with a current that you can tolerate but does not cause you pain.

How often should tap water iontophoresis treatment be performed?

There are two phases of treatment: the symptomatic phase and the maintenance phase.

In the symptomatic phase, you reduce the symptoms with intensive (daily) treatments, and then, after they have disappeared, you maintain the achieved condition with less frequent, but regular treatments. Over time, sweating may return, at which point you may switch to more intensive treatment again.

The required frequency of treatments at the symptomatic phase depends on the extent of hyperhidrosis.

  • Mild: 3-5 times a week for 1-2 weeks.
  • Moderate: 3-5 times a week for 2-3 weeks.
  • Severe: 3-5 times a week for 4-6 weeks.

With the Dermadry device, the treatment takes only 15 minutes (armpits) or 20 minutes (hands and feet).

Once the desired level of dryness has been achieved, the frequency of treatments can be reduced, but you still need to treat in order to maintain the results.

  • Mild: once a week for an additional 2-3 weeks
  • Moderate: once a week continuously
  • Severe: 1-3 times a week continuously

Is tap water iontophoresis effective?

More and more clinical trials prove the efficacy and safety of tap water iontophoresis in the treatment of hyperhidrosis. In the majority of studies, the success rate for a two-week use is around 90%, meaning that almost all patients receiving treatment report a beneficial effect.

Studies have consistently demonstrated that tap water iontophoresis is a simple, safe, economical, and effective treatment form for hyperhidrosis. It is worth applying it if the simpler and cheaper antiperspirants and cosmetics do not lead to adequate results.

Tap water iontophoresis should definitely be used before deciding on, or instead of Botox injections, surgical interventions, and prescription, long-term medication.

It is a natural, drug-free, needle-free and non-invasive treatment option that provides long-term results. It can effectively treat different degrees of hyperhidrosis, from mild to severe cases.

The latest hyperhidrosis research findings

I reviewed some medical research data. These are just some of those studies that have examined the effectiveness of tap water iontophoresis in case of hyperhidrosis. What they have in common is that the results were found to be favourable, regardless of age, also in mild, moderate and severe conditions.

Summary results from medical studies:

  • Tap water iontophoresis significantly improves the patient’s quality of life during treatment.
  • 92.9% of those treated already improved after two weeks of iontophoresis treatment.
  • 88.9% of them experienced a positive result, i.e., improvement, reduction or complete cessation of sweating.
  • According to the majority of scientists, the treatment program can easy be implemented and integrated into your lifestyle.
  • After 2 weeks of treatment, 78.6% of those receiving treatment reported a significant improvement in their quality of life.
  • Tap water iontophoresis is a simple, safe, and effective therapeutic option for hyperhidrosis.
  • Children can also be treated safely and effectively with tap water iontophoresis.
  • Minimal side effects should be considered during tap water iontophoresis treatments.
  • After a total of eight treatments, tap water iontophoresis has been shown to be effective in treating palmar hyperhidrosis.
  • Iontophoresis treatment is safe, effective, and easy to use, so it should be used before deciding on surgery or botulinum toxin injection.
  • Tap water iontophoresis suppresses palmar hyperhidrosis. Iontophoresis is a simple, economical, and effective therapy to be offered to patients before considering surgery or Botox treatment as an option. Iontophoresis is an excellent alternative to long-term drug treatment. The study showed a success rate of 83.3%.
  • Modern pulsed current tap water iontophoresis is considered the most effective therapy for palmar and plantar hyperhidrosis. Patients with extremely heavy sweating also respond to treatment. No adverse effects were observed even during long-term treatment.
  • The treatments were so effective in axillary hyperhidrosis that iontophoresis was recommended instead of surgical interventions.
  • Tap water iontophoresis can be used with complete success. All patients receiving treatment experienced complete cessation of sweating and no adverse reactions occurred.
  • In 2014, the FDA (U.S. Food and Drug Administration) concluded that “eight studies have consistently shown that tap water iontophoresis effectively reduces perspiration in the vast majority of treated individuals”.

Sources

  1. Doolittle, James, Patricia Walker, Thomas Mills, and Jane Thurston. “Hyperhidrosis: an update on prevalence and severity in the United States.” Archives of dermatological research 308, no. 10 (2016): 743-749.
  2. Kim, Do Hun, Tae Han Kim, Seung Ho Lee, and Ai Young Lee. “Treatment of Palmar Hyperhidrosis with Tap Water Iontophoresis: A Randomized, Sham-Controlled, Single-Blind, and Parallel-Designed Clinical Trial.” Annals of dermatology29, no. 6 (2017): 728-734.
  3. Elkhyat A and Agache P. Treatment of hyperhidrosis by iontophoresis of weakly mineralised water. 1993. Cutaneous Biophysics Laboratory, Department of Functional Dermatology, 25030 Besancon, France.
  4. Hölzle, E., M. Pauli, and O. Braun-Falco. “Leitungswasser-Iontophorese zur Behandlung von Hyperhidrosis manuum et pedum.” Der Hautarzt 35, no. 3 (1984): 142-147.
  5. Stolman, Lewis P. “Hyperhidrosis: medical and surgical treatment.” Eplasty 8 (2008).
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  7. Kim, Do Hun, Tae Han Kim, Seung Ho Lee, and Ai Young Lee. “Treatment of Palmar Hyperhidrosis with Tap Water Iontophoresis: A Randomized, Sham-Controlled, Single-Blind, and Parallel-Designed Clinical Trial.” Annals of dermatology29, no. 6 (2017): 728-734.
  8. Maj, NS WALIA, BS RATHORE Lt Col, and AK JAISWAL Col. “TREATMENT OF PALMOPLANTER HYPERHIDROSIS BY IONTOPHORESIS.” Medical Journal Armed Forces India 56, no. 1 (2000): 27-28
  9. Kim, Do Hun, Tae Han Kim, Seung Ho Lee, and Ai Young Lee. “Treatment of Palmar Hyperhidrosis with Tap Water Iontophoresis: A Randomized, Sham-Controlled, Single-Blind, and Parallel-Designed Clinical Trial.” Annals of dermatology 29, no. 6 (2017): 728-734.
  10. Yardi, S. S., U. S. Khopkar, V. A. Phadke, and S. S. Idgunji. “Tap water iontophoresis for palmoplantar hyperhidrosis.” Indian Journal of Dermatology 42, no. 3 (1997): 164-167.
  11. Dagash, Haitham, Sinead McCaffrey, Katie Mellor, Agnes Roycroft, and Ingrid Helbling. “Tap water iontophoresis in the treatment of pediatric hyperhidrosis.” Journal of pediatric surgery 52, no. 2 (2017): 309-312.
  12. Dogruk Kacar, Seval, Pinar Ozuguz, Selma Eroglu, Serap Polat, and Semsettin Karaca. “Treatment of primary hyperhidrosis with tap water iontophoresis in paediatric patients: a retrospective analysis.” Cutaneous and ocular toxicology 33, no. 4 (2014): 313-316.
  13. Karakoç, Yunus, Ertuğrul H. Aydemir, M. Tunaya Kalkan, and Gaye Ünal. “Safe control of palmoplantar hyperhidrosis with direct electrical current.” International journal of dermatology41, no. 9 (2002): 602-605.
  14. Safe control of palmoplantar hyperhidrosis with direct electrical current. Karakoç Y, Aydemir EH, Kalkan MT, Unal G. Int J Dermatol. 2002 Sep
  15. Stolman, Lewis P. “Treatment of excess sweating of the palms by iontophoresis.” Archives of dermatology 123, no. 7 (1987): 893-896.
  16. Hölzle, E., and N. Alberti. “Long-term efficacy and side effects of tap water iontophoresis of palmoplantar hyperhidrosis–the usefulness of home therapy.” Dermatology 175, no. 3 (1987): 126-135.
  17. Midtgaard, K. “A new device for the treatment of hyperhidrosis by iontophoresis.” British Journal of Dermatology 114, no. 4 (1986): 485-488.
  18. Hölzle, E., and T. Ruzicka. “Treatment of hyperhidrosis by a battery-operated iontophoretic device.” Dermatology 172, no. 1 (1986): 41-47.
  19. Hölzle, E. “Leitungswasseriontophorese.” Der Hautarzt 63, no. 6 (2012): 462-468.
  20. U.S. Food and Drug Administration. “Reclassification of Iontophoresis Devices Intended for Any Other Purposes.” Office of the Federal Register (accessed September 1, 2018).

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