The comparison of efficacy and long-lasting effect of tap water iontophoresis in continuous direct and pulsed direct currents on primary hyperhidrosis of hand

Document Type : Original article

Authors

1 Students' Research Office, MSc Student in Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Assistant Professor, PhD in Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Associate Professor, PhD in Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Associate Professor of Biostatistics, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Department of Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background and Aims: Primary Hyperhidrosis (PHH) is a functional disorder of idiopathic etiology caused by overstimulation of the sympathetic nervous system stimulating the sweat glands. In the recent years, many studies have evaluated the effectiveness of the palmar hyperhidrosis; one of these methods is the use of pulsed direct current which has been of interest to researchers due to its effect on prevention and reduction of the risk of burns and electrical shock, polarity, and discomfort. The aim of the present study was to compare the efficacy and long-lasting effect of tap water iontophoresis in continous direct and pulsed direct currents on primary hyperhidrosis of hand.
Materials and Method: A total of 20 participants, aged 18-45, volunteerd and were diagnosed with the primary palmar hyperhidrosis. Participants were randomly assigned into two intervention groups treated by either ontophoresis of the tap water with DC or with pulsed DC.  Gravimetric method was also applied to measure the sweating rate at the baseline, 4 days, 1 week, 4 weeks, 8 weeks, and 12 weeks after the treatment. Participants’ quality of life was also assessed using the DLQI at baseline and all follow-up time points. 
Results: Sweating rate significantly reduced during the eight treatment sessions in both intervention groups.The quality of life, too, improved in both intervention groups (P<0.01).
Conclusion: The findings of the present study suggest that both continuous and pulsed direct current is effective in the treatment of palmar hyperhidrosis, but Iontophoresis with pulsed direct current has less side effects.

Keywords

References

  1. Gelbard C, Epstein H, Hebert A, Primary pediatric Hyperhidrosis: A Review of current treatment options, Dermatology 2008;25(6):591-598##
  2. Haider A, Solish N, Focal hyperhidrosis: diagnosis and management ٫ CMAJ  2005;172(1):69-75##
  3. Atkins J, Butler P. Hyperhidrosis: A review of current management, Plastic and Reconstructve Surgry 2002;100(1):222-228##
  4. Kreyden O, Scheidegger P. Anatomy of the Sweat Glands, Pharmacology of Botulinum Toxin, and Distinctive Syndromes Associated with Hyperhidrosis, clinic in Dermatology 2004;22:40-44##
  5. Hoorens I,Ongenae K.Primary focal hyperhidrosis and a step-by-step approach,JEADV2012;26:1-8##
  6. Hornberger J, Grimes K, Naumann M, Glaser D, Lowe N, Naver H, Ahn S, Stolman L. Recognition, diagnosis, and treatment of primary focal hyperhidrosis, J Am Acad Dermatol 2004;51:274-86##
  7. Sanders Bellet J . Diagnosis and Treatment of Primary Focal Hyperhidrosis in Children and Adolescents . Semin Cutan Med  Surg 2010;29:121-12##
  8. Walling H, Clinical differentiation of primary from secondary hyperhidrosis. J Am Avad Dermatol 2011;64:690-5##
  9. Walling H, Primary hyperhidrosis increases the risk of cutaneous infection: A case-control study of 387 patients, J Am Acad Dermatol 2009;61:242-6##
  10. Boboschko I, Jockenhofer S, Sinkgraven R, Rzany B.Hyperhidrosis as risk factor for tinea pedis. Hautarzt 2005;56:151-5.##
  11. Hoorens I,Onagenae K .Primary focal hyoerhidrosis and a step-by-step approach JEAVD2012;26:1-8##
  12. D.Lakraj A,Moghimi  N,jabbari  B.Hyperhidrosis:Anatomy and treatment with emphasis on the role of  Botulinum toxins.Toxins2013;5(4):821-840##
  13. Akari A,kordzadeh A,Hanlee G,Harvey M.Endoscopic thoracic sympathectomy for primary hyperhidrosis:A 16 year followup in a single UK centre.The surgeon2013;11(3)130-133##
  14. Muller C,Berensmeier A,Hamm H,Dirrschka T,Reich K,Fischer T, Rzany B.Efficacy  and safety of methantheline bromide(Vagantin)in axillary and palmar hyperhidrosis:result from a multi center,randomized,placebo-controlled trial.JEADV2013;27:1278-1284##
  15. Walling H.Systemic therapy for primary hyperhidrosis:A retrospective study of 59 patients treated with glycopyrrolate or clondine journal of  American Academy of  Dermatology2012;66(3):387-392##
  16. Mijnhout GS, Kloosterman H, Simsek S, Strack van Schijndel RJ, Netelenbos JC. Oxybutynin: dry days for patients with hyperhidrosis. Neth J Med 2006; 64:326-8.##
  17. Eisenach J, Atkinson J, Fealey R. Hyperhidrosis:Evolving Therapies for a Well-Established Phenomenon, Mayo Clin Proc. 2005;80(5):657-666##
  18. Murray CA, Cohen JL, Solish N. Treatment of focal hyperhidrosis. J Cutan Med Surg 2007;11:67-77.##
  19. Gelbard C, Epstein H, Hebert A. Primary Pediatric Hyperhidrosis: A Review of Current Treatment Options Pediatric Dermatology 2008;25(6):591-598##
  20. Kreyden O,  Iontophoresis for palmoplantar hyperhidrosis, Journal of Cosmetic Dermatology.2004;4:211–214##
  21. Aghaei S, Sodaifi M, Jafari P, Mazhahinia N, Finlay AY. DLQI score in vitiligo:reliability and validity of the Persian version. Bmc Dermatology 2004;4:8##
  22. Phadke VA, Joshi RS, Khopkar US, Wadhwa SL.Comparison of topical methenamine, glutaraldehyde and tap water Iontophoresis for palmoplantar hyperhidrosis.Indian J Dermatol Venereol Leprol 1995; 61:346-348##
  23. Dolianitis C, Scarff CE, Kelly J et al. Iontophoresis with glycopyrrolate for the treatment of palmoplantar hyperhidrosis. Australas J Dermatol 2004;45:208–212. 25.##
  24. Kavangah GM, Shams k. Botulinum toxin type A by iontophoresis for primary palmar hyperhidrosis. J Am Acad Dermatol2006;55(5):S115-S117##
  25. Davarian S, Kalantari KK, Rezasoltani A, Rahimi A. Effect and persistency of botulinum toxin iontophoresis in the treatment of palmar hyperhidrosis. Australas J Dermatol 2008; 49(2):75-9.##
  26. Shen JL, Lin GS, Li WM. A new strategy of iontophoresis for hyperhidrosis. J Am Acad Dermal 1990; 22(2 Pt 1):239-41.##
  27. Lucchi M, Bilancini S, Tucci S. Palmoplantar hyperhidrosis:a therapeutic approach using iontophoresis. MinervaCardioangiol 1998; 46:397-8.##
  28. Holzle E, Alberti N. Long-term efficacy and side effects of tap water iontophoresis of palmoplantar hyperhidrosis--theusefulness of home therapy. Dermatologica 1987; 175:126-35.##
  29. Reinauer S, Neusser A, Schauf G, Hölzle E. Iontophoresis with alternating current and direct current offset (AC/DC iontophoresis): a new approach for the treatment of hyperhidrosis. Br J Dermatol. 1993 Aug;129(2):166-9.##
  30. Karakoc Y, Aydemir EH, Kalkan MT, Gayeunal MD. Safe control of palmoplantar hyperhidrosis with direct electrical current International Journal of Dermatology 2002;41(9):602-605##
  31. Pacini S, Punzi T, Gulisano M, Cecchi F, Vannucchi S, Ruggiero M. Transdermal Delivery of Heparin Using Pulsed Current Iontophoresis Pharmaceutical Research 2006;23(1):114-120##
  32. Dixit N,  Bali V, Baboota S,  Ahuja A , Ali J. Iontophoresis - An Approach for Controlled Drug Delivery: A Review Current Drug Delivery  2007; 4: 1-10##
  33. Mizutani K,  Watanabe D,  Akita Y,  Akimoto M, Tamada Y.Matsumoto Y.Photodynamic therapy using direct-current pulsed iontophoresis for 5-aminolevulinic acid application Photodermatology, Photoimmunology & Photomedicine 2009; 25: 280–282##
  34. Chan LY, Tang WYM, KK Lo, WK Mok, CYF Ly, AWC Ip, Treatment of palmar hyperhidrosis using tap water iontophoresis: local experience, HKMJ 1999;5:191-4##
  35. Sandip B. Tiwari, N. Udupa. Investigation into the potential of iontophoresis facilitated delivery of ketorolac International Journal of Pharmaceutics2003; 260:93–103##
  36. Raimana J, Koljonen M, Huikko K. Delivery and stability of LHRH and Nafarelin in human skin: the effect of constant/pulsed iontophoresis  European Journal of Pharmaceutical Sciences 2004;21:371–377##
The Scientific Journal of Rehabilitation Medicine
Volume 5, Issue 2
July and August 2016
Pages 122-131

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History

  • Receive Date: 03 April 2015
  • Revise Date: 27 August 2015
  • Accept Date: 28 October 2015
  • First Publish Date: 21 June 2016

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