Tap water iontophoresis

A device for direct current conduction water iontophoresis

The tap water iontophoresis is a direct-current therapy for the treatment of skin disorders and is primarily for the conservative treatment of focal hyperhidrosis used, a localized, increased tendency to weld to the hands, feet and armpits. In addition, tap water iontophoresis u. a. also used for the treatment of hand eczema.

Procedure

In tap water iontophoresis (LWI), the hands or feet are placed in two tubs of tap water. An electrode that is connected to a voltage source (control unit) is placed in each tub . The tap water serves as an electrical contact medium between the electrode and the hand or foot. By inserting the hands or feet, the electrical circuit is closed over the body, so that ions are transported through the skin (ionto = ion, phoresis = transport). In the case of armpit treatment, two water-soaked sponge pockets with internal electrodes are used instead of the water tubs.

The therapeutic effect of the LWI is directly dependent on the current density, i. H. the current per wetted skin area. According to Ohm's law, the level of the current results from the applied voltage and the individual body resistance. Normally, currents of a maximum of 15  mA are used for the treatment of the hands and a maximum of 25  mA for the feet. The current or voltage is adjusted depending on the patient and extremity so that it is noticeable in the form of a tingling sensation, but not painful.

The current is applied as direct current or as pulsed current (pulsed direct current). In contrast to the direct current, the pulse current generates a lower stimulus sensation; it is suitable for particularly sensitive and young patients. The direct current, on the other hand, is rated as more effective than the pulse current.

The LWI is applied in two phases: the initial phase and the maintenance phase. In the initial phase, the increased tendency to perspire is gradually reduced. A therapy session lasts 15 to 20 minutes and must be repeated in this phase 3 to 5 times a week over a period of 5 to 6 weeks. In the subsequent maintenance phase, 1 to 2 sessions per week are sufficient to ensure that the therapy is successful.

Working principle

The working principle of iontophoresis in the case of hyperhidrosis treatment has not yet been conclusively scientifically clarified. One explanation is based on a reversible disruption of the ion transport in the secretory tangle of the sweat glands.

The therapeutic effect of tap water iontophoresis is reversible in nature and requires so-called maintenance therapy (see above).

effectiveness

To assess the effectiveness of tap water iontophoresis for the treatment of hyperhidrosis, only small randomized studies are available so far. In several uncontrolled studies and case series, an effectiveness of 80-100% has been reported.

Tap water iontophoresis is widely assessed as an effective, safe treatment method with few side effects.

Tap water iontophoresis devices

Modern iontophoresis device with either direct or pulsed current

LWI devices are not only used in a professional environment (clinic, practice), but also frequently in the home. The LWI devices are subject to medical device law and therefore require appropriate testing and approval by so-called notified bodies .

There is a large number of LWI devices on the market, which differ mainly in the following points:

• Power range (max. Voltage or amperage)
• Direct and / or pulsed current
• Metal or silicone / graphite electrodes
• Availability of special electrodes (e.g. face electrode)

Health insurance

The LWI devices are listed as a separate product group in the aids catalog of the statutory health insurance funds (product group 09.30.01 - monophasic electrotherapy devices for skin dysfunction). If a corresponding prescription is presented , the health insurance companies usually cover the costs for permanent or temporary provision of the LWI device for domestic use by the insured person.

Individual evidence

1. ↑ B. Wörle et al. a .: Definition and therapy of primary hyperhidrosis . Ed .: AWMF Online - The portal of scientific medicine. AWMF Register No. 013/059, Class: S1, 2012.
2. ↑ E. Hölzle et al. a .: Iontophoresis . In: Th. Rustemeyer, P. Elsner, SM John, HI Maibach (Eds.): Kanerva's Occupational Dermatology . Springer-Verlag, 2012, ISBN 978-3-642-02035-3 , pp. 1061-1071 .
3. ↑ TL Diepgen u. a .: Management of hand eczema . In: Vereinigung Deutschsprachiger Dermatologen eV (Ed.): Guideline . 2009.
4. ↑ ^{a b} E. Hölzle u. a .: tap water iontophoresis . Ed .: German Dermatological Society. AWMF Online - The Portal of Scientific Medicine, 2009.
5. ↑ St. Reinauer u. a .: The pulsed direct current iontophoresis as a new treatment option for hyperhidrosis . In: The dermatologist . Volume 46, Issue 8, 1995, pp. 543 -547 .
6. ↑ K. Sato et al. a .: Generation and transit pathway of H + is critical for inhibition of palmar sweating by iontophoresis in water . In: J Appl Physiol . No. 75 , 1993, pp. 2258-2264 .
7. ↑ MA Callejas u. a .: Hyperhidrosis Update . In: Actas Dermosfiliogr. tape 101 (2) , 2010, pp. 110-118 .
8. ^ I. Schiller-Frühwirth: Tap water iontophoresis . In: Main Association of Austrian Social Insurance Institutions (Ed.): Evidence-based economic health care . 2013.
9. ↑ T. Schlereth et al. a .: Hyperhidrosis - causes and therapy of excessive sweating . In: Deutsches Ärzteblatt . Volume 106, Issue 3, 2009.
10. ↑ M. Sonntag: Hyperhidrosis: Causes and Current Treatment Options . In: Z Allg Med . No. 80 . Georg Thieme Verlag KG, Stuttgart New York 2004, p. 289-294 .

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !