A Great Treatment For Palmar/Plantar Hyperhidrosis!  Read up– this can help…

Iontophoresis entails the patient’s hands or feet being placed on a metal plate and gauze in two trays containing glycopyrronium bromide solution and water, or just water if preferred. The plates are connected to a machine generating varying degrees of electrical current, which is passed through the plates, effectively facilitating a circuit through the body (for example, left hand to right hand). This process is then repeated with the current flowing in the opposite direction.

Tap water does not work for me, so I need the glycopyrronium bromide solution; but I understand that tap water works for about 85% of people who use iontophoresis, and that this is the normal practice throughout the UK in many dermatology departments. If people do not get a complete cessation of sweating with tap water alone, then they are switched over to the solution.

The treatment feels different depending on the sensitivity of the individual. I am very sensitive to the electric current and the solution, and I experience most of the known side effects, such as extremely dry and sore mouth and throat and dizziness, usually up to 24 hours after treatment. I also use Vaseline on my wrists and cuticles to prevent burning. The sensation is like placing your hands on an electric fence. It is often uncomfortable and sometimes painful, although I am particularly sensitive. It is not known precisely how iontophoresis works, but it seems to be extremely effective in blocking the sweating temporarily.

Although the glycopyrronium bromide solution provides total relief in localised areas as well as the entire body, it also prevents serious physical activity for 24 hours after a treatment as it blocks the body’s ability to control temperature fully. Iontophoresis gives me relief from hyperhidrosis for about five days, with a steady decline in effects thereafter. I usually have my treatment once a week to maintain the effects.

Through the guidance, warmth, and support of the dermatology nurses, iontophoresis changed my life. It gave me, for the first time ever, total temporary relief from my hyperhidrosis. In short, I felt normal, as though a black cloud had been lifted. For the first time, I could wear sandals, enjoy a summer’s day, hold hands, touch someone on the arm, sit with my hands in my lap, enjoy formal occasions, and shake people’s hands without dread. These examples may all sound inconsequential, but they revolutionised my life.

Professionally, the improvement in my confidence for auditions and performances as a singer and actress has been immeasurable. It has been difficult, given my sensitivity and the side effects, to plan my time around my iontophoresis and arrange treatment times around concerts, rehearsals, and anything involving physical activity. However, the treatment has such positive benefits, both to my life and to my self esteem, that it makes any difficulties worth the inconvenience. Thanks to it and to the support of groups such as Hyperhidrosis UK, I can begin to see my hyperhidrosis as a condition I manage, not as a condition that manages me.

By: Julie Halford, specialist nurse , adviser 1,2, Laura Hunt, patient3, George Millington, consultant dermatologist 4
Originally published: Published 7 April 2009, doi:10.1136/bmj.b1166
Cite this as: BMJ 2009;338:b1166