Tap-Water Iontophoresis (TWI)

In cases where antiperspirants are not effective, a physician may recommend Tap Water Iontophoresis for the treatment of palm or foot hyperhidrosis. In medical terms, iontophoresis is the topical introduction of ionized drugs into the skin using direct current (DC).

Typical treatments consist of placing the hands (and/or feet) into two water baths, each with a connection to the Galvanic Unit. Current is applied typically for 10-20 minutes per session, initially with 2-3 sessions per week followed by a maintenance program of treatments at 1 to 3 week intervals, depending upon response. Devices include the Fischer Galvanic Unit and the Drionic Unit. Both of these devices are available for home use.

• Galvanic devices are more effective than Drionic devices
• Mostly indicated for palmar (palm) and plantar (sole) hyperhidrosis.
• Mechanism of action is unknown but recent research suggests that a plug is formed, blocking the duct without damaging the sweat gland.

Effectiveness:

• About 50-75% of patients find TWI relatively effective

Side Effects and Drawbacks:

• Local dysthesias or burning sensations
• Erythema (skin redness) and urticarias (hives)
• Electrical stinging
• Electric burns on uncovered skin defects such as, small paper cuts
• Requires daily or several times per week treatment
• Can be time consuming
• Cost - C$1,200 for each device