Hyperhidrosis Forum

[administrator]

http://www.mayoclinicproceedings.com/inside.asp?AID=903&UID=

Iontophoresis

Since 1984, commercial iontophoresis devices have been available for home use. The mechanism of action is unknown. The battery-powered unit delivers a current through tap water–saturated wool pads, separated by a nonconducting barrier placed directly on the treatment site. Patients increase amperage to the maximum output tolerable and treat each site for 30 minutes, up to twice daily. Patients may require daily treatments for up to 2 weeks, which should decrease sweating for several weeks, and repeat treatments as needed. Adverse effects may include pain and small skin burns from the direct current; therefore, alternating current applicators are being developed. Recently, Dolianitis et al have shown iontophoresis with a 0.05% glycopyrrolate solution to be significantly superior to tap water in suppression of palmar hyperhidrosis. Further development and standardization of the technique and equipment for iontophoresis should substantially enhance this treatment alternative.

[administrator]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15527429&dopt=Abstract

Iontophoresis with glycopyrrolate for the treatment of palmoplantar hyperhidrosis.

Dolianitis C, Scarff CE, Kelly J, Sinclair R.

Department of Dermatology, The Alfred Hospital, Melbourne, Victoria, Australia. constantinos1@optusnet.com.au

To determine the comparative efficacy of tap water iontophoresis to iontophoresis with the anticholinergic glycopyrrolate, we undertook a single-blinded right-left comparison study in 20 patients with palmoplantar hyperhidrosis. Most patients had their palms treated and one patient had the soles treated. We compared the duration of symptom relief following iontophoresis with glycopyrrolate unilaterally to iontophoresis with glycopyrrolate bilaterally. Patients filled in daily efficacy assessment cards. Each palm was rated as 'dry', 'slightly wet', 'moderately wet' or 'very wet'. Following treatment with unilateral tap water iontophoresis, unilateral glycopyrrolate and bilateral glycopyrrolate, patients reported hand dryness for a median of 3, 5 and 11 days, respectively. As the data was paired, treatment differences were analysed using a sign-rank test. Bilateral glycopyrrolate was superior to both unilateral glycopyrrolate and tap water in most patients. Unilateral glycopyrrolate was superior to tap water in most patients. All differences between groups were found to be statistically significant. We postulate that the increased efficacy of bilateral glycopyrrolate when compared with unilateral glycopyrrolate relates to its systemic absorption. We conclude that glycopyrrolate iontophoresis is more effective than tap water iontophoresis in the treatment of palmoplantar hyperhidrosis and that glycopyrrolate iontophoresis has both local and systemic effects on perspiration.

[pinker]

I've been using Glycopyrrolate for around 10 months or so now. It has been very successful at reducing my hyperhidrosis of the hands and feet.

One 20 minute treatment of the area (10 minutes on each polatity) will usually make my hand/foot 95-100% dry for a week or longer before the sweating of the fingertips and the centre of my palm starts to kick in.

I origionally found using the solution was a compromise because of the short term side effects that came with every treatment. I always got a very dry mouth which lasted around 20 hours at the most, so eating food was difficult with very little saliva. I also got a dry nose and dry eyes and a slight headache.
I strongly advise to at the most, treat one hand and foot one day, and the other limbs on another day, instead of one limb each day. The side effects with treating both hands and feet in one treatment is multiplied to the point it is unbearable.
I've also found the prominence of the side effects increases with current and treatment length. However, longer durations increase the effectivness of the treatment.

However, I have now found that adding glycopyrrolate solution and tap water together in roughly a half and half ratio maintains the same effectivness and gives a significant reduction in side effects. I recieve four 500ml bottles of glycopyrrolate on prescription, I add 250ml to each tray along with approx 250ml of water. This does dilute the solution slightly, but I still feel a very strong current around 8mA and higher, so glycopyrrolate solution must be quite conductive, or the water aids it in some way. I do experience the dry mouth, nose and a little blurred vision which last a few hours; but this is no where near the level it was when using glycopyrrolate on its own.

[Viking]

pinker, thanks for the detailed info.

Where do you buy your glyco from? Do you need a prescription in your country?