To date, there are two types of iontophoresis devices that are currently seeing use in the United States: (1) The Drionic Iontophoresis unit, and (2) the Fischer Model MD-1a Iontophoresis unit. These two iontophoresis devices have received approval for treating hyperhidrosis from the United States Food and Drug Administration.

The use of electricity to treat human diseases has been studied for more than two centuries, not long after its discovery in the 18th century. It’s been mentioned in a few studies that Pivati introduced the use of iontophoresis in the treatment of arthritis in the 1740’s. Further studies in the following two hundred years have confirmed the efficiency of the procedure in administering drugs through a patient’s skin.

The use of iontophoresis to treat hyperhidrosis gained popularity in the 20th century:

1936 – Ichikasa realized that drugs administered through iontophoresis resulted in reduced sweating activity in the affected area.
1940’s – In a study independent from Ichikasa’s, Takata and Shelley successfully obtained anhidrosis (the reverse of hyperhidrosis) through iontophoresis with tap water.
1968 – Levit published his ideas on a practical device that administered iontophoresis to patients, further boosting the procedure’s popularity.

Studies have also shown that the skin’s sweat glands provide the least amount of electrical resistance during an iontophoresis procedure, indicating that drugs mainly enter the patient’s skin through these channels. While iontophoresis have been used by dermatologists in attempts to treat other medical conditions (such as scleroderma and vitiligo), hyperhidrosis seems to be the only medical condition readily treated by the procedure, owing to its widespread popularity and high success rate.

Iontophoresis delivers a charged molecule across the skin. This is done by placing it near an electrode of the same charge as itself, while another electrode of opposite charged is placed on another part of the body. While this explains how drugs are transported across the skin, it does not explain how tap water iontophoresis reduces sweat output. Exactly how this is done is still a mystery, although several theories have been suggested.

One early theory suggested that iontophoresis plugged sweat gland ducts, since iatrogenic miliaria developed when iontophoresis was administered on the back, chest, or arms of patients. Microscopic analysis did show keratin plugs blocking sweat ducts, but light and electron microscopy found no such blockages in a patient treated for palmar hyperhidrosis.

It would seem that iontophoresis may cause an impairment in a sweat gland’s function instead of a blockage. Other theories suggest that the procedure raises the threshold for transmission of sympathetic nerve impulse, or that it changes the physiology of cellular secretory system. Neurotransmitter levels in the eccrine gland or surrounding microciruclation remain unchanged after iontophoresis, however, so the subject still remains open to debate.

Iontophoresis treatment regimens vary with the device used, the areas of the body to be treated, and whether the procedures will be done at home or at the clinic.