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Hyperhidrosis Treatments
Treatments for Primary Focal Hyperhidrosis
How to Make Iontophoresis More Effective
Written by Katie Crissman
October 01 2020

Iontophoresis is a treatment for palmar and plantar hyperhidrosis that uses a direct current to introduce an ionized substance through the skin. It conveniently allows patients to manage their hyperhidrosis at home. Typically, once a patient obtains a machine, the process is cheap and relatively easy to maintain. Iontophoresis for palmar and plantar hyperhidrosis has been proven to be an effective treatment.[1] However, some people find that iontophoresis is not working for them. There are several modifications people can make to their treatment plan that can make iontophoresis more effective.

Most of the time, a hyperhidrosis patient will learn how to use iontophoresis under a doctor, or other medical care professional’s, guidance. This is important because there are many factors to consider when beginning iontophoresis, such as the machine settings, length of sessions, frequency of sessions, and the strength of the current. Patients should follow their doctor’s instructions carefully.

Sticking to the Plan and Giving It Time

Many times, patients begin iontophoresis sessions at home expecting results. When those results fail to happen, the patient is disappointed and often jumps to the conclusion that iontophoresis is not going to work for them. This may be true, but it is more likely that they just need to give iontophoresis more time to work. Often, sticking to the original plan will yield results if given enough time.

If a patient has not consulted a medical professional and has purchased a machine on their own, the problem may be that they do not have a sufficient plan. They either need to consult a professional, or learn how to use iontophoresis efficiently in order to make a plan that will work.

In most cases, iontophoresis takes at least two weeks of consistent use to show results. Sometimes it can take even longer.[2] For a patient dealing with burdensome symptoms, that is a long time, and it can lead some to change their treatment plan prematurely. When patients discontinue, or alter iontophoresis sessions out of frustration, this can greatly impact results. It is best to give iontophoresis time to work. If no progress is seen after several weeks, a patient should ideally consult their doctor who can help them come up with a new course of action.

Track Progress

Sometimes it is hard to notice changes that occur over time. Monitoring symptoms and writing them down can help patients determine whether or not iontophoresis is helping them. Writing down symptoms will not make iontophoresis work any better, but it will help patients and doctors determine whether changes to the treatment plan need to be made.

Change the Settings

There are several settings on an iontophoresis machine that can be adjusted to increase effectiveness. These include the session length, current strength, type of current, and anode or cathode settings. Turning up the voltage can make iontophoresis more efficient if a lower voltage setting is not working. Unfortunately, a higher voltage is more likely to cause irritation and can make sessions more uncomfortable. Increasing the length of an iontophoresis session can also help in some circumstances. Before changing too many settings, it is wise to speak with a professional who is familiar with iontophoresis and can give advice based on individual circumstances.

Adding New Ingredients

Some people find that iontophoresis with tap water alone is not enough to reduce their sweating. While there are several studies that show tap water iontophoresis is quite effective, in some situations ingredients can be added to increase the potency of iontophoresis.

Add Baking Soda

Tap water in some areas may not have enough mineral content for iontophoresis to work properly. When mineral content is too low the current can’t flow through the water sufficiently for iontophoresis to be effective. This can easily be corrected by adding one teaspoon of baking soda to each tray of water. This should improve the situation and make iontophoresis work if low mineral content is the underlying problem.[1]

Add a Medication

When tap water iontophoresis is not working for an individual, medication can be added to the tap water to make improve treatment.Glycopyrrolate has been used to treat excessive sweating for years, as it is an anticholinergic medication which acts on the autonomic nervous system in such a way that it prevents the body from producing sweat. It is also one of the oral medications for hyperhidrosis that doctors prescribe. When glycopyrrolate is crushed and added to the tap water in iontophoresis trays, it has been shown to enhance the effects of iontophoresis. One study looked at the effectiveness of iontophoresis with tap water, tap water and glycopyrrolate, and a combination of both to determine whether glycopyrrolate made improved iontophoresis. In the study patients were given either bilateral (both hands), unilateral (one hand), or no treatment with glycopyrrolate. It was found that the patients who received bilateral treatment with glycopyrrolate added to the tap water had a reduction in sweating that occurred sooner and lasted longer than the other groups. If a patient decides to begin using the medication, it is suggested that they start with 2 mg tablets of glycopyrrolate crushed and added to the tap water in the iontophoresis trays. The dose can be adjusted up or down based on the patient’s needs. Side effects from glycopyrrolate can occur.[1]

Another medication that can be added to tap water is botulinum toxin, or botox. Botox is a neurotoxin, produced by the bacteria Clostridium botulinum, that can prevent neurotransmitters from activating eccrine sweat glands. Botox injections for the treatment of axillary hyperhidrosis are approved by the FDA, and have been successfully used to reduce sweating in the hands and feet. One study of eight patients with palmar hyperhidrosis demonstrated that botox can make symptoms of hyperhidrosis lesson. The patients in the study who were given botox mixed with tap water experienced symptom relief at one week versus the patients in the other group who experienced relief at three weeks.[3]

Consider Combination Therapy

If iontophoresis is only partially effective, even with added medications and adjustments, patients should consider combination therapy. This often means combining clinical strength over-the-counter antiperspirants or prescription antiperspirants with an iontophoresis regimen. Mixed therapy allows patients to use iontophoresis less frequently, which can in turn increase convenience and patient compliance.[1] Patients can also use iontophoresis along with other treatment options as their doctors see fit.

Iontophoresis really does work for most hyperhidrosis patients who try it. The struggle patients go through to get iontophoresis to work is usually worth it, as iontophoresis is one of the safest effective treatments available for palmar and plantar hyperhidrosis.

Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Philadelphia, PA: Elsevier.
  2. Walling, H. W., & Swick, B. L. (2011). Treatment Options for Hyperhidrosis. American Journal of Clinical Dermatology, 12(5), 285-295. Retrieved October 9, 2018.
  3. Benson, R A, et al. “Diagnosis and Management of Hyperhidrosis.” British Medical Journal, vol. 347, 25 Nov. 2013, doi:10.1136/bmj.f6800.
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Antiperspirant

What You Need to Know About Carpe Clinical Regimen

By Katie Crissman /

One of the newest clinical strength antiperspirants to hit the market is Carpe’s Clinical Grade Regimen - it combines several high performing products with a specific care routine to provide long term sweat reduction for even the heaviest sweaters. Read on to see if Carpe Clinical Regimen is right for you!

Antiperspirant is great - for most people. You apply it once a day and it stops your sweat! It’s easy. But, what if that’s not what happened? You bought it, read the label, and used it exactly as directed and, unfortunately, you’re still sweating - excessively. If this is you, then you’ve come to the right place. There are products specifically made for heavy sweaters who haven’t had luck with traditional antiperspirants. These products typically include the words “extra strength”, “clinical strength” or “prescription strength” and they are, thankfully, available over the counter without a doctor’s prescription. 


The difference between clinical strength products and their weaker counterparts are the active ingredients they use. Clinical strength lines typically use one of several newer types of metallic salt ingredients that are known to be both stronger and less irritating than aluminum chloride (which is the standard active ingredient in antiperspirants) [1]. While there are many clinical strength products on the market, we are going to focus on a new clinical strength regimen that combines a strong active ingredient with a specific care routine to get excessive sweating under control. 


Carpe Clinical Regimen -  What It Is and How It’s Different

One of the newest clinical strength antiperspirants to hit the market is Carpe’s Clinical Grade Regimen. It’s different from other prescription grade products because it combines several strong products with a specific care routine to ensure maximum product performance. It’s also different from Carpe’s other products because it uses a stronger active ingredient and delivery system. The system is geared toward people who experience intractable armpit sweating, but Carpe also makes products for people who struggle with other types of sweat. The Carpe Clinical Grade Underarm includes three specific products that, when used together, have been found to be highly effective at reducing sweat production. These products include:

  • Carpe Clinical Grade Underarm Antiperspirant 
  • Carpe Clinical Grade Exfoliating Wash
  • Carpe Clinical Grade Underarm Wipes[2]

Carpe Clinical Grade Regimen uses an active ingredient called Aluminum Zirconium Tetrachlorohydrex GLY (20%) combined with other soothing inactive ingredients to effectively stop sweat in its tracks while reducing skin irritation.[3] Aluminum Zirconium Tetrachlorohydrex is a newer generation metallic salt that stops sweat production and is known to be more effective than other types of active ingredients antiperspirants typically use. One study mentioned in the journal Dermatologic Clinics found that antiperspirants using Aluminum Zirconium Tetrachlorohydrex were, on average, 34% more effective than antiperspirants that used aluminum chloride as an active ingredient.[1] Carpe’s traditional products use an active ingredient called Aluminum Sesquichlorohydrate at 15% which is effective, but less potent than Aluminum Zirconium Tetrachlorohydrex.[4]


It’s important to note that Carpe’s Clinical Grade Regimen provides a long term impact on sweat reduction from making short term lifestyle changes. This is because the results build up over time and peak at about 4 weeks. It takes 4 weeks of using the Carpe clinical grade products once each morning and every other night to see the full effect of what they can do. This is typical of all antiperspirants as their effects tend to build up with consistent use. Consistently using antiperspirant products is especially important for those with hard to treat sweat problems because it can be the difference between treatment success or failure.[1][2] 


If you’re frustrated with the way your current antiperspirant is working or how it isn’t working, then consider giving Carpe’s Clinical Grade Regimen a try! It’s active ingredient is comparable to other prescription strength products on the market but it’s multistep system with easy to use wipes is completely unique! Remember, an easy to use, consistent antiperspirant routine is going to give you long term sweat reduction so it’s important to find a system that works for your lifestyle. 


Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved from https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0>https://www.elsevier.com/books/hyperhidrosis-an-issue-of-dermatologic-clinics/pariser/978-0-323-32607-0
  2. How It Works (Clinical). Carpe. https://mycarpe.com/pages/how-it-works-clinical
  3. Clinical Underarm  PM Wipes. Carpe. https://mycarpe.com/products/clinical-grade-underarm-antiperspirant-wipes?variant=34814174724229
  4. Underarm Antiperspirant for Excessive Underarm Sweating. Carpe. https://mycarpe.com/products/underarm-antiperspirant-tube?variant=39247505358981
Body Areas Affected by Hyperhidrosis

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating

By Daniel McCarthy /

9 Outrageous Things People Try to Avoid Excessive Armpit Sweating


On my first day of work a few years ago, I got dressed to impress and walked the 20 minutes to my new office to meet my new colleagues for the first time. Having just moved to the southern US, I’d been getting used to the unbearable humidity and its effects on my excessive armpit sweating. Luckily (I thought), the sun wasn’t out and the temps dropped below 80, so maybe my sweat glands wouldn’t take center stage! Well...I arrived to meet my colleagues looking like a wet bass in business clothes. Thank goodness I arrived 15 minutes early, which brings me to the first outrageous thing people try to avoid armpit sweating. 

  1. The Hand Dryer 

I anxiously scurried to the nearest bathroom, declothed, and put the hand dryer to good use on my shirt stains and sweat stains. More outrageously, I awkwardly hovered my sweaty extremities (including my sweaty underarms) over the hand dryer. Thankfully, I reapplied my antiperspirant and headed out to meet my colleagues a decently dry man. That was the day I knew I really needed clinical strength antiperspirant for my excessive armpit sweating (and a car). 


  1. Pantyliners


Many with excessive underarm sweating already know that underarm pads are one way to help with sweating armpits. But if you find yourself sans pad and worried about your excessive armpit sweating, you would not be the first person to try pantyliners. That’s right, pantyliners have been used in a pinch to help keep sweat stains at bay. 

  1. Give a shirt

In 2019, a reddit user posted that to combat his excessive armpit sweating, he skipped the typical clothing and made his own shirt. He posted asking others to try out his creation and received over 250 replies! By creating and giving others shirts, this innovative reddit user designed his way into the hearts of many with smelly armpits. 

  1. Get inked

If you’ve been debating whether to get a tasteful tattoo and you have hyperhidrosis, this finding may just help you make your decision. A 2017 study found that getting inked helped reduce sweat [1]! Now, I don’t recommend choosing a tattoo as a means of treatment for excessive armpit sweating (and maybe don’t tattoo your armpit), but the connection is a fun little fact nonetheless. 

  1. Become a naked mole rat

If you can’t pull the trigger on an armpit tattoo, another method some people have tried is hair removal. Yes, like Steve Carrell (who actually has hyperhidrosis himself) in the hit movie 40-year Old Virgin, removing hair can help reduce sweat buildup for you too. Many likely already “naturally” lose hair thanks to some sweat prevention products, but more natural hair removal may just be the trick to solving excessive sweating

  1. Armpit art

Even though we know most sweaty armpit causes, like too much caffeine or spicy foods, it’s no fun to cut these out completely. A more outrageous approach to excessive underarm sweating is actually turning sweating armpits into art. Multiple users of the Reddit community r/Hyperhidrosis have created shirts, sweatshirts, and other clothing that includes beautiful tie-dye in the armpits. Creative, fun, and beautiful, and even better when combined with sweat prevention like antiperspirant or carpe underarm

  1. Vinegar your armpit

You may already know how to get rid of pit stains with vinegar, but there are other interesting ways it can help with excessive armpit sweating. Splashing vinegar on your sweaty underarms  is one method many recommend. Those that swear by this method also recommend using deodorant or antiperspirant, too. 

While we don’t know how this was discovered, I like to think someone accidentally splashed vinegar on their pits hundreds of years ago and voila! Too bad the first person to splash his pits with vinegar didn’t also have access to the best antiperspirant for his excessive armpit sweating. 

  1. Baking soda your sweaty underarms

If you find deodorant or antiperspirant irritating, one creative way to help alleviate your excessive underarm sweating is baking soda. Many crafty people with hyperhidrosis swear that not only can baking soda help reduce sweat, but it can also help alleviate pesky underarm smell with some of the best sweat prevention. 

  1. Restart the plaid fad

Black t-shirt, black sweatshirt, black button down, black tank top. If this sounds like your closet, you’re clearly an expert on the hyperhidrosis wardrobe. But if you want some variety as you fight excessive armpit sweating, add some plaid, a trick many with hyperhidrosis use that you may not know. Hey, you just may be starting the resurgence of the plaid fad, and at worst, you’ll add some fun, lumberjack variety to your dark closet. 


Sources: 

[1] Luetkemeier, M. J., Hanisko, J. M., & Aho, K. M. (2017). Skin Tattoos Alter Sweat Rate and Na+ Concentration. Medicine and science in sports and exercise, 49(7), 1432–1436. https://doi.org/10.1249/MSS.0000000000001244
Body Areas Affected by Hyperhidrosis

How to Cure Sweaty Hands Permanently at Home

By Daniel McCarthy /

How to Cure Sweaty Hands Permanently at Home 

Scenario 1: You’re invited into the office, confident you will land the job. You’ve prepared, you’re highly qualified, you have absolutely nothing to worry about. You walk in and confidently reach out to shake the CEOs hand. But then, your confidence turns to dread as the CEO pulls her hand back, wet with your sweat. 

Scenario 2: You’re at home, playing video games with your friends and absolutely dominating. They get so upset, they tell you to take a break to let another friend play. But there’s another problem... nobody wants to use your controller after you finish. Despite your domination, your palmar hyperhidrosis (excessively sweaty hands) has taken center stage. 

Do these scenarios sound familiar? Wondering how to cure sweaty hands permanently? Although you may not have had these exact things happen to you, your sweaty hands likely have caused something similar and you’re looking for a home remedy. To stop sweating these situations, let’s talk about how to cure sweaty hands permanently at home. 

One of the best ways to cure sweaty hands at home is actually not related to the hands at all. Instead, working on reducing anxiety can have immensely positive results on how to cure sweaty hands permanently naturally. There are many root causes of anxiety, and some or many may be related to your hyperhidrosis. Likewise, it is easier said than done to reduce anxiety. But there are also many ways to work on reducing anxiety that are worth a try. One interesting way to reduce anxiety, and in turn, sweaty hands, is to be grateful. Specifically, Petrocchi and Couyoumdjian found that “grateful people experience less anxiety mostly because they are able to encourage and be compassionate and reassuring toward themselves when things go wrong in life” [1]. Other ways include stepping outside for a walk, drinking tea, or even distracting yourself. In general, starting with anxiety reduction not only can help with how to cure sweaty hands, but also your wellbeing in general. 

Another great way to cure sweaty hands at home permanently is to reduce consumption of coffee and alcohol. Now you may be reading this and thinking “Hey, those are all my favorite things! I’m done with this article!”. And while I wholeheartedly agree and enjoy coffee and alcohol myself, consumption in moderation is key, especially with hyperhidrosis. Caffeine, for example, activates part of the brain that is already a main part in causing hyperhidrosis symptoms. Instead of giving it up, try to reduce consumption to under 200 mg or add in decaf to your routine. Alcohol can affect hyperhidrosis in a similar manner, but like coffee, 1-2 glasses of alcohol may be okay. When figuring out how to cure sweaty hands permanently naturally, it is important to find a balance of coffee, alcohol, and managing your hyperhidrosis. And remember to always drink responsibly, in moderation. 

Tackling how to cure sweaty hands permanently, naturally, and at home may require more than behavioral changes we’ve talked about so far. Luckily, there are other great remedies you can try at home! First, finding the right antiperspirant is of paramount importance, especially appropriate antiperspirant for hands. Another possible over the counter option is anti-sweat wipes. If neither of these work for you, another option to cure your sweaty hands permanently is to buy your very own iontophoresis machine for at-home use. This machine delivers mild electrical currents to your hands (or other affected body part) while submerged in water. A combination of these treatments may have your hands feeling less clammy in no time! 

Ultimately, your palmar hyperhidrosis may not be treatable at home and permanently, but these recommendations may help alleviate some of your symptoms. If symptoms persist, consult a medical professional for further assistance with how to cure sweaty hands. 



Sources

Sources

1. Nicola Petrocchi & Alessandro Couyoumdjian (2016) The impact of gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring the self, Self and Identity, 15:2, 191-205, DOI: 10.1080/15298868.2015.1095794

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