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Hyperhidrosis Treatments
Treatments for Primary Focal Hyperhidrosis
Iontophoresis for Palmar and Plantar Hyperhidrosis
Written by Katie Crissman
October 01 2020

Iontophoresis is one of the many treatment options available for people trying to manage hyperhidrosis with a doctor. The process of iontophoresis involves passing an ionized substance through the skin with the use of a direct current.[1] Iontophoresis is most effective for the treatment of treating sweaty hands and feet, these are also known as palmar and plantar hyperhidrosis respectively. Once a patient becomes comfortable with the iontophoresis process, a machine can also be purchased by patients and used to manage their hyperhidrosis at home.

It is usually considered to be a third line treatment and is typically used after both topical treatments for hyperhidrosis and oral medications have been tried, and deemed unsuccessful at alleviating symptoms.[2] Interestingly, iontophoresis is a treatment that has been available for the past 70 years and is considered to be very effective although it is not well understood.[1]

How does iontophoresis work?

Iontophoresis essentially works by delivering an ionized substance, usually tap water or a medication when necessary, into a patient’s eccrine (sweat) glands, through the use of an electrical current. As the current travels across the patient’s skin, the ionized tap water or medication is able to affect sweat glands in such a way that it reduces their ability to produce sweat. The mechanism behind this effect is not well understood. Most of the time iontophoresis only requires tap water to be used, but if that is not working there are ways to make iontophoresis more effective. Doctors can add medication, usually an anticholinergic like glycopyrrolate or oxybutynin, to the tap water to make iontophoresis more effective for patients who are not getting satisfactory results. Skin is semi-permeable and therefore only allows a small amount of any drug to cross into a patient’s body. Iontophoresis aids the body’s absorption of the drug because the electric current drives the medication through the barrier of the skin. This is especially important for the absorption of ionized drugs because they cannot otherwise pass through the skin.

Although it may sound unpleasant, iontophoresis is considered to be safe and noninvasive. It is not a painful treatment, and it is actually less painful than other comparable treatment options like botox for palmar and plantar hyperhidrosis.[3]

Iontophoresis can be done at home once a patient learns how to perform iontophoresis. There are three types of iontophoresis machines available in the United States that are currently approved by the FDA.[1] When using an iontophoresis machine a patient will most likely have two electrodes (these can be trays of water) attached to the affected area, one passive and one active, which will also be connected with wires to a voltage delivery system. Once turned on, the current passes through the water and moves it through the skin via the current. A patient undergoing treatment must repeat the iontophoresis process multiple times over a period of time to see results.[3]

There are several theories about why iontophoresis works so well, but the truth is that no one is sure why it is so effective. Some of the proposed theories suggest that iontophoresis may work because ion deposition plugs the sweat glands, or because it decreases the pH of skin. Another theory asserts that iontophoresis blocks sympathetic nerve transmission. Despite the fact that science has yet to fully explain the phenomenon, it is agreed that iontophoresis is able to slow overactive sweat glands and shows measurable benefits to those with palmar and plantar hyperhidrosis.[1]

Efficacy of Iontophoresis

It is accepted in the medical community that iontophoresis really works as a treatment for palmar hyperhidrosis and plantar hyperhidrosis, especially considering that is it less invasive than some of the other treatments available. A number of studies have shown significant improvement in participants, although the reason for improvement is not well understood.[1] A study of 112 patients with hyperhidrosis done in 2002 found that they had an 81.2% reduction of symptoms from their original baseline and these findings are concurrent with findings from other similar studies.[1] Some people assert that iontophoresis made their sweating worse initially, although there is no scientific data to back this up. However, even for those who experienced that, iontophoresis was effective in reducing sweat production, for most people, if they continued treatment.

Advantages of Iontophoresis

The main advantage of iontophoresis is that it is a noninvasive treatment that can give patients measurable results. Another benefit of iontophoresis is that it treat hyperhidrosis locally. Unlike oral medications, which can have systemic effects on the body, iontophoresis only affects the areas of the body where is it applied. Iontophoresis also doesn't come with as many possible complications or side effects as other available treatments.[3] It is a mode of treatment that can be used when first line treatments fail, but before considering more invasive and possibly dangerous treatments like endoscopic thoracic sympathectomy. Iontophoresis can be used in a patient’s home and is a relatively inexpensive and low-risk therapy. The cost of hyperhidrosis can be high, so finding a treatment that is inexpensive over time can be a significant benefit.

Adverse Effects and Possible Drawbacks

Typically, adverse effects from iontophoresis are mild and it is not necessary for patients to stop treatment, even if they experience some of them. Possible negative reactions can include mild shocks, scratches or cuts on the treated area, vesiculation (similar to blistering), and redness of the skin. All of these are minor effects and tend to resolve on their own. It is not recommended as a treatment for pregnant women, those with pacemakers, or people with large amounts of metal in their body.[1]

In conclusion, iontophoresis is a safe and effective treatment for palmar and plantar hyperhidrosis that has been around for decades. It may seem a little unorthodox, but it has the potential to be an important tool for dealing with a frustrating and debilitating disorder. Iontophoresis can also be used as a medical treatment for children with hyperhidrosis, which is significant as children can't use many of the other potential treatments available for the disorder. Along with other treatment modalities, iontophoresis can be part of a comprehensive treatment plan that can help those with hyperhidrosis to live a fuller life free of constant perspiration. Lastly, if used in conjunction with alternative methods to manage hyperhidrosis and creative ways to manage hyperhidrosis at home, it can possibly prevent patients from having to use invasive treatments and medications.

Sources
  1. Pariser, D. M. (2014). Hyperhidrosis (4th ed., Vol. 32). Amsterdam: Elsevier Pub. Co., 2014. Retrieved
  2. Walling, H. W., & Swick, B. L. (2011). Treatment Options for Hyperhidrosis. American Journal of Clinical Dermatology, 12(5), 285-295. Retrieved July 25, 2018, from http://ke2nk8za8p.search.serialssolutions.com
  3. Rai, R., & Srinivas, C. (2005). Iontophoresis in dermatology. Indian Journal of Dermatology, Venereology and Leprology, 71(4), 236-241. Retrieved July 25, 2018, from https://search-proquest-com.ezproxy.wakegov.com/docview/195074488?pq-origsite=summon.
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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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