Hyperhidrosis Forum

Goal: to figure out why iontophoresis treatment results vary when it comes to stopping hyperhidrosis, and what can be done to ensure the greatest chance for success.

It is quite surprising that despite iontophoresis being the best nonsurgical treatment available to stop localized hyperhidrosis for so many people, no-one has a clear cut idea as to how and why this treatment works. One often cited theory is that the minerals in the water get into your skin via the electric force from the iontophoresis and block your sweat ducts in the process. This seems to make sense, since water type has such a major effect on success versus failure. However, even when using the same water type for years, many people will have success for a period, followed by limited results for a period, and then success again after completely stopping and then restarting treatment. Nobody knows why this happens, so I hope that this project will lead to some understanding of the science behind iontophoresis (especially the impact of water type used on treatment outcome). Other things to research include: why some people have better results after adding baking soda, salt or even crushed Robinul to the water; why some people have better results if they change water temperature; why some people have success with certain machines and not with others, while some people have success with even the most basic home-made contraptions; whether one can develop resistance to iontophoresis like one can to antibiotics; and many other such things that I read on the hyperhidrosis forums on this site.

After delaying the project for years, I am hoping that with your help and feedback, I can create a mini-database or weblog on this site that houses detailed information about people's success versus failure using various machines and various water types. I hope to pay at least some of you for your efforts, but this would totally be at my discretion.

Water properties and impact on success

After my lack of success using Drionic in 2004, followed by excellent success with Hidrex in 2010 (except when using it briefly in England), followed by success with Idromed, followed by mixed results later on (!!), I felt like it was time to finally start this project and try to take a stab at figuring out why some people have continuous success with iontophoresis for over a decade, others have mixed results, and yet others have hardly any success at all. A quality machine obviously helps, but even that can not be sufficient to ensure victory in this fight. One historical study on iontophoresis concluded a success rate of around 70 percent, but most modern machine vendors proclaim a much higher success rate. I am beginning to think that these high success rates include even those who have on and off success, as well as those who just have some reduction in sweating rather than full cessation.

The main goal of this project is to analyze the water that you use in great detail. It would also help if you tested at least two or three water types. Perhaps water from two different cities, and one brand of bottled water. Or just your own city water, your city rain water that is probably somewhat polluted, and one brand of bottled water. You would have to start with 10-15 days of continuous treatment with one water type, then if you have a successful outcome, you would switch to once a week treatment with a second water type water, followed by once a week treatment with a this water type. If the first water type works and the second one fails, for the third water type, you would have to do 10-15 days of treatment again before making any kind of conclusion. You would measure water properties such as hardness and softness, temperature, mineral content and so on. I myself might not be doing this for some time until I understand the science behind this and lead a slightly more relaxed life (my feet sweating also does not bother me anywhere near as much as my hands used to, so I get lazy with following a daily treatment regimen). So this project will probably take a while to get going, but I wanted to put this page out there to give others some notice, and also to remind myself of the importance of getting this going at some point in the future.

I need to do some research for this so that I can decide what water characteristics are worth measuring, and what devices would be needed to measure each of these characteristics. I also do not want to put in the effort if only 2-3 people end up reporting the required information to me (very possible, based on the limited forum posts I see about success or failure with Hidrex and/or Idromed even though hundreds of people have purchased these machines via the banners on this site). This whole endeavor to figure out the impact of water type on iontophoresis would only be meaningful it I get at least 20 or so takers from across the country/world. PLEASE E-MAIL ME (my e-mail address is at the bottom of the home page) OR PM ME in the forum if you willing to do this.

The reasons I can not do this experiment myself are:

1) I would have to travel to different cities and stay there for weeks, or collect water and come back to my hometown and hope the water mineral and chemical profile has not changed as a result of travel time.

2) I am also somewhat concerned about doing 2 weeks of daily treatment on a regular basis myself, since that is what is required almost each time I test a new water type in a different city (or each time when treatment stops working and I take a break and then restart). This concern stems entirely from the issues raised in the forum thread about hexavalent chromium ions (based on Dr. Zierer's unexpected e-mails to me and his published journal article). I am willing to ignore Dr. Zierer's warnings if I am just doing once a week maintenance treatments, but 15 days in a row of chromium and nickel ion infestation many times each year is not something I want to risk. FYI -- in recent years, I have definitely developed some hypochondria!

Note that there are numerous people who have had decades of continuous success with iontophoresis with no side effects or health issues that Dr. Zierer warns about, so I do not want to scare you. Just want to inform you about any risk potential. Electrocution is also another risk if you use a defective outlet-powered machine, although I have never heard of someone dying from iontophoresis and do not take this threat seriously myself.

It would be great to figure out whether continuous success is completely based on water type and proper treatment protocol, or whether other factors (such as skin thickness, body chemistry, genetic propensity to develop treatment resistance etc...) are also key determinants for success or failure.

Key factors to consider

When considering water characteristics, an analysis of Evian water provides us some hints of what kind of things to measure:

Another useful piece of information, posted by user "coolate" on the forum on this site:

"If anyone has had very good luck with their water, maybe they could test with a site like this: water analysis. We have used them for checking whats in the water for brewing beer."

Yet another useful piece of information from a post by user Hyper-Hydro on another site:

"So in order to make the ionic density effective in tap water (or any water) you must keep a high level of HCO3-, but also try to exclude other anions like sulphate and chloride from the water, in order not to raise conductivity excessively. Especially in densely populated areas water works tend to mix in chloride to control biological content from surface water. In my opinion the ideal way to use iontophoresis will be to mix your own water to the exact level of HCO3- by using baking soda and de-mineralised water, or destilled water, but recently I also discovered from a mail conversation with a scottish dermatologist, that mineral waters with very high HCO3- content and quite low sulphate and chloride content had shown to be superior to local tap water in efficiency in iontophoresis.

An example of such a mineral water is the bottled french Badoit mineral water, which contains no less than 1.300 mg/l of bicarbonate (HCO3-) and only 40 mg/l of sulphate and 40 mg/l of chloride. Using bottled water is expensive in the long run, but if anybody is experiencing pain in iontophoresis, or if you´re suspecting that your local tap water doesn´t have the right mineral content, then buying some bottles of Badoit, and using it for a series of iontophoresis treatments might just clear up the question for you, whether you should begin mixing your own."

Some useful threads from the hyperhidrosis forum on this site:

Worked in Toronto (Canada), but did not work in Vancouver (Canada).

Voltage difference has a major impact on treatment effectiveness?

Great advice, especially on water type, from various forum members.

Hexavalent Chromium and other potentially harmful ions resulting from iontophoresis

One other important area of research is to see if hexavalent chromium, nickel and other such harmful ions are present in the water as well as in your body after iontophoresis. The following several-page long forum thread is a highly useful read in its entirety: iontophoresis electrodes and potential toxicity. The length of that thread is largely due to Dr. Zierer's e-mails to me. No other doctor, surgeon, researcher or scientist has ever e-mailed me about such issues, but one person is enough to spoil the party:-) To his credit though, Dr. Zierer has no ulterior motives and I hope that our research leads to some more evidence in favor of iontophoresis irrespective of electrode material, or perhaps leads to the development of unique reasonably priced electrodes made from safer materials.

Dr. Zierer's thoughts on urine tests for chromium and comparisons with sample groups:

"To give an imagination on the urinary concentration of chromium among the population of northern Germany which was publish by a validated laboratory: the average concentration is approminately 1 microgram / liter urine, which is regarded as normal. From workers exposed to chromium in galvano-factories we found an average concentration of 5 to 7 microgram chromium / liter urine. Regarding an analysis of the urine one should consider to take the sample approximately 5 to 7 hours after exposure to galvano spa bath or iontophoresis, e.g. in the morning the application and drinking approx 1 to 2 liter of liquid and in the late afternoon the urinary sample (10 mL)."