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Digital Iontophoresis Manual

Digital Iontophoresis Manual

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Published by Sarin Avni

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Published by: Sarin Avni on Nov 03, 2012
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DIGITAL IONTOPHORESIS
Iontophoresis is a needle free, non invasive technology for delivering water soluble, ionicdrugs or other compounds through the skin using a microprocessor controlled electrical current.The current carries the compounds into underlying tissue and into the blood stream, making thedelivery either site specific or systemic. The microprocessor facilitates variable dose controlenabling programmable or patient controlled dosing as well as rapid onset and cessation of delivery, where desired.
Defining Hyperhidrosis :
Sweating is necessary to control body temperature during timesof exercise and warm/hot surroundings. Sweating is regulated by the sympathetic nervoussystem. In 0.6 to /1.0% of the population, this system is revved - up and works at a very highlevel causing sweating to occur at inappropriate times in specific areas of the body. This conditionis known as
hyperhidrosis.Classification -
causes of hyperhidrosis can be primary or secondary.
Regions of the body -
scalp, facial ( face ), palmar ( hands ), axillary( armpits ), truncal ( trunk ), plantar ( feet ).
Primary or idiopathic hyperhidrosis -
Hyperhidrosis without a known cause. A morefrequent condition than secondary hyperhidrosis. Localized commonly in the hands, armpits,scalp, face, and or feet. Starts during childhood or early adolesence, worsens during puberty andthen persists for the rest of one’s life. Nervousness and psychiatric disorders are rarely thecause. The excessive sweating is very embarrassing and social, professional, and intimaterelationships are often seriously affected.
Secondary hyperhidrosis -
Caused by an underlying condition. Usually causes excesssweating of the entire body, however. Some of these conditions are : endocrine disorders such ashyperthyroidism, endocrine treatment for malignant disease, menopause, obesity, psychiatricdisorders, systemic malignant disease.
 
 
Manifestations of Primary Hyperhidrosis.PALMAR HYPERHIDROSIS ( HANDS )
Far and above the area of the body causing the most distressing condition. Thehands are used socially and professionally more than any other part of thebody. Excessively wet/moist hands may even limit the choice of one’sprofession. Avoiding social contact is common for individuals with severehyperhidrosis palmaris. Patients notice not only that their hands feel verymoist/wet all the time, but also feel cool/cold. Some individuals have a bluish /purple discoloration of their hands as well.
AXILLARY HYPERHIDROSIS ( ARMPITS )
Hyperhidrosis of the armpits causes large wet marks and staining on theclothes. A strong body odor develops quickly which can cause very negativeemotional / psychological repercussions. Slightly more common in femalesthan males. The highest incidence occurs with people of Asian and Jewishancestry, but can affect all races.
SCALP / FACIAL HYPERHIDROSIS AND BLUSHING.
Excessive sweating of the scalp and face. Commonly associated withmoderate to severe facial blushing as well. This condition often causes theindividual to become self- conscious and to develop a low self esteem. 
PLANTAR HYPERHIDROSIS.( FEET )
Excessive sweating of the feet. Can be associated with hyperhidrosis of other areas of the body.
TRUNCAL AND / OR THIGH HYPERHIDROSIS . ( TRUNK )
Less frequent.Can be associated with hyperhidrosis of other areas of thebody.Characteristics Either sudden onset or continuous sweating. Sweatingusually brought on by no apparent reason. Usually not aggravated byexercise. Emotional stress, high ambient temperatures, and /or gustatorystimuli are the mos2t important aggravating factors. Hyperhidrosis usuallyimproves during the cold /cool months and worsens during hot / warm months.Sweating usually stops during sleep. Hereditary ( 25% of individuals withhyperhidrosis tend to have a family member with symptoms as well.)
 
 
TREATMENT-
Secondary hyperhidrosis is treated by first addressing the underlying disorder.If a patient is on hormonal therapy then administration of an anti estrogen ( ciproteroneacetate ) can give relief to sweat attacks. Primary hyperhidrosis patients and secondaryhyperhidrosis patients experiencing moderate to severe sweating not relieved otherwise maybenefit from the Iontophoresis.
IONTOPHORESIS -
Tried, if antiperspirants not effective. Used to treat palmar, axillaryand plantar hyperhidrosis. Low intensity electric current ( 0 to 14 mA ) applied to thepalms and or soles immersed in an electrolyte solution. Has to be repeated regularly,initially in 20 minute sessions several times / week, gradually stretching out the intervalbetween treatments to 1-2 weeks. The results vary; many patients (70%) suffering fromlight to moderate hyperhiderosis, are happy with the method, some may consider it tootime-consuming or inefficient and comparably expensive, it is difficult to apply inaxillary, and impossible to use in diffuse hyperhidrosis of the face or the trunk/thighregion. Side effects include: burning electric shock, discomfort, tingling, skin irritation( erythema and vesicle formation). Sweating returns after cessation.
 

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