Treatments & Therapies

Tap Water Iontophoresis – Treatment, Effects & Risks

Tap water iontophoresis

Tap water iontophoresis is mainly used for the treatment of hyper- and dyshidrosis on the soles of the hands and feet as well as on other defined skin areas using direct current. The treatment is carried out with either continuous or pulsed direct current, whereby the pulsed direct current is more pleasant and also suitable for young children, but shows weaker therapeutic effect.

What is tap water iontophoresis?

Tap water iontophoresis (LWI) consists of a direct current treatment of certain skin areas such as palms and soles of the feet using suitable equipment. The most common devices consist of two small tubs, in each of which a flat electrode is placed with the size of a sole of the foot, so that the feet or hands can be comfortably accommodated on them.

The tap water in the two shells serves only as a contact medium between the electrodes and the skin. Alternatively, two sponge electrodes soaked in tap water can be used for the treatment of other skin areas. Tap water iontophoresis can be performed with either continuous or pulsed direct current to treat excessive sweat production (hyperhidrosis and dyshidrosis).

Since iontophoresis with pulsed is considered less effective, only continuous direct current is used for the treatment of pronounced hyperhidrosis. Although the effectiveness of tap water iontophoresis with regard to reducing sweat production in the treated areas has been proven, the physiological processes of the principle of action are not yet fully understood and are controversially discussed.

Function, impact & goals

The main areas of application are the reduction of pathologically increased sweat production on the soles of the feet, palms and armpits. Hyperhidroses occur predominantly on the palms, soles of the feet and in the armpits. It is a perspiration that does not primarily serve thermoregulation.

Rather, it is based on a malfunction caused by a hormonal disorder (e.g. hyperthyroidism) or on excessive stimulation of sympathetic nerve fibers, which stimulate the affected sweat glands to pathological overproduction.

Even with a less severe dyshidrosis, which carries secondary diseases such as hand and foot eczema, recurrent fungal infections or multiple wart formation in the luggage, a tap water iontophoresis can bring relief and healing. Another area of application of the LWI is the treatment of Keratoma sulcatum, which is caused by a bacterial infection. The cornea on the soles of the feet is covered with small, worm-like holes.

This disease is also favored by hyperhidrosis and made possible in the first place. As standard, continuous (galvanic) direct current is used in the application of the LWI, because experience has shown that this can achieve the best results.

A pulsed direct current is only used if the patient is a small child or a person who is hypersensitive to continuous direct current. There is still no consensus among experts about the actual operating principle of the LWI and why the process is highly successful.

One of the hypotheses assumes that the weak direct current disturbs the ion transport in the secretory tangle of the sweat glands and the glands cannot react effectively to the “commands” of the sympathetic nerve fibers.

According to another hypothesis, there is an accumulation of hydrogen ions in the excretory ducts of the glands, resulting in a low pH, which leads to damage in the excretory ducts. According to a third theory, the positive cations and negative anions dissolved in tap water influence the membrane potentials, so that a desensitization of the cells is achieved, which is reflected in a normalization of sweat secretion.

LWI therapy usually extends over a period of 5 to 6 weeks with three to five times a week during the initial phase. A single application takes about 10 to 15 minutes. During the later “maintenance phase”, one application once or twice a week is sufficient.

The maintenance phase must be downstream because the desensitization of the sweat glands is reversible and hyperhidrosis would return without subsequent treatment. The therapy is very well suited for applications at home and is then also very cost-effective, apart from the purchase of a device. The aim of the treatment is always to reduce sweat production on the skin areas affected by hyperhidrosis to a normal level.

Risks, side effects & dangers

The tap water iontophoresis is almost free of side effects with proper handling of the devices. There is no age restriction, except for children under 6 years of age, where treatment should only take place under supervision.

The plate electrodes in the small tubs are made of either nickel-free material or even neutral silicone, so that even patients with a nickel allergy do not have to worry about an allergic reaction. This also applies to people who show allergic reactions when they come into contact with chromium or other metals.

You should only use devices with silicone electrodes. Improper handling and sudden immersion of the hands or feet in the bowl with the electrodes can lead to a mild electric shock (electric fence effect).

Otherwise, the treatment is completely painless, except for a slight tingling, which can be perceived by sensitive patients at high operating level of the device or there is a slight twitching of individual muscle strands at irregular intervals. Because there are no data for pregnant women, the LWI is contraindicated for them.

This also applies to people who have been implanted with an electronic device, such as a pacemaker. There should be no metallic implants near the treated skin areas, as they could heat up.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.