Management of Postsurgical Hyperhidrosis With Direct Current and Tap Water

Abstract

Background and Purpose. Excessive sweating, known as hyperhidrosis, involves the eccrine sweat glands of the axillae, soles, palms, and/or forehead. The use of iontophoresis to reduce or eliminate excessive sweating has been described since 1952. The purpose of this case report is to describe the use of tap water galvanism (TWG) using direct current (DC) with a patient who had postsurgical hyperhidrosis. Case Description. The patient was a 36-year-old male electrician with traumatic phalangeal amputation and postsurgical development of hyperhidrosis. Tap water galvanism was administered using a DC generator, 2 to 3 times per week for 10 treatments. The patient's hands were individually submerged in 2 containers of tap water with the electrodes immersed directly into the containers. Each hand was treated with 30 minutes of TWG at 12 mA. Hyperhidrosis was measured by a 5-second imprint and subsequent tracing of the left hand placed on dry paper toweling. Outcomes. The patient's hyperhidrosis decreased from the full left palmar pad, with a surface area of 10.3ϫ12.0 cm, to a reduced area of wetness that covered a 2.2-ϫ2.7-cm area. The patient returned to work as an electrician without needing absorbent gloves, which had prevented him from performing electrical work. Discussion. Following use of TWG, the patient's palmar hyperhidrosis returned to normhidrosis. [Gillick BT, Kloth LC, Starsky A, Cincinelli-Walker L. Management of postsurgical hyperhidrosis with direct current and tap water. Phys Ther. 2004;84:262-267.]

Comparison of Tap Water and Normal Saline Iontophoresis in Idiopathic Hyperhidrosis: A Case Report

“…Tap water and normal saline iontophoresis are said to be the effective, safe, and inexpensive treatments for idiopathic hyperhidrosis with minimal adverse side effects. Similar to some findings, we showed the efficacy of our local tap water 2 , 4 , 15 , 16 ) and normal saline 11 ) in iontophoresis treatment for idiopathic hyperhidrosis. However, in contrast to some findings 11 ) , the efficacy of normal saline iontophoresis was greater (70% more efficient) than that of tap water iontophoresis.…”

“…Excessive palmoplantar, axillae, facial, or cervical region sweating in idiopathic hyperhidrosis usually occurs bilaterally and causes social, psychological, emotional, and professional difficulties for the afflicted. The incidence of idiopathic hyperhidrosis is reported to be between 0.6 to 2.8% in both genders 1 , 2 , 3 ) . Idiopathic hyperhidrosis may begin in childhood and continues for the rest of the subject’s life.…”

“…If patients fail to respond to drug and injection therapies, surgical treatment including sympathectomy may be considered for idiopathic hyperhidrosis of the palms. However, some considerable post-surgical dysfunction usually limits the practice of sympathectomy for idiopathic hyperhidrosis of the soles 2 , 3 ) .…”

Efficacy of Pulsed Direct Current in Tap Water Iontophoresis in Treating Primary Palmar Hyperhidrosis in pediatrics

“…Chan et al, (1999) 7 concluded that tap water iontophoresis is a safe and useful treatment modality for palmar hyperhidrosis. Gillick et al, (2004) 8 described the use of tap water galvanism (TWG) using direct current (DC) with a patient who had postsurgical hyperhidrosis. The patient was a 36-year-old male electrician with traumatic phalangeal amputation and postsurgical development of hyperhidrosis.…”