Palmo-plantar HH- Can Iontophoresis help?

[solutionsexplor]

Hi Guys,

I am 35 M, had HH since I was born. Got sick and tired of giving wet hand shakes and went with 50Us botox on each hand in July. It worked only 3-4 days but I would still sweat when its hot out or when body gets hot. Doctor upped the botox to 100u each hand in September. Luckily insurance covered both procedures. 100us made me absolutely sweat-free for 2 weeks and then it started failing when I am about to shake hands or when its hot. I noticed an interesting thing, my hands were dry surprisingly my feet were dry too. I didn't get them treated. I was trying to see a situation where my hands would be dry coz of botox and feet to sweat. That never happened. Not sure if I was relaxed coz of confidence from botox. Even prior to botox, I was in the same situation. Used to sweat only when I have to shake ppls hands and when body gets worked up. If I didnt have to shake hands and if ppl don't notice my issue, I am fine like this. But its when I have to shake hands and don't want to get embarrassed with my issue, my hands and feet get more sweaty and dripping sometimes.
Is there a successful treatment or solution for my problem?
Can I ever achieve sweat free hands in socially stressful and hot weather conditions?
Can Iontophoresis do this for me? Even when I had failed with botox?
If so, what is the best machine I can get?
What power do I start with? What frequency should I have for maintenance?
Can I do this on my own or do I need to go to dr for starting instructions?

I saw some people had success with ionto here. I want see if my goal is achievable and give it proper good shot if ionto can help me.
Thanks for your time reading this and would really appreciate any help here.

 

[blueherron]

There are several brands of machines available and even ways to make your own. I can only speak to the RA Fischer MD-1A. Ionto is typically tried before Botox.

I've been using the MD-1A for almost 2 years with good success. Everyone seems to respond differently but the key for me is consistency. I have read more success stories on this forum using ionto than any other treatment. I do 20 minute treatments (10 ea polarity) every 2-3 days. I also add a little baking soda in each tray. Is it time consuming? Yes, but it does work for me.

I still get a little clammy when I get nervous, but that is more of a normal sweating reaction that a lot of people get. I would definitely recommend you give it a shot.

 

[Sprawling]

There are several brands of machines available and even ways to make your own. I can only speak to the RA Fischer MD-1A. Ionto is typically tried before Botox.

I've been using the MD-1A for almost 2 years with good success. Everyone seems to respond differently but the key for me is consistency. I have read more success stories on this forum using ionto than any other treatment. I do 20 minute treatments (10 ea polarity) every 2-3 days. I also add a little baking soda in each tray. Is it time consuming? Yes, but it does work for me.

I still get a little clammy when I get nervous, but that is more of a normal sweating reaction that a lot of people get. I would definitely recommend you give it a shot.

I also used the Fischer MD-1A for over 5 years and now use a Pulsed Unit which is just more comfortable. Treatments vary from individual to individual. My treatment schedule now is once a week. Hands in two trays (trays connected by a wire). Two trays for the feet. I do 15 minutes each polarity via my pulsed current machine. Total time is 1/2 hour. For the most part my hands lately have been staying pretty dry.

 

[solutionsexplor]

Thank you blueherron and Sprawling.
Since you find success with Ionto, let me ask you this.
Does your palms sweat in Summer and in social situations, like before shaking someones hand? Can the other person tell ur hands sweat?
If they still do, is it like a quick burst and can be wiped away or is it like constant sweat (may be not dripping) but uncontrollable.
I am asking you in detail as it looks like I only sweat before shaking someones hands (it used to be lil clammy, but now they drip and I dread occasions), stressful situations or when its hot. I am mainly looking to get this situation treated.
Thank you for your time and help. Hope to see a miradry like solution for hands.

 

[blueherron]

Sounds like your anxiousness is exaggerating things. This can happen to me as well. I'd say I have a mild case. A couple of years ago I noticed that when I started to get anxious, I would start sweating more (e.g. in a meeting or something). Once I became aware of it, I started worrying more and more and when I did get in a situation where I would have to shake hands (almost daily), I would get anxious and start sweating. It has never been constant sweating with me, more situational related to stress and anxiety (other than my feet which have always sweat in shoes since I was a kid).

Ionto has definitely helped not only with the sweating but once you realize it is working, it's a real confidence booster as well. Those tied together work wonders. I still can get a burst of hand sweat if I get really anxious, but it goes away quickly and the abnormal after sweating has been relieved with ionto. I also take a small dose of glyco each morning (1.5 mg). And I use drysol on my feet but am going to start ionto there soon. Could be a combination of things that works but I am ok with that. I'll say I started taking glyco for several months before doing into. It helped, but not 100%. There are several that only take glyco, but usually a slightly higher does than me, but when I take more than 2 mg per day, the side effects are too bothersome for me.

I will occasionally experiment with things (spread out ionto, more or less glyco, etc.) but if things start to digress, I go back to what I know worked in the past. I've also recently started taking a very low dose of Xanax to help with anxiety, which helps as well. It helps get me out of the "worrying" cycle which causes anxiety then sweating, then anxiety and sweating, etc.

 

[hh_sucks]

blueherron, do your hands drip if you don't use iontophoresis?

 

[blueherron]

No, more clammy than anything but only when I am anxious. Like I said, mild for me but bothersome enough that I choose to treat it.

 

[solutionsexplor]

Thanks Blue.
My derm prescibed me glyco. I am little hesitant to take it as it some side effects with brain fog and stuff. Since I mainly want to take it for office meetings, gatherings I would like to have clear mind.
For me mainly two things make me sweat, shaking hands (fear/anxiety) and hot weather.
My hands are 100% clammy in outdoors in summer and drippy in between.

How are your hands under hot, humid weather with inoto?

 

[blueherron]

The trick to the glyco is to find what works for you. I started out taking 1 mg three times per day. I would take it with a meal. Then I read a lot about people having success taking it first thing in the am on an empty stomach and waiting 2 hours or so to eat. That is definitely most effective as far as I can tell. You'll have to find out how much you need...too much will cause serious dry mouth. 1.5 mg is about what I can stand and I only take it first thing in the AM. I have increased it before and started to get the side effects. I don't really have any cloudiness. I have been taking it for 2 yrs + daily. I'd start out with a low dose on an empty stomach and see how it does. Trial and error will most likely be the way to find out.

If I am outside working in summer my hands may sweat a bit even with ionto. And if I get really nervous, my hands will still sweat a bit. I debated doing ionto for about a year before I started...trying several topicals prior to. It was the best decision I made and I feel the most effective. If you are struggling I would go for it. I use the Fischer MD-1A and I picked it up on ebay for around $350. You'll have to watch for them. Or you can get your doc to prescribe it for you and order it direct. There are other lower cost ways to do ionto but I cannot vouch for them.

You may find that you have to "stack" your treatment to get the full effect. What I mean is doing multiple things....cut out caffeine, examine your diet, work on overcoming your anxiety, taking low dose of glyco and doing ionto. That is the formula that I am on.

 

[blueherron]

Here is a good article about ionto, treatment schedule and such:

sweathelp.org/en/treatments-hcp/iontophoresis.html

Interesting on initial response time:

"Patients used the device on the involved area, using the opposite side as control, for 30 minutes twice a day for 5 days followed by 30 minutes daily. Sweat production was assessed using a computerized image analysis of chemically treated paper applied to the involved area. Two axillae and one foot did not respond to treatment. It took 2 weeks for 80% of palms to respond, and by 20 days 100% of hands, 78% of feet, and 75% of axillae responded. "

And also check out the mean dry days for ionto with glyco and aluminum chloride:

"The mean remission duration after the 4-day treatment was 3.5 days for tap water iontophoresis and 20 days for combination therapy"

That is a compelling argument to try glyco and ionto together.

And here is a flow chart for the recommended treatment paths:

sweathelp.org/en/about-hyperhidrosis/clinical-guidelines/hyperhidrosis-treatment-algorithms.html

 

[solutionsexplor]

Blueherron,
Thanks for the information.
Do you know what 'Patients used the device on the involved area, using the opposite side as control, for 30 minutes ' mean? switching polarities after 30 mins?

 

[blueherron]

I believe they are saying that one side was treated and the other was not so they could compare the treated area results to the non treated area (the control). E.G. Treated left hand and foot but not right hand and foot. In an experiment you have to alter one thing but keep another constant to determine if the alteration had the desired effect.

 

[solutionsexplor]

I am going to try this.
I am doing only two trays for both hands n feet in each tray 15 mins each polarity once a day since 4 days.
Should I just do the same twice a day for 5 more days and continue daily? or up the time to 30 mins each polarity?

 

[blueherron]

I would continue with daily treatments. Not sure about both hands in one tray and both feet in the other. I have read of people doing that but when I inquired about it with one of the ionto manufacturers they said that it could reduce the effectiveness because there is less electrical current traveling per area of the hand/foot. So the therapy is not as strong/concentrated as just one hand or one foot in a tray. It may require a stronger current or longer treatment time.

If I were you, I would do hands, 20 minutes, switch polarity at 10. I would do feet 30 minutes, switching polarity at 15.

OR

Do one hand and one foot for 20, switching polarity at 10. Then do the same for the other side.

Trial and error, but stick with something and do it daily until you see results. Give it 10+ treatments up to 3 weeks before you get discouraged.

 

[solutionsexplor]

I am using 2 big aluminum trays. I can spread the fingers freely and have maximum contact with rubber sheets in the tray. I don't know but felt more current with total aluminum trays than plastic ones with aluminum sheets in them.
I increased the baking powder and current, my hands are crazy dry. Its cool outside and I am at home since morning, no stress.

 

[Sprawling]

By using the galvanic device one has ample current to do both hands and feet at the same time.

When I used the Fischer unit it only had what looked like a washer, no aluminum anything. Used it for years and kept my hands very dry.

Glad you have reached dryness solutionsexplor. If your hands get too dry use some hand cream to prevent your skin from cracking.

 

[solutionsexplor]

Yeah, they are crazy dry and feel very soft. Again its nice outside and I have no stress or anxiety. This is after my 6th treatment. Just done with my 7th today.

 

[backfish]

to answer your question : what is the best machine ? my answer would be the Idromed 5PC its the machine that got me dry and is keeping me dry.

 

[Sprawling]

Keep in mind that "backfish" is biased because this is the machine he sells. All ionto devices work the same (except for the pulsed current feature). There is no good reason for anyone to spend the kind of money for the machine he offers. Maybe a few more bells and whistles, yet guaranteed to have limited power compared to an off brand galvanic pulsed stimulator.

All ionto devices are "galvanic stimulators."