Comparison of 10 versus 20 sessions tap water iontophoresis efficacy in the treatment of palmoplantar hyperhidrosis

Abstract

Background Tap water iontophoresis (TWI) is an effective treatment option for palmoplantar hyperhidrosis (HH). However, the optimal number and frequency of TWI sessions to control profuse sweating are unclear. Objective To compare the efficacy of 10 and 20 sessions of TWI in patients with palmoplantar HH and determine the adequate number of sessions to achieve a favorable clinical response. Methods Eighty patients treated with TWI for palmoplantar HH were included. The alteration in sweating intensity considering the mean value of gravimetric measurement and mean visual analog scale (VAS) scores after the 10th and 20th session of TWI were calculated. The difference between performing 10 and 20 sessions of TWI in providing improvement of HH was analyzed. We also conducted a telephone-based inquiry to determine the patients' outcome. Results The reduction in sweating intensity was significant both after the 10th (p < 0.001) and 20th (p < 0.001) sessions when compared with the basal level considering gravimetry and VAS. When the mean sweating intensity after the 10th and 20th sessions were compared, no difference was observed gravimetrically (p = 0.03); the difference between the mean score of VAS after the 10th and 20th sessions (p < 0.001) was significant. Eleven and nine patients not considering a maintenance or an alternative treatment had lower and same sweating intensity as compared with the baseline, respectively. Conclusion Ten TWI sessions within two weeks for managing palmoplantar HH are adequate to achieve a clinical response. However, the patients are more satisfied when they receive 20 sessions instead of 10 sessions of TWI.