• Erhard HölzleEmail author
Reference work entry


The prevalence of idiopathic hyperhidrosis is between 1% and 2%.

Focal hyperhidrosis has a severe impact on quality of life. Impairment for the patients includes limitations in work, social interaction, physical activities, and leisure as well as emotional and psychological distress.

The first description of iontophoresis was given in the eighteenth century. Its clinical use was manifold, also in dermatology. In 1952 tap water iontophoresis was first described for the treatment of palmoplantar hyperhidrosis.

The most comfortable means of iontophoretic treatment employs pulsed direct current of high frequency (5–10 kHz).

Side effects are minimal and transient. Only slight skin irritation or sensations of discomfort may occur during treatment. Electric burns and electric shock have to be avoided.

The main cause of anhidrosis after tap water iontophoresis is most likely a transient functional disturbance of the secretory mechanism of eccrine glands.

It was shown that tap water iontophoresis with pulsed current can extend symptom-free intervals in dyshidrotic palmar eczema.

Contraindications of tap water iontophoresis are pregnancy and metallic implants, such as cardiac pacemakers or orthopedic joint or bone implants. Defects in the skin barrier, which cannot be protected by petrolatum or insulating tape, also represent a transient contraindication.


Palmoplantar hyperhidrosis Axillary hyperhidrosis Dyshidrotic eczema Tap water iontophoresis Pulsed direct current 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Dermatology and AllergologyUniversity Hospital, Klinikum OldenburgOldenburgGermany

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