Iontophoresis

 

The therapeutic techniques involving the introduction of ion into the body tissue through patient’s skin is called Iontophoresis.

Principle:

Place the ions under the electrode with the same charge i.e. negative ions placed under cathode and positive ions under anode. The electrode under which ions are placed is called active electrode. Iontophoresis is used for hyperhydrosis (excessive sweating).

Use of tape water:

The use of tape water produces no side effect but the ions in it may not inhibit sweating sufficiently. So an anticollinerfic compound in distilled water is recommended. The hands and feet may be affected and require treatment but no attempt should be made to treat the hands and feet on the same day. There should be elapse of several days in their treatment.

Apparatus:

1. Source of direct current
2. Shallow plastic tray
3. Foot or arm bath for cathode
4. Two lint pads to cover electrodes
5. Anti-cholinergic compound solution
6. Distilled water

Methods of application:

Hands:

The shallow plastic tray is placed on arm bath table and patient sit along its side. The active electrode is placed in the plastic tray (anode) and is covered with one of the lint pads, the pads should be minimum 8 layers thick so that they make good contact with the tissues and the electrodes. The tray may also contain 0.05 % solution of anti – cholinergic compound glycopyronium in distilled water. The hand is placed in the tray and the electrode is connected to the positive terminal.

Feet:

One of the feet is placed in a few cm water in a foot bath and the lint pads covered electrode (cathode) which is connected to the negative terminal and slowly increased to the desired effect for desired time.

Dosage:

The dosage is based on the size of the patient and skin tolerance. For an average Adult the dosage is 12mA for 12 min and half of this treatment for child. The need to repeat the treatment varies with each patient. Some patients have relief for month after treatment and some patients require a repeat less than 4 – 6 weeks.

Precautions of Iontophoresis:

• Care about skin abrasion
• Open wounds
• Remove the rings
• Thickness of pads (minimum 8 layers)
• Warm the patient

Side effects:

Anti – cholinergic compound act as sympathomimatic (increases heart rate, respiratory rate)

Ions which are used for different conditions:

Ions	Source	Condition	Concentration
Acetateˉ	Acetic acid	Deposition of Ca over tendon e.g. tendonitis	2 -5 %
Chlorideˉ	Sodium chloride	Adherent scars	2 %
Copper +	CuSO4	Fungal infestation e.g. allergic rhinitis	2 %
Dexamethasone phosphate ˉ	Dexa Na2PO3	Inflammation	0.5 %
Iodine ˉ	Iodex (potassium Iodide)	Scar mobilization	5 %
Lidocane +	Lidocane	Local anesthetic	5 %
Magnesium+	MgSO4	Muscle relaxant, vasodilatation, oedema reduction	2 %
Salicylate ˉ	Na Sal (Na2S2O3)	Inflammation, pain management	2 %
Zinc +	ZnO	Dermal ulcer	20 %
Glycopyronium Bromide ˉ	Cholinergic compound + distilled water	Hyperhydrosis	20 %
Calcium+	CaCl2	Mycospasm (tremors)	2 %

Difference between Iontophoresis and Phonophoresis

         i.            Iontophoresis uses electric current to transport ions into tissues through skin while Phonophoresis uses acoustic energy (ultrasound) to drive molecules into the tissue through skin.

       ii.            Iontophoresis has immediate effect while Phonophoresis has prolong effect

      iii.            The treatment time for Iontophoresis is 15 – 20 min while that for Phonophoresis is 5 -10 min.

     iv.            Iontophoresis is done through electrode while Phonophoresis is through probe (transducer head)

       v.            In Iontophoresis there are chances of chemical burn while Phonophoresis is safe.

     vi.            Iontophoresis is painful while Phonophoresis is painless.

    vii.            Iontophoresis is difficult method while Phonophoresis is simple method