Every now and then we gets an email related to skin irritation and the use of DryDerm gel or solution. Go-to strategies for reducing irritation include reducing product use frequency (e.g. using on alternate days) and using a hydrocortisone cream (0.5% or 1%) available at local pharmacies. Be sure to consult our 'Avoiding Irritation' page for more details.
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I was recently reminded of this when a customer emailed me and said: ' I think the three times that I used the solution for iontophoresis really kick started the drying and the PP cream kind of cemented it'. The reality here was that this person was using DryDerm iontophoresis solution for his palms but it wasn't quite doing the trick. Adding DryDerm PP to the iontophoresis treatment made the difference he was looking for.
Unfortunately hyperhidrosis doesn't fall into any of the conditions using 'cookie cutter' treatments. Therapies have to tweaked by changing and/or adding therapies or increasing product strengths. Treatment must be individualized as no one's conditions is quite the same and severity also varies according to region. Whether you are currently trying to treat your excessive sweating or are not quite satisfied with your treatment, always think 'two is better than one' before abandoning your current therapy.
The report is based on a 43 year old woman that presented with glycemia values that were consistantly lower than her true values. As a result, her insulin doses were lowered to reflect her low glucose values. Three months later her glycated hemoglobin (a measure of glucose levels over the long-term) was on the high side which translates into poor control of glycemia levels or hyperglycemia (a tendency of having higher than normal values over the long term). In other words, while this individual's testing provided normal values, these were in fact artificially lower than her true values.
Fortunately there is a simple solution to this problem. All diabetic individuals that have palmar hyperhidrosis should be encouraged to dry their finger tip prior to testing. This ensures that the droplet of blood does not mix with sweat and lead to erroneous test values.
Pretty good, considering the difficulty associated with treating hyperhidrosis of the palms. Initial treatment is usually administered three times weekly (for example, 20-minute sessions on a monday/wednesday/friday schedule) and can be tapered to once weekly as the condition improves.
Mineral content of water is important for proper conduction of electrical current. A tablespoon of baking soda in each tray usually does the trick. In more resistant cases, the addition of glycopyrrolate or aluminum chloride hexahydrate - AlClHex (ingredients in DryDerm preparations) appears to increase the efficacy of the treatment. In one study, using an AlClHex iontophoresis solution, sweating returns to less than 60% of pre-treatment levels one month after treatment. In other words, AlClHex helps to reduce the frequency of treatments.
Combining iontophoresis with the nighttime use of a high-strength antiperspirant such as DryDerm is also recommended for greater efficacy. This strategy also reduces the frequency of iontophoresis treatments.
While often overlooked, iontoporesis is a treatment option that deserves trial. It works well, is cost-effective, and relatively safe. Keep in mind that its efficacy can also be 'notched' up with the use of AlClHex or mixed treatment, that is, used in tandem with a high-strength antiperspirant.
If you are going to remember anything, keep the following key aspects in mind: 1) aluminum chloride hexahydrate products such as DryDerm should be left on the skin for 6 to 8 hours to be effective; 2) product should be applied to skin that remains dry for that period of time, for example, at nighttime during sleeping hours. Applied to a damp region will affect its efficacy in a negative manner and increase the likelihood of skin irritation. Though it is tempting to apply product in the morning, this is discouraged. The inevitable sweating that occurs during the day will adversely affect product efficacy; 3) the treated region should be washed off in the morning to avoid irritation from product that remains on the skin for an extended period of time; 4) irritation can usually be successfully treated with hydrocortisone 1% cream (available over or behind the counter in pharmacies) for up to 2 weeks. If the region has to be shaved occasionally, wait 24 to 48 hours before reapplying product to avoid possible irritation. See our Treatment DOs and DON'Ts to get the most from your treatment.
*Dermatol Clin 32 (2014) 485–490
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