title: Tap water iontophoresis in the treatment of pediatric hyperhidrosis.
abstract: OBJECTIVE
  The treatment options for localized hyperhidrosis include antiperspirants, anticholinergics, iontophoresis, botulinum toxin and surgery. Tap water iontophoresis (TWI) involves immersing the affected area in tap water and passing a small electrical current through the area. Our aim was to assess the success of this therapy in a pediatric cohort.
  
  
  METHODS
  Retrospective case note review of all patients younger than 18years who underwent TWI between 2002 and 2015. Demographic data, number of treatment sessions, side effects and overall success were analyzed. Individuals undergo 7 treatments over 4weeks. A positive outcome was determined as an improvement in symptoms. Pre- and posttreatment hyperhidrosis disease severity scale (HDSS) was measured. Data are presented as mean (range). Statistical analysis was by paired t-test. A P value of <0.05 was regarded as significant.
  
  
  RESULTS
  There were 43 patients (30 females) with a mean age of 15 (8-17) years. Palmar and/or plantar hyperhidrosis (PPH) was present in 39/43 (91%) patients. Axillary hyperhidrosis (AH) was present in 19/43 (44%) patients. All patients (with the exception of one) underwent 7 sessions (5-7). Side effects included paresthesia (88%), pruritus (26%), pain (26%), erythema (14%), dryness (12%) as well as vesicle formation and abrasions in one patient (2%). A positive outcome was found in 84% (36/43) of patients. There was a significant reduction in mean HDSS (pre 3.5 vs. post 2; P=0.0001).
  
  
  CONCLUSIONS
  TWI is a safe and effective modality of treatment for both PPH and AH in the pediatric population, with minimal side effects. Pediatric surgeons should offer this treatment option before considering more invasive surgical procedures.
  
  
  METHODS
  IV: Retrospective study.
authors.affiliation: Department of Paediatric Surgery, University Hospitals of Leicester, Leicester, UK. Electronic address: Haitham.dagash@uhl-tr.nhs.uk.
authors.forename: Haitham
authors.initials: H
authors.lastname: Dagash
authors.affiliation: Medical School, University of Leicester, Leicester, UK.
authors.forename: Sinead
authors.initials: S
authors.lastname: McCaffrey
authors.affiliation: Medical School, University of Leicester, Leicester, UK.
authors.forename: Katie
authors.initials: K
authors.lastname: Mellor
authors.affiliation: Department of Dermatology, University Hospitals of Leicester, Leicester, UK.
authors.forename: Agnes
authors.initials: A
authors.lastname: Roycroft
authors.affiliation: Department of Dermatology, University Hospitals of Leicester, Leicester, UK.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Helbling
mesh_terms: D000293:Adolescent; D001365:Axilla; D002648:Child; D005260:Female; D005528:Foot; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000175:diagnosis / Q000628:therapy*; D007478:Iontophoresis / Q000009:adverse effects / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014867:Water
chemical_list: D014867:Water
keywords: Compensatory sweating; Hyperhidrosis; Tap water iontophoresis