Purchase an iontophoresis machine – differences and details
- Electrical output during iontophoresis
- The difference between direct and pulsed current
- Individual pulse width – is it necessary?
- Metal or silicone electrodes
- Iontophoresis machines in suitcases or trays?
- Electrical safety
- Disadvantage of battery and power pack operation
- Basic handling
- Service and transparency
- Warranty and guarantee
- Customer opinions on iontophoresis
Where to buy one’s iontophoresis device?
How do you recognize a good therapy machines?
Electrical output of iontophoresis devices
Sufficient electrical output is imperative for an effective therapy and rapid success. The decisive factor is the current strength or amperage (in mA (milliamps)) which the iontophoresis unit can put out.
The iontophoresis devices available in the market today state max. output levels of 20 to 30 mA. This does not mean, however, that the systems will actually reach these values in every case. The stated value frequently refers to a theoretical body resistance of 2,000 Ohm. The 20 or 30 mA, respectively, are really rather to be considered a max. current limit and not a performance level.
Theoretical output vs. actually flowing current: why output counts
Body resistance varies individually to a great extent and skin resistance (as part of the body resistance) typically increases in the course of a treatment due to the drying skin. Body resistances of 4,000 to 6,000 Ohm are not unusual. Another point to consider is soft tap water, where applicable, which also decreases the general conductivity. It does, therefore, make more sense to pay attention to the max. output voltage when comparing iontophoresis units since voltage is the driving force for the current.
Powerful iontophoresis devices build up a max. output voltage of 60 V, less powerful devices only 30 to 40 Volt. According to Ohm’s law, even powerful units at an (admittedly high) assumed total resistance of 6,000 Ohm, for example, only manage a max. output of 10 mA.
Identifying the actually flowing current
Unfortunately, only a few of the iontophoresis devices communicate this huge discrepancy between „current passing through” – i.e. power theoretically delivered and „actual power being delivered“ to the user. In the marketplace here we are currently only aware of the Saalio® iontophoresis system. Its continuously updated „bar display“ visualizes the percentage of the desired power that can in fact actually be delivered [BILD].
Anyone who does not know his/her individual „current values“ and „voltages“ and also wants to prepare for the hopefully successful outcome of the therapy (drier skin), should therefore choose a powerful iontophoresis device with an output voltage of 60 V. Moreover, it is advisable to pay attention to the „actual current passing through“ reading on the display for further reference.
An additional aspect of the required electrical output of an iontophoresis device is the size of the skin area to be treated.
The larger the skin area (e.g. hands, feet or even the combined hand-/foot treatment (simultaneous therapy)), the more power the device is expected to provide in order for a required current density (mA/cm2) to be effective.
In this case as well, a powerful device (max. voltage 60 V) puts you on the safe side so that the iontophoresis can demonstrate its theoretically very high effectiveness.
The difference between direct and pulsed current
Here are almost as many misconceptions as recommendations regarding the subject of „direct or pulsed current“. It is, therefore, sensible to merely consider the facts. Generally speaking: direct current is in most cases more effective for iontophoresis therapy, whereas pulsed current is usually the more pleasant variation (based on an identical current value). In this context, „pleasant“ refers to the subjective current sensation of most users.
It is not surprising that in most cases a pulsed current used for an iontophoresis treatment is perceived as more tolerable since from a technical point of view the pulsed current is nothing else but a „pulsed direct current“. The „pulsation“ is generated by the change of current flow and load breaks. At a „pulse width“ of 50 %, the current dose (current x time x pulse width) is therefore only half as much as with direct current. This explains why the skin can tolerate higher currents when they are pulsed. Anyone who believes that due to the seemingly higher current values the therapy is more effective is mistaken. Essentially, only the cumulative dose of the current flowing into the skin is relevant.
Pulsed current is a useful complement to direct current and is certainly justified for sensitive users, children and patients in the maintenance phase. Only with pulsed current can even some sensitive body regions be treated (of course one should always verify if treatment with a lower direct current would not be the more effective choice).
Conclusion: Anyone who does not have any experience with tap water iontophoresis and the current type suitable for him/her should always select a device with both direct and pulsed current. Such a device offers all treatment options with regard to duration of treatment, strength of application and the body region to be treated.
Adjust individual pulse width – is that necessary?
Only few iontophoresis systems offer an adjustable pulse width which permits incremental increase of the pulse width in pulsed current from 50 %, up to 100 % (direct current). It is often claimed that higher currents can be achieved this way, that therapy takes effect faster and less sessions are required.
Correct is: pulsed currents actually permit higher current strengths which in most cases initially are perceived as positive.
Erroneous would be: the sweeping conclusion that less applications warrant faster therapeutic success
Justification: Therapeutic success does not depend on the current level, but rather the current dose
current x pulse width x duration of treatment
The higher, more tolerable current strengths – made possible with pulsed current (no matter which pulse width) are more than compensated by shortened pulse widths, so that the actual dose in the pulsed current is usually lower.
Example: in case of a 50% pulse width one can hardly manage to tolerate a current strength more than twice that required for a comparable dose. In the majority of cases, direct current thus is and remains the more efficient choice. As mentioned before, pulsed current (with 50% pulse width) undoubtedly also has its justification. It is the opinion of the author that the examination of variable pulse widths in most scenarios resembles a fallacy and can even distract from the basic requirements of a successful iontophoresis therapy.
Metal or plastic / silicone electrodes
Strangely enough, tap water iontophoresis is the only kind of electric stimulation therapy where metal electrodes are still to be found. This is certainly due to the more than 30 year history of the process. At first glance, the metal plates appear to be a long-term, robust solution.
Nonetheless, metal electrodes do have some disadvantages:
- unsuitable for users with metal allergies
- danger of skin burns when touched
- corrosion and surface changes occur
- frequently, sharp edges are noticeable
- heavy-weight (except when aluminum is used)
Corrosion and additional changes in the metal surface are warning signs indicating that the metal electrodes in the electrolytic bath containing tap or sweat water probably do not exhibit chemically neutral behavior.
Aluminum electrodes tarnish after some time and require elaborate cleaning. Stainless steel electrodes undergo a discoloration process. This is not really reassuring and merits closer consideration.
Any change in the material or even actual corrosion of the metal electrodes indicates that a chemical reaction with separation of metal ions is taking place. Ultimately, the tap water iontophoresis might drive these into the tissue. Even though corrosion is of no concern with aluminum electrodes, the same phenomenon may also occur in them!
It is remarkable that the penetration of aluminum in antiperspirants into the skin (at least in the media) is considered critical and is being discussed with an almost unbearable fervor, whereas nobody pays any attention (yet) to the separation of nano particles from metal electrodes.
Tarnished aluminum electrodes lose their conductivity. Moreover, it is our experience that cleaning is quite cumbersome.
Tarnished stainless steel electrodes do not have any functional impairments but discoloration indicates chemical separation processes of alloying elements. The elements most frequently separated are most likely chrome and nickel. This is one reason why in the evolution of iontophoresis devices the aluminum electrodes appeared later (these, however, have some disadvantages of their own).
The advantages of silicone-/graphite electrodes
An alternative to metal electrodes are the more modern electrodes made of plastic. Their base material is silicone enriched with a high percentage of conductive graphite. Graphite is known to be an absolutely neutral (chemically inert) electrode material. Silicone-/graphite electrodes are especially lightweight and pliable and can – if needed and they are large enough – be trimmed to an alternative shape (e.g. for treating the entire foot, to fit a higher treatment tray with smaller surface area).
The conductivity of a good all-plastic electrode is sufficient to ensure an even current distribution as well the current strength required for treatment. On the other hand it also prevents the occasionally high current peaks that can occur when coming in contact with metal electrodes. From the user’s point of view, these combined properties should be the optimal solution.
But as with most other items, there are quality differences – even in plastic electrodes. It is best to pay attention to how the electrodes are termed. If the manufacturer declares them as „wear parts“, one can assume they have a short service life.
Suitcases or trays? Systemic advantages and disadvantages
Admittedly, suitcases look handy at first glance. But are they really? The following arguments can be put forward against customary suitcases, the half shells of which are used as treatment trays:
suitcase half shells which are used to rests the forearms on can have sharp edges. Therefore, some manufacturers also offer foam cushions for the edges
the size (length x width) of the suitcases is often not sufficient to treat hands and feet simultaneously. Things get even tighter regarding the level of the water line, if higher-lying partial areas, like the sides of the feet, are to be treated.
Note: some suppliers of iontophoresis devices bypass the two first-mentioned aspects with so-called „comfort trays“, which must be acquired for a surcharge as add-on. But even in this case the size of the trays is not necessarily suitable for a simultaneous treatment of hand and foot.
Even storage or transport of an iontophoresis unit in a suitcase has its pitfalls, for example when only insufficiently dried components are stored or transported. Formation of unpleasant odor is the least problem to be expected; mildew or technical damage are likely to occur.
A sturdy tray, sufficiently large and high, suitable for the simultaneous treatment of hand and foot and equipped with a proper arm rest should, therefore, be preferable to a suitcase and offers relief and comfort in day-to-day operation.
Precautionary measures are a mandatory prerequisite when dealing with electricity. The device should, therefore, have a series of safeguards to provide the greatest possible protection:
- provisions to reduce, if not prevent the so-called electric fence effectprovisions to reduce, if not prevent the so-called electric fence effect
- automatic activation: device recognition as soon as the electrical circuit is closed by the body
- protection against splashing water (facilitates operation during treatment)
- no open connectors or metal contacts
- connectors and contacts are located outside of the water
- the display of the iontophoresis-control device shows the actually flowing current
- comprehensive and up-to-date certification by German test centers
Disadvantage of battery and power pack operation
An iontophoresis device operated by power pack or battery permits a certain flexibility in the application. On the other hand, however, many battery operated devices are associated with a limited maximum electrical output of 20 mA or 40 Volt, respectively. Here it is especially important to consider the trade-off between individual advantages in comfort (when travelling) against the obvious disadvantages regarding therapy possibilities.
Consequently, a modern iontophoresis device should have the following properties:
- clearly structured user guidance, based on explicit symbols, if possible
- auto-start function
- timer function to monitor the duration of a session
- pause function to interrupt the treatment
- memory function: device stores the most recent settings
- direct and pulsed current in one device
Service and transparency of the manufacturer
Ultimately, service and transparency of the manufacturer are also crucial selling points. Oftentimes, the websites of manufacturer or online store already convey a first impression and are a helpful tool to assess their diligence and integrity.
- what depth of information do manufacturer or dealer permit?
- is any documentation, for example the manual, available as download?
- are all certificates and test seals present?
- is any information missing, maybe even legally binding, mandatory data like a disclaimer?
Warranty and Guarantee
The devices available in the market today come with warranties between 1 to 2 years. Since such customer protection can be associated with costs for the manufacturer and is generally based on empirical values, you might already get a good sense of how much (or little) trust individual manufacturers place in their own devices.
Iontophoresis: customer opinions, ratings, reviews
One should generally be wary of product reviews on the internet, especially if they have not been subject to an evaluation system (e.g. eKomi, Trusted Shops, Google Trusted Stores) or if they exclusively refer to unverified purchases. Amazon & eBay, for example, have special labels to identify the evaluations of shoppers who verifiably purchased a product from their system prior to evaluating it. This does not mean that conversely all „unverified purchases“ are automatically fake evaluations. A remarkable accumulation of those should, however, be viewed with a grain of salt. The use of customer pictures in connection with iontophoresis (a taboo topic) seems to point to so-called „fakes“.
A good indication for real evaluations in online stores are accumulations of some hundred ratings, the identity of which have been verified by external enterprises and also contain negative opinions and criticism!
Purchasing an iontophoresis unit
Specialist supplier, pharmacy or „as cheap as possible“?
Anyone who wants to purchase a device for tap water iontophoresis can try to acquire a unit at a medical supplies specialist retailer. First off one has to locate an iontophoresis device at a local retailer. Neither medical supply stores nor pharmacies will have devices for home therapy in stock so that the dealer will have to first place an order for the iontophoresis device. In most cases, expert advice that fully deserves the name cannot be given for lack of first-hand experience with iontophoresis!
Here in particular, Internet-specialist suppliers can be at their best and score with continuous product availability as well as (due to their specialization) a very high level of advice (also after the purchase). Sascha Ballweg, owner of the theme shop schwitzen.com (sweatrelief.info), knows for sure: „the expert advice on excessive sweating regarding our products is well beyond what most pharmacies and medical supply stores and even a number of medical professionals are able to provide. Being afflicted persons ourselves, we naturally know our few select products very well and frequently even from hands-on experience. Moreover, we have a very close relationship with the manufacturers and maintain a regular information exchange regarding development and application of antiperspirants and iontophoresis units.“ Thus, specialization pays off for both dealer and customer.
Savings on the internet: order iontophoresis units on the web
- continuous product availability for iontophoresis units in their own warehouse (buy-now, immediate deliverability)
- in-depth expert knowledge by specialization of select items proven to be effective
- advice based on the dealers’ first-hand experience (hyperhidrotics themselves)
- excellent quality of advice, also after sales (telephone, email, live-chat)
- verified, predominantly positive customer opinions regarding iontophoresis system and online store
- alternative treatment methods are also offered
Bottom line on iontophoresis units requiring intensive consultancy support: iontophoresis therapy requires expert advice. As significant as the basics of therapy and safe handling are, the efficient use of the iontophoresis system (by trained nursing staff, in home therapy but also by the user him/herself) is just as important.
Market places: as regards to expert advice, it is a given that the large market places, pharmacies and medical supplies retailers cannot keep up with specialized companies on such a specific topic like iontophoresis.
Accessibility & competence: anyone who is in the market for an iontophoresis unit and who emphasizes price over value, buying from the cheapest source, may already regret the missing competence of a dealer (if the latter is even available) during the first application. The regret will certainly increase when first problems with the device creep up.
Paying for advice? Examples can be found on the internet where after sales assistance has to be paid separately. Providing support costs money and is time intensive. Anyone, however, who makes the customer pay for this service either miscalculated or has obvious shortcomings in the quality or organization of the information material made available.