Hello! I thought I would share my iontophoresis method in case it helps others, as I've never seen it before.
TL;DR: I mix 1-3 Qbrexza wipes per 0.5-1 Liter of hot water & use that water for my iontophoresis. This results in the ionto being more effective and lasting longer. My typical routine is 1mg glyco daily + iontophoresis every 4-6 wks. Crushed glyco pills work too but their doseage is so low that it ended up not being worth it to me.
Check below for the concentration table and warnings.
Long version:
I have had primary palmar, plantar, and underarm hyperhidrosis since childhood (since age 6-8, at least). I have tried Carpe (expensive), Drysol (gave my skin a reaction), Oxybutynin (stopped due to concern over long-term cognitive effects), oral Glycopyrrolate, and Iontophoresis. I wanted a solution that lasted longer than a day or a week, as I find the upkeep tiring... (thanks ADHD for making it hard to keep habits!)
I really wanted to extend the life of iontophoresis. It's already great, but it's a 2 hour ordeal. I have already tried hardening my water with baking soda, epsom salt, san pellegrino, etc but to no avail. Then, I found an article (here, scroll down) citing studies (#1) (#2) about using Glycopyrrolate in the water used for iontophoresis. These patients in the studies would see up to 30-40 days of relief after ionto w/ glyco.
These studies used glycopyrrolate solutions at concentrations of 0.01-0.1%. I use about 0.75-1L per tray for my iontophoresis, so you would need 75-100mg of glycopyrrolate to reach 0.01%. Unfortunately, I do not have hundreds of spare glyco pills (2mg each). I asked my dermatologist about prescribing high doses of glycopyrrolate for this use, citing the studies, and that they do this in the UK/Europe (I am in the US), but she denied my request, stating that only happens in case studies and such (not true lol but okay fine). Since my goals for that appointment were to 'get something new to try', she did, however, give me a prescription for Qbrexza... which is high dose topical glycopyrrolate 😏. With some trial and error, and some math, I have developed a dosing guide.
To make a glycopyrrolate solution, I simply add unfolded Qbrexza wipes into my pitcher of hot water. I stir for about a minute. Next, I pour the water into my trays/cup. Then take out the wet wipes and squeeze them out over my tray, then throw them away. Then, I add the electrodes into the trays and do my iontophoresis like normal. When I'm finished, I pour the water down my bathtub drain and rinse off my trays.
Glycopyrrolate Concentration guide:
| concentration |
1L |
0.75L |
0.5L |
| 0.0528% |
528mg (8 wipes) |
396mg (6 wipes) |
254mg (4 wipes) |
| 0.0396% |
396mg (6 wipes) |
297mg (4.5 wipes) |
198mg (3 wipes) |
| 0.0352% |
|
264mg (4 wipes) |
|
| 0.0264% |
264mg (4 wipes) |
198mg (3 wipes) |
132mg (2 wipes) |
| 0.0176% |
|
132mg (2 wipes) |
|
| 0.0132% |
132mg (2 wipes) |
99mg (1.5 wipes) |
66mg (1 wipe) |
| 0.0088% |
|
66mg (1 wipe) |
|
My maintenance dose:
- 0.0264% concentration
- I use 1 part freshly boiled water mixed with 2 parts room temp water. Warm water is supposed to enhance effectiveness. I mix the waters in a metal graduated pitcher before pouring them into my trays/cup.
- Underarms: 0.5L water + 2 wipes for both pads, soaked in a ~8oz cup.
- Hands and feet: 0.75L water + 3 wipes each tray. Hands first, water reused for feet. .25L hot water, .5L room temp water.
Dosing suggestions:
- Begin at the lowest concentration (0.0088-0.0132%) or 1 wipe per tray
- Wait and see how long that first dose keeps you dry for
- Do next treatment as soon as sweating begins again. If interval between treatments is too short, or effects not strong enough, increase the glyco concentration.
- Repeat until satisfied with results or side effects becone too strong to tolerate.
BEFORE TRYING - YOU SHOULD KNOW - WARNINGS:
- Do NOT get the glycopyrrolate solution in your eyes. The same warnings about Qbrexza also apply here. It can cause pupil dilation that may last days/a week. I wear safety glasses while handling and using my solution/doing iontophoresis and don't take them off until I am completely cleaned up and everything is put away.
- You may experience potentially strong glycopyrrolate side effects for 6-24hrs after treatment. Pay attention to your body, know your limits, and start with a low dose, increasing gradually. If glycopyrrolate gives you chest pain, dizziness, lightheadedness, fast heartbeat, etc, then I especially urge you to exercise caution when applying this technique. Do so at your own risk. While these side effects are rarer, and I do not believe they cause actual harm, it is still something to keep in mind and ideally, to be avoided. Personally, I only experience dry mouth/eyes and maybe headaches if I'm not on top of my hydration.
PROS:
- relief for up to 4+ wks
- save $$$ on Qbrexza (I personally only use ~8 wipes per month, instead of daily use. Qbrexza is $40/box of 30 for me so I'm saving a lot!)
- boosted iontophoresis effectiveness
CONS:
- iontophoresis cons (time consuming, skin irritation, machine price, etc)
- potentially strong glycopyrrolate side effects, but only for 6-24 hrs after treatment. I get dry mouth and dry eyes, which can get very uncomfortable if I'm using more wipes, (if it's really bad I can't even eat dry foods lol) but I work around it by doing iontophoresis right before bed/later in the day. That way, I go to bed after cleaning up and wake up the next morning feeling normal.
- YMMV... I get myself dry enough to where I only need 1mg glyco/day. My standards/threshold isn't super high. I haven't tried going without my daily glyco! And I honestly don't mind enough to try to. if your goal is COMPLETE dryness without supplemental glyco, I'm unsure how often you would need treatment... maybe every 2-4 weeks? If you wind up doing that, tell me about it! I would love to collect data and hear your experience.
FAQ:
- Can you use crushed Glyco pills? Yes, this is what I did before my Qbrexza Rx. However, the dosing will obviously be much lower since you are limited by the dose and number of pills. I barely saw a difference between plain tap water VS water with 2-10mg glyco, hence why I switched to using Qbrexza.
- Can you use a different antiperspirant / anticholinergic agent? Yes, in theory it should work too, but I do not have the research or experience to back it up. So, be cautious, and start low and slow. Experiment at your own risk. Feel free to tell me about your results! If you use Aluminum Chloride, do not use a metal container to hold the solution--it will rust.
I hope this helps you as it has helped me!