Finding studies proving the efficacy of iontophoresis for hyperhidrosis was not as difficult as figuring out how iontophoresis works. The hands and feet are placed in a water bath and a direct electric current is run through it. This is a popular treatment if topical aluminum salts have failed. Iontophoresis is also used to help with the cutaneous absorption of drugs.
This article (and others following it) have related the accumulation of hydrogen ions in the sweat glands to secretory damage. With the electric current, water becomes acidified and the ions more easily penetrate the skin because of the current. They collect in the sweat glands and damage them. It takes multiple treatments for hyperhidrosis treatment, as after one treatment, there was only a mild decrease in activity with choline stimulation.
Sato K, Timm DE, Sato F, Templeton EA, Meletiou DS, Toyomoto T, Soos G, Sato SK. Generation and transit pathway of H+ is critical for inhibition of palmar sweating by iontophoresis in water. J Appl Physiol. 1993 Nov;75(5):2258-64.
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