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Introduction to dermatological treatment
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Iontophoresis involves passing a low electric current into the skin. Skin resistance is lower through the sweat ducts than the skin so the current passes preferentially down them. This is a useful treatment for hyperhidrosis of the hands and feet and with a new attachment for the axillae. It is available in most dermatology or physiotherapy departments, where the first course of treatment should be given. If this is beneficial, then mains and battery operated units are commercially available from STD Pharmaceutical, (Plough Lane, Hereford, HR4 0EL, England, tel. 01432-373555) or Iontocentre.com (tel. freephone 08006 124812) for treatment at home.
Preclinical and Clinical Safety Assessment of Transdermal and Topical Dermatological Products
Published in Tapash K. Ghosh, Dermal Drug Delivery, 2020
Lindsey C. Yeh, Howard I. Maibach
Iontophoresis and ultrasound techniques are physical methods used to enhance the percutaneous penetration of drugs. However, a major concern with the use of iontophoresis is that the device may cause painful destruction of the skin with high-current settings. High-quality electrodes with adequate skin adhesion, uniform current distribution and well-controlled ionic properties are essential to the safe use of the method.
Iontophoresis for Local Anesthesia
Published in Marwali Harahap, Adel R. Abadir, Anesthesia and Analgesia in Dermatologic Surgery, 2019
Adverse effects from iontophoresis are predominately related to the iontophoretic current. They tend to be proportional to the total iontophoretic dose delivered and are more problematic at higher current levels. Many patients experience tingling, itching, or warmth during iontophoretic treatment. Erythema occurs after treatment often under the cathode for lidocaine iontophoresis. Urticaria secondary to mast cell activation can also be seen under the electrodes. Petechiae can also occur under the electrode placement areas. Occasionally, a patient will experience muscle spasm or parathesias during treatment, but these reactions resolve spontaneously. In our earlier study, about 5% of pediatric patients did not tolerate the electrical sensation associated with iontophoresis and asked that the treatment be terminated (4). This was not a problem in our recent study that utilized a lower total iontophoretic dose than previous studies, while not sacrificing efficacy (5).
Application of iontophoresis in ophthalmic practice: an innovative strategy to deliver drugs into the eye
Published in Drug Delivery, 2023
Dong Wei, Ning Pu, Si-Yu Li, Yan-Ge Wang, Ye Tao
Since the development of iontophoresis from the twentieth century, there has been a lack of regulatory standards from device production to rational application. Moreover, many animal studies have used self-assembled devices that lack reproducibility when testing the efficacy of the technology, which may lead to large discrepancies between animal studies and clinical trials. Another issue of concern is that most of the iontophoresis techniques in animal experiments use reversible electrodes such as Ag/Agcl. On the other hand, inert electrodes such as platinum electrodes are mostly used in clinical trials. In the ionization process using inert electrodes, the PH of the anode will keep decreasing while the PH of the cathode will keep increasing. This difference in pH changes due to electrode materials may lead to enhanced toxicity or diminished efficacy of iontophoresis technique in clinical trials. Therefore, it is necessary to use a buffer to balance this PH change in clinical trials (Gratieri et al., 2017). Excitingly, more and more devices have been developed and patented for clinical use. Many clinical trials are also struggling to find a ‘gold standard’ for therapeutic use. As the scope of clinical trials expands and the safety data accumulates, a satisfied standard will eventually be established for iontophoresis.
Enhanced transdermal insulin basal release from silk fibroin (SF) hydrogels via iontophoresis
Published in Drug Delivery, 2022
Phimchanok Sakunpongpitiporn, Witthawat Naeowong, Anuvat Sirivat
TDDS is an attractive drug administration as it can avoid the metabolization and the first-pass effect through a painless administration route. This method can provide a proper and prolonged drug delivery with a steady state drug profile (Alexander et al., 2012). The suitable drug characteristics are low molecular weight (500 Da), high lipophilicity, and low therapeutic dose (Murthy, 2012). The limitation of TDDS is the stratum corneum (SC) which acts as a barrier to prevent the drug permeation (Alkilani et al., 2015). To overcome this limitation, several active methods (ultrasound, iontophoresis, microneedle) are applied in TDDS. Iontophoresis is a popular technique as it uses a low electrical current (0.1–1.0 mA/cm2) without harming the human skin to drive the drug across SC and to enhance the skin permeation resistance (Chen et al., 2009). The iontophoresis approach can control the drug release rate, amount and duration with a predetermined electric current (Szunerits & Boukherroub, 2018).
Transdermal delivery via medical device technologies
Published in Expert Opinion on Drug Delivery, 2022
Shubhangi Shukla, Ryan H. Huston, Blake D. Cox, Abhay R. Satoskar, Roger J. Narayan
Iontophoresis is especially promising in medicine because it transmits a relatively high dose of drug to a localized target site of disease, as directed by the current from the electrodes. However, iontophoresis can have some side effects at the target site such as irritation from drug permeation or electrical burns, which are associated with excessive current duration or poorly controlled frequency of use [105–108]. Studies have also looked at iontophoresis with the aim of delivering drugs systemically through subcutaneous breast papillae or blood vessels [18,109]. As already mentioned regarding systemic delivery via microneedles, these uses have an additional benefit compared to oral ingestion as the drug escapes first-pass metabolism (degradation or modification of the active drug at a site other than the target site) by the stomach and liver [110].