Iontophoresis is the introduction of various ions into the skin by means of a direct electric current for the purpose of transporting chemicals across the membrane. It is used clinically in treatment of inflammatory musculoskeletal conditions, for analgesic effects, scar modification, wound healing, and in treating edema, calcium deposits, and hyperhidrosis. In vivo studies have reported penetration of ions to at least 1 cm into the gluteal muscles. Lidocaine ion penetration was found with a current of 4 mA applied for 10 minutes with a 4 percent lidocaine solution.20 The effectiveness of iontophoresis is directly related to the medication administered or the solution used for ion transfer. Each medication has its own effect, regardless of the method of application. For example, a corticosteriod inhibits the inflammatory process by reducing the migration of neutrophils and monocytes into the inflamed area and reducing the activity of these white blood cells.64 Lidocaine, however, causes dilation of blood vessels and a topical anesthesia of the skin.
Cardiopulmonary effects are directly related to the medication that is administered. For example, lidocaine produces dilation of blood vessels whereas epinephrine causes vasoconstriction. Epinephrine acts on alpha- and beta-adrenergic receptors throughout the body, producing sympathomimetic effects like cardiovascular stimulation, elevations in blood glucose, and dilation of bronchioles.62 The use of iontophoresis is contraindicatedin patients who have nonshielded pacemakers.
The redness of the skin that occurs after treatment is probably mediated by histamine release.
Gastrointestinal, Genitourinary, OB/GYN Systems
The use of iontophoresis is contraindicated in cases of pregnancy.
The skin is considered isoelectric (no charge). The migration of ions from the continuous direct electrical current changes the normal pH level of the skin, which is normally between 3 and 4.With an acidic reaction, the pH falls below 3; in an alkaline reaction the pH is greater than 5. Chemical burns may occur under each electrode. It is more common at the cathode, where there is an accumulation of sodium hydroxide. Skin redness can occur at the conclusion of treatment. The alkaline reaction usually causes sclerolysis. Changes in the pH level can also be responsible for the discomfort and skin irritation sometimes associated with iontophoresis.
Peripheral Vascular/Lymph Systems
Unlike systemic concentration, iontophoresis is directed at large quantities of ions into a localized treatment region. The localized ions minimize the systemic concentration caused by circulatory removal of the material from the area.
Effect of Iontophoresis in body
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