Glycopyrrolate Iontophoresis Versus Tap Water Iontophoresis in Primary Focal Hyperhidrosis: A Randomized Controlled Superiority Trial
| Author | Ranchit Narang | en |
| Author | Pratibha Gupta | en |
| Author | Sharang Gupta | en |
| Orcid | Ranchit Narang [0009-0001-0345-0088] | en |
| Orcid | Pratibha Gupta [0009-0001-4727-7256] | en |
| Orcid | Sharang Gupta [0000-0002-1054-1738] | en |
| Issued Date | 2026-06-30 | en |
| Abstract | Background: Primary hyperhidrosis is a chronic disorder that substantially impairs quality of life. Tap-water iontophoresis is an established noninvasive treatment; however, relapse after cessation of treatment is common. Glycopyrronium bromide delivered by iontophoresis may provide additional antimuscarinic activity at eccrine sweat glands. Objectives: To compare the clinical effectiveness and short-term persistence of glycopyrrolate iontophoresis with those of tap-water iontophoresis in patients with primary focal hyperhidrosis. Methods: This 2-month, parallel-group, open-label, 2-arm randomized controlled superiority trial was conducted at a tertiary care center in Himachal Pradesh, India. Forty participants were randomized in a 1:1 ratio to glycopyrronium bromide 0.04% iontophoresis (n = 20) or tap-water iontophoresis (n = 20). Treatment comprised two 20-minute sessions weekly for 4 weeks, followed by 4 weeks without treatment. The Hyperhidrosis Disease Severity Scale (HDSS) and the number of dry days were assessed at baseline and at weeks 4 and 8. Results: All 40 randomized participants completed follow-up and were included in the analysis. At week 4, the glycopyrrolate group had a median of 4 dry days compared with 2 days in the tap-water group (Hodges-Lehmann median difference, 1 day; 95% CI, 0 to 2; Mann-Whitney U test, P < 0.001). At week 8, the corresponding medians were 4 and 2 days (Hodges-Lehmann median difference, 2 days; 95% CI, 1 to 3; P < 0.001). HDSS also favored glycopyrrolate at week 4 (Hodges-Lehmann median difference, -1 point; 95% CI, -2 to 0; P = 0.009) and at week 8 (-1 point; 95% CI, -2 to 0; P = 0.001). Local irritation along the water line occurred in 1 of 20 participants (5%) in the glycopyrrolate group and 2 of 20 participants (10%) in the tap-water group; no systemic adverse events or withdrawals were reported. Conclusions: Both interventions improved HDSS and dry-day outcomes over 4 weeks. Glycopyrrolate iontophoresis produced greater between-group improvements and maintained the observed benefit during an additional 4-week treatment-free observation period. Larger, blinded, adequately powered trials with objective sweat measurements and longer follow-up are warranted. | en |
| DOI | https://doi.org/10.5812/jssc-172992 | en |
| URI | https://brieflands.com/journals/jssc/articles/172992 | en |
| Keyword | Primary Focal Hyperhidrosis | en |
| Keyword | Glycopyrrolate | en |
| Keyword | Iontophoresis | en |
| Keyword | Tap Water | en |
| Keyword | Randomized Controlled Trial | en |
| Publisher | Brieflands | en |
| Title | Glycopyrrolate Iontophoresis Versus Tap Water Iontophoresis in Primary Focal Hyperhidrosis: A Randomized Controlled Superiority Trial | en |
| Type | Research Article | en |
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