Iontophoresis is an electrical treatment used to help move substances across the skin or other body surfaces such as the eye. Although the effect was first noted in the eighteenth century, its use in medicine only began in earnest in the 1890s.
[W]hile the constant current has proved so very useful to the medical profession for diagnosis, for stimulating nerve and muscle, for electrical endoscopy, and for cauterization, we must not neglect its cataphoretic property, by which remedial agents are diffused through the tissues and fluids of the body to improve nutrition, to produce anaesthesia, to relieve pain, to destroy germs, to modify morbid processes, and to make soluble chemical combinations with deleterious substances which quite frequently collect in the organism.
Iontophoresis works on ions – water-soluble substances that have either a positive or negative charge – and is based on the general principle that like charges repel and unlike charges attract. By using a direct (galvanic) current, an ion can be ‘pushed’ into the skin if the electrode (the active or working electrode) being used has the same charge as the ion in question, i.e. a positive ion (cation) will be pushed into the skin by a positive electrode (anode) and a negative ion (anion) will be similarly affected by a negative electrode (cathode).
It is very difficult to move water-soluble chemicals across the skin’s surface, so when it was first introduced the medical profession hoped that iontophoresis would be able to deliver drugs across the skin without using needles. Unfortunately, due to a variety of factors – including the excellent barrier properties of the skin – this has not held up in practice and iontophoresis currently has limited medical applications, such as treatments for hyperhidrosis (abnormal sweating of the palms or other areas of the body).
Early mentions of the technique refer to the process by a variety of names including electric osmosis, electro-chemical osmosis, ionic medication and cataphoresis, the latter coming from the fact that the liquid is carried down (cata, down; pherein, to bear). These were general terms applied when either the positive (anode) or the negative (cathode) electrode was used.
Over time the medical profession began to distinguish between procedures that used different working electrodes. The term cataphoresis then became restricted to treatments where the positive electrode was the working electrode (it pushes cations) and a new term, anaphoresis, began to be employed for those that used the negative electrode (it pushes anions). As this distinction took hold, both process were sometimes referred to as phoresis but over time this term gave way to iontophoresis.
The earliest record I have for a salon practice being called iontophoresis is by Helena Rubinstein in 1935 but many beauty experts continued to call it phoresis or cataphoresis (as the term was originally coined) for many years after that.
Using electricity to increase the penetration of chemicals into the skin was quickly adopted by Beauty Culture. Ruth D. Maurer [1871-1945], who began Marinello, makes mention of the principle in the book she almost certainly wrote in 1903.
Experiments have proved that by moistening electrodes with certain substances and applying them to the unbroken skin, making the current sufficiently strong, the materials have been forced into circulation. For instance, concentrated solutions of sulphate of quinine and iodide of potassium can be detected in the urine thirty minutes after they have been applied to the skin. The amount detected after four or five hours is even greater, showing that the process has been going on steadily. In all of this work the idea is, of course, to cause the drugs to enter the circulation.
Like other beauty experts of her time, Maurer – writing under her pseudonym, Emily Lloyd – referred to the practice as cataphoresis rather than phoresis or iontophoresis.
In some instances and by a few authorities the general process is known by the term “phoresis.” When the positive electrode is employed, it is called the “anophoresis,” [sic] and when the negative is used it is called cataphoresis. As this method is somewhat confusing to the student, we shall throughout refer to the process as cataphoresis no matter which electrode is employed.
Maurer’s first use of cataphoresis, as she called it, was to help in bleaching the skin.
Initially enthusiastic, Maurer later dissuaded Marinello practitioners from using cataphoresis during regular skin bleaches and suggested restricting its use to situations where the discolouration was very deep, such as in chloasma.
After the paste has become thoroughly dry it may be removed by washing the skin with luke-warm water, and then if the patches on the face or neck are very deep, the bleaching lotion may be forced into the skin by means of the negative electrode, … continuing the process until the skin is thoroughly reddened. This process, it should be understood, is only used for moth patch or chloasma, and would not be used in the ordinary treatment at all.
Maurer also described how cataphoresis could be used to administer a local anaesthetic – a mixture of cocaine and adrenalin – to relieve pain during electrolysis, a technique she may have picked up from the dental profession.
Owing to the danger of infection, no one cares to administer cocaine by means of the hypodermic needle and to place this solution upon the skin alone will have absolutely no effect, unless it can be used on the mucous membrane.
It may, however, be successfully forced into the tissues by means of the positive electrode and thus the portion treated without any sensation whatever.
Solutions containing sulphur compounds, applied with the positive electrode, were also widely employed in early beauty culture to treat acne-prone skin or seborrhoea.
Iontophoretic solutions used in salons today are made with a wide variety of ingredients including vitamins, minerals, collagen, elastin, amino acids, hyaluronic acid and a range of animal and plant extracts. These come in a range of prepared packages including gels, serums and ampoules. Therapists are usually provided with very little information on how these work, other than the skin condition for which they apply and the polarity of the electrode to be used.
As with many ingredients in skin creams, it is doubtful whether some of these substances could penetrate the skin – whether or not an electric current is used – let alone whether they would be effective.
Working electrodes come in a variety of forms including balls, rollers, disks and full face masks. As a direct current is used, another electrode (the passive, indifferent or return electrode) is required to complete the electrical circuit and get the current to flow. This electrode can be a bar given to the client to hold, or a pad placed somewhere where it makes good body contact, e.g., under the shoulder or wrapped around the upper arm. Current placement of the return electrode appears to differ from the earliest application of this procedure. Initially, both the working and return electrodes – covered with saturated cotton wool – were applied to the face.
Current claims for iontophoretic treatments include hydration, repair and regeneration of mature or damaged skin, stimulation of sluggish circulation and, in the case of body treatments, the softening and absorption of fat and cellulite. Many of these claims are suspect, given that they rely on the transfer and action of specific ingredients deep into skin tissue.
A galvanic treatment often combined with iontophoresis is ‘de-incrustation’. This treatment – developed in the early 1930s by the Société P.A.B. in France – used a direct current to remove ‘incrustations’ from the skin.
The developers of the treatment described these ‘incrustations’ as ‘microscopic crystallisations’ formed by chemical reactions between certain chemicals and minerals in creams, make-up, atmospheric pollution and perspiration. As the impurities built up they clogged the skin causing wrinkles, pimples, acne and blackheads. They had to be removed, that is, the skin had to be ‘de-incrustated’.
The chief characteristics of the method consist in breaking up, reducing and eliminating all the impurities (waste matter, dust, toxins, crystallisations, etc.) which block up the glandular tubes. … The immediate result is—increased blood circulation and, gradually, recolouring of the epidermis.
Incrustations could be eliminated without electricity either by undertaking a deep-cleansing facial treatment – using cleansers, warm sprays and massage – in a salon or by using a facial scrub at home. In France these treatments were also known as désincrustation but in the English speaking world the term usually only applies to the electrical treatment.
Electrical desincrustation relies on a well-known effect of direct (galvanic) currents, that an alkali (sodium hydroxide) is produced at the negative electrode and an acid (hydrochloric acid) is generated at the positive electrode.
This chemical reaction was well known in the nineteenth century and was the basic science behind the electrical removal of unwanted hair through electrolysis.
See also: Electrolysis
Unlike electrolysis, where the sodium hydroxide (lye) is concentrated in a small area in the living dermis of the skin through the insertion of a needle, in desincrustation the sodium hydroxide is spread over the stratum corneum of the epidermis. So, rather than destroying tissue, as in electrolysis, in desincrustation the sodium hydroxide merely softens the keratin in the epidermis. This assists in desquamating surface keratinocytes and helps loosen any hard plugs of sebum such as those that occur in blackheads. The treatment is therefore commonly employed on ‘congested skin’ as precursor to extractions.
Like iontophoresis, the negative electrode used in desincrustation can be a disk, roller or ball electrode, a full facial mask, or something as simple as a tweezer electrode encased in a pad of cotton wool soaked in conducting solution. Unlike iontophoresis, where specialised ampoules are needed, a simple salt solution is all that is required. One can be made up using the following formula:
|Baking soda (sodium bicarbonate)||5 ml (1 teaspoon)|
|Distilled water||250 ml (1 cup)|
Sodium bicarbonate beaks down into sodium (positive) and bicarbonate (negative) ions when dissolved in water. This creates a slightly alkaline solution which is more effective than using common table salt (sodium chloride). In the 1930s, I believe a copper sulphate solution was also used but this would not be recommended today.
The suggested treatment in the 1930s started with a cleansing massage to soften and hydrate the skin as much as possible. A warm pulveriser or steam bath under coloured light may also have been used to improve the skin hydration.
See also: Vapourisers (Steamers & Atomisers)
The client was then connected to the positive electrode while the operator worked on the face with the negative electrode saturated with the desincrustation solution. The session generally lasted about 10 to 15 minutes depending on the strength of the electric current and the sensitivity of the skin to electricity. The strength of the current was adjusted to suit the client with most subjects withstanding a current of between ½ to 3 milliamps.
In order to carry out either desincrustation or iontophoresis, a salon had to purchase a galvanic machine. Having done so it made sense for them to maximise the return on their outlay by combining iontophoresis and desincrustation into a single treatment. This was commonly done by first carrying out desincrustation, using the negative electrode, and then following this with iontophoresis, using the positive electrode.
The reasoning behind this is as follows. Starting with desincrustation reduces the barrier properties of the skin by assisting with exfoliation, in theory making it easier for ions to move across the skin during iontophoresis. Then, as acid is produced under the positive electrode during iontophoresis this helps to restore the acid balance of the skin upset by the alkali generated during desincrustation.
Updated: 22nd September 2017
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