Primary hyperhidrosis is a condition that causes abnormal
sweating not related to exercise or resulting from another
underlying condition. While it can affect different areas of the
body, severe palmar and plantar hyperhidrosis (involving the
hands or feet) can often cause social distress or occupational
difficulties.
Medical treatments of palmar hyperhidrosis include
application of topical agents (chemical antiperspirants such as
aluminum chloride), Iontophoresis (treatment with electrical
current), Botox™ injections, or surgery (endoscopic sympathectomy).
In cases where antiperspirants are not effective, a physician
may recommend "Tap Water Iontophoresis" for treatment
of palmar or plantar hyperhidrosis. In medical terms,
iontophoresis is defined as the topical introduction of ionized
drugs into the skin using direct current (DC). However, use of
iontophoresis with simple tap water has been documented as early
as 1952, and later studies by Dr. Fred Levit and Dr. Lewis P.
Stolman demonstrated its efficacy in the treatment of palmar
hyperhidrosis.
Typical treatments consist of placing the hands
(and/or feet) into two water baths, each with a connection to the
Galvanic Unit. Current is applied typically for 10-20 minutes per
session, initially with 2-3 sessions per week followed by a
maintenance program of treatments at 1 to 3 week intervals,
depending upon the patient's response.
While the exact mechanism for the effects of tap water
iontophoresis on hyperhidrosis remains uncertain, recent research
suggests that a parakeratotic plug is formed, blocking the duct
without damaging the sweat gland. Dr. Stolman found
iontophoresis to be effective in about 83% of the 18 subjects treated in his
study.
Physicians can request an instructional DVD entitled "Iontophoresis for Hyperhidrosis with the Fischer Galvanic Unit". Part of the DLC Training Series by Dr. Lewis P. Stolman, this 12 minute video describes treatment of the hands and feet using the Model MD-1a including operation with and without an assistant. This instructional video is available to physicians only.
Physicians Only: Please call or order online
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After your doctor has issued a prescription for the MD-1a, you can mail or fax it to us for processing (visit our Home page for address and phone/fax numbers).
You can place your order by telephone, or online using our order form.
The MD-1a is available with waterbath trays (for treating hands or feet), with wet pads (for treating the axillae), or with both waterbath trays and wet pads.
To check current pricing, click the button below.
 The Model MD-1a is a medical device which requires a prescription. You should therefore consult with a dermatologist or podiatrist to evaluate your condition and determine a proper course of treatment, which may include iontophoresis. Your doctor may then issue a prescription for the device, which we require before an order can be accepted.
To request additional information for review by your doctor, complete our Feedback Form or email us at orders@rafischer.com Tapwater Iontophoresis is a recognized medical therapy for treatment and control of primary hyperhidrosis. Many healthcare plans consider this treatment as a medical necessity while others may not, so you may wish to contact your provider for pre-authorization if in doubt.
R.A. Fischer Company does not bill health insurance companies; patients typically purchase the device and then obtain reimbursement from their health plan.
Your insurance company may require one or more of the following codes to process a claim:
- CPT / HCPCS Code: 97033
- ICD-9 Code: 705.21
- HIC/PIC Code: E1399 "Tapwater Iontophoresis"
- FDA Classification Code: 89KTB Iontophoresis, specific use
- FDA 510k Number: K964208
- FEIN Number (A.R. Hinkel Co. dba R.A. Fischer Co.): 95-40163106
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For additional information and useful forms for insurance, we recommend the following links (courtesy www.sweathelp.org):
 Insurance Tools from International Hyperhidrosis Society
Sample Letter of Medical Necessity (PDF)
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