The Effect of Saline Iontophoresis on Skin Integrity in Human Volunteers: I. Methodology and Reproducibility

This study, conducted in 36 human volunteers, was an evaluationof the effects of saline iontophoresis on skin temperature,irritation, and barrier function. The major objectives wereto assess the effects of low-level ionic currents, to validatethe proposed methodology of assessment, and to establish reproducibilityin repeated saline iontophoresis applications. This was thefirst of a multistage study designed to assess the safety of24-hr saline iontophoresis episodes at selected currents andcurrent densities. Since an iontophoresis patch challenges theskin harrier both by occluding the skin surface and by passingionic current through the skin, the experimental protocol wasdesigned to permit measurement of the contribution of each ofthese processes to the overall response. In this first stagewe investigated the effect of 10 min of current delivery, at0.1 mA/cm² on a 1-cm² area patch and 0.2 mA/cm² on a 6.5-cm²area patch compared to unpowered control patches. Twelve subjectswere tested under each condition on two separate occasions toexamine reproducibility of the response variable measurements.A further 12 subjects were tested once under the 0.2 mA/cm 6.5-cm2condition. Skin irritation was evaluated via repeated measurementsof transepidermal water loss, capacitance, skin temperature,skin color, and a visual scoring system, before the iontophoresisepisode and after patch removal. No damage to skin harrier functionin terms of skin-water loss or skin-water content was detected.Slight, subclinical, short-lasting erythema was observed forboth conditions. Assessment of correlation coefficients showedhighly statistically significant indications of reproducibilityfor all five response variables measured. The experimental design,in combination with a repeated measures analysis, provided clearseparation of the occlusion and ionic current components ofthe iontophoretic patch challenge. Further, the repeated measuresanalysis gave a highly sensitive assessment of skin irritationand resolution after patch removal. We conclude that the experimentalmethodology is appropriate for assessing possible changes inskin integrity resulting from saline iontophoresis under similaroperating conditions for longer durations and for other skinchallenges from which a subclinical response is expected.