Iontophoresis-Based Topical Drug Delivery for Dermatologic Conditions: A Systematic Review

Area of Science:

• Dermatology
• Pharmacology
• Biomedical Engineering

Background:

• Topical dermatologic therapies face challenges with stratum corneum barrier function limiting drug penetration.
• Iontophoresis offers a non-invasive transdermal method to enhance drug transport using low-intensity electrical current.
• This technique aims to improve local drug bioavailability while minimizing systemic exposure.

Purpose of the Study:

• To systematically review clinical evidence on the efficacy, safety, and pharmacologic performance of iontophoresis-assisted topical drug delivery in dermatologic diseases.
• To assess the potential of iontophoresis as a strategy to overcome skin barrier limitations.

Main Methods:

• A systematic review following PRISMA guidelines, registered prospectively in PROSPERO.
• Searched major databases (PubMed, Embase, Web of Science, CENTRAL, ClinicalTrials.gov) up to November 2025.
• Included 21 studies (15 randomized, 6 non-randomized) assessing various dermatologic conditions and iontophoresis parameters, with risk of bias assessment.

Main Results:

• Findings were mixed across 21 studies investigating conditions like psoriasis, eczema, melasma, and onychomycosis.
• Consistent benefits observed in pigmentary disorders and infectious diseases; more heterogeneous results in inflammatory dermatoses.
• Generally favorable tolerability with mild, reversible local reactions; no serious adverse events reported.

Conclusions:

• Iontophoresis shows potential as a non-invasive delivery enhancement strategy for specific dermatologic conditions limited by skin barriers.
• Heterogeneity in study protocols, formulations, and outcomes limits broad efficacy conclusions across all conditions.
• Larger, standardized trials are necessary to define its therapeutic role, long-term efficacy, and specific indications.