Referral

Back
Policies Toggle Pages
Abdominal hernia in adults Adult Snoring Surgery (in the absence of Obstructive Sleep Apnoea) Arthroscopic shoulder decompression for subacromial shoulder pain Arthroscopic surgery for meniscal tears Artificial urinary sphincters for post-prostatectomy incontinence Assisted Conception Benign Skin and Subcutaneous Lesions Commissioning Policy Blepharoplasty (upper and lower lid) including brow lift Botulinum Toxin A for the management of focal hyperhidrosis Breast implants - removal and replacement Breast reduction surgery Carpal tunnel syndrome (surgery) Cataract Surgery Chronic rhinosinusitis with or without polyps Circumcision Cosmetic Treatments Cryopreservation to Preserve Fertility Dilatation and curettage for heavy menstrual bleeding in women Dupuytren's contracture treatment Ear Wax Removal Femoro–Acetabular Impingement, open or arthroscopic surgery Fusion surgery for non-specific, mechanical back pain Haemorrhoids in adults Hallux Valgus (Bunion) - Commissioned pathway Heavy Menstrual Bleeding - Referral for Surgical Management Hip and knee replacement surgery in obese patients (those with a body mass index of 30 or greater) Individual Funding Requests (IFRs) Injections for non-specific low back pain without sciatica Knee arthroscopy for patients with osteoarthritis Lumbar spine procedures – for simple lumber back pain Meibomian cysts (chalazia) Myringotomy/grommets with or without adjuvant adenoidectomy for the management of otitis media in children under 12 years Myringotomy with and without grommets in adults and children aged 12 years+ Open Magnetic Resonance Imaging (MRI) Scanning Radiofrequency Denervation Reversal of male and female sterilisation Spinal injections for sciatica Surgery for ganglion cyst Surgical procedures for the treatment of LUTS caused by BPH Tonsillectomy Trigger finger release in adults Varicose vein referral
Print this page
Contact us about this page

Botulinum Toxin A for the management of focal hyperhidrosis

This is a summary of the NHS Devon commissioning policy for focal hyperhidrosis.

Toggle all

Referral Criteria

Referral Criteria:

  • Hyperhidrosis Disease Severity Scale score of 3 or more (sweating which is barely tolerable and frequently interferes with daily activities)
  • which has failed to respond to at least six weeks of topical aluminium chloride and self-management strategies.

Botulinum toxin A is only commissioned for use in patients with severe axillary hyperhidrosis. Patients must satisfy the above referral criteria AND have a resting sweat production of at least 100mg/5 minutes (per axilla).

In severe cases which are unresponsive to these treatments, surgical intervention can be considered. However, the procedure (endoscopic thoracic sympathectomy) often leads to compensatory hyperhidrosis and so is rarely used in practice.

Please note iontophoresis is no longer available in secondary care.

Generalised hyperhidrosis

Consider referral to Dermatology for patients with generalised hyperhidrosis where:

  • underlying causes cannot be identified despite appropriate investigations.
  • Symptoms persist despite management of underlying conditions and/or adjustments to potential causative medications

NHS Devon commissioning policy for Botulinum Toxin A for the management of focal hyperhidrosis

Where the circumstances of treatment for an individual patient do not meet the criteria described above exceptional funding can be sought. Individual cases will be reviewed by the appropriate panel of NHS Devon upon receipt of a completed application from the patient's GP, consultant or clinician. Applications cannot be considered from patients personally.

Exceptional /Individual Funding Requests (IFR).

Applications for consideration for funding approval should be sent to:

Email: d-icb.ifr-newsdt@nhs.net

Patient Information

Individual Funding Request (IFR)

Date of publication: May 2013

Updated: November 2023

Back to Top