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This is a summary of the NHS Devon commissioning policy for Botulinum Toxin A for the management of focal hyperhidrosis
Referral Criteria:
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:
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)
Email: d-icb.ifr-newsdt@nhs.net
Individual Funding Request (IFR) Patient information leaflet
Publication date: May 2013
Updated: November 2023