Focal hyperhidrosis treatment

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


Referral Criteria

Treatments for focal hyperhidrosis are commissioned in the following circumstances:

Topical aluminium Chloride preparations may be prescribed for patients with a hyperhidrosis disease severity score of 2 or greater (sweating is tolerable but sometimes interferes with daily activities).

In patients with a 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 treatment for at least one month with topical aluminium, the following specialist services are commissioned through direct referral to the department of dermatology:

  • Systemic oral anticholinergic drugs
  • Iontophoresis
  • Patients with palmoplantar hyperhidrosis

Botulinum toxin is commissioned for use in patients with palmoplantar hyperhidrosis who have not achieved a 50% reduction in sweat production with the above treatments. Botulinum toxin for use in patients with axillary hyperhidrosis in whom the above treatments have proven unsuccessful and who have a resting sweat production per axilla of greater than 50mg in 5 minutes.

Surgical treatment with endoscopic thoracic sympathectomy for severe resistant axillary or palmar hyperhidrosis may be offered with explanation of the risk, benefits and side effects of the procedure.

NHS Devon Treatment of focal hyperhidrosis policy

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)

Referral Instructions

Applications for consideration for funding approval should be sent to:


Supporting Information

Patient Information

Individual Funding Request (IFR) Patient information leaflet

Publication date: May 2013

This policy has been adopted from Northern, Eastern and Western Devon CCG

and South Devon and Torbay CCG by NHS Devon CCG from 1 April 2019


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