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Hyperhidrosis is defined as excessive sweating at rest and during normal temperature, and can be classified as being focal or generalised. Primary or focal hyperhidrosis, which presents without an associated condition, is a common disorder affecting approximately 1% of the population.
Referral Criteria:
Focal hyperhidrosis see Devon policy
Generalised hyperhidrosis please see referral section.
Most cases of focal hyperhidrosis are idiopathic, with a possible genetic predisposition. Most commonly affected areas are the axillae, palms and soles. There are no standardised diagnostic criteria for focal hyperhidrosis, and the diagnosis is based on history and physical signs.
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).
Aluminium Chloride preparation often causes irritancy leading to discontinuation of treatment. This can be prevented/ treated in some cases by ensuring the skin completely dry before application, and treating irritant dermatitis with a mildly potent topical steroid.
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:
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 the CCG upon receipt of a completed application from the patient's GP, consultant or clinician. Applications cannot be considered from patients personally.
MyHealth patient information - Hyperhidrosis
North and East Devon formulary - Skin
The Primary Care Dermatology Society.
This guideline has been signed off by the Eastern Locality on behalf of NHS Devon.
Publication date: 30 January 2017
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