Botulinum toxin for hyperhidrosis
National Referral Protocol
Procedures not routinely provided by NHSScotland
- Botulinum toxin injections will only be considered in those with palmar hyperhidrosis, who have failed to respond to other treatment options where function or capacity to work is impaired.
- Axillary hyperhidrosis is not treated by NHS Scotland
Clinical psychology
- Referral to a specialist Clinical Psychologist may be made at the discretion of the clinical team.
BMI
- There are no specific restrictions, but a significantly raised BMI may be a factor.
Considerations for treatment
Indications for referral
- Excessive palmar hyperhidrosis and where treatment options in Primary Care have proven to be unsuccessful.
- Treatment of Frey’s syndrome may be considered as this is a post operative & usually time limited condition.
Contraindications for referral
- Where sweating may be secondary to an underlying cause (patients should be referred for appropriate investigations).
Waiting Times
- These patients are not subject to the 18-week Referral to Treatment Standard.
Botulinum toxin for hyperhidrosis - evidence summary
Treatment for these conditions is not routinely offered by NHSScotland and can only be considered when all criteria are met.