Excessive sweating (hyperhidrosis)

What is excessive sweating?

Normal sweating helps to keep the body temperature steady in hot weather, during a high temperature (fever) or during exercise. Excessive sweating (hyperhidrosis) means the patient sweats more than normal. 

Excessive sweating can be challenging to treat and it may take a while to find the best treatment. Treatment options can include a powerful muscle relaxer (botox) but this is only licensed for underarm sweating as use for excessive sweating on hands and feet and may cause muscle weakness and pain.

Alternative, less invasive treatments are recommended first. These may include:

  • Lifestyle changes
  • Stronger antiperspirants
  • Prescribing nervous system blocking drugs (anticholinergics)
  • Referral to a dermatologist.

Not normally funded treatment or procedure:

The use of botox (botulinum toxin, type A) for excessive sweating is not normally funded by the patient’s local NHS commissioning organisation. This is because botox (botulinum toxin) is not commonly used in the palms and soles because it can cause temporary weakness of hand and foot muscles and is painful.

The clinician in charge of the care of the patient’s specific condition, usually a hospital doctor, can assist the application, if there is exceptional clinical need for the treatment to be funded. The patient’s clinician must evidence clinical exceptionality and must be supported by the patient’s local NHS commissioning organisation. See separate leaflet for more information on Individual Funding Requests (IFRs).

Advice and further guidance:

  • For more information search ‘hyperhidrosis excessive sweating’ at www.nhs.uk
  • Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.

Treatment policy for patients covered by NHS Birmingham and Solihull CCG

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