Useful link: http://www.pcds.org.uk/clinical-guidance/hyperhidrosis


Can be classified as:


  • Focal/primary
  • Generalised – consider the need to investigate for an underlying medical condition
  • Gustatory


Primary care management prior to referral


Focal hyperhidrosis


  1. Antiperspirants e.g. Anydrol Forte or Driclor
  2. Systemic anticholinergics
    • Propanthelene 15mg od/bd, increasing as tolerated to 30mg tds (licensed).
    • If intolerant, trial modified release oxybutynin e.g. Lyrinel XL 10mg.


Generalised hyperhidrosis


  1. Systemic anticholinergics as above


When to consider a referral


Essentially for iontophoresis which can be useful for axillary, palmar and plantar hyperhidrosis if primary care management has failed.

Please include details of treatments in primary care when referring.


Not available on the NHS


Botulinum toxin

Endoscopic thoracic sympathectomy (ETS)