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Hyperhidrosis

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)