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Treatment of Hyperhidrosis

Treatment of primary focal hyperhidrosis using the following therapies (Table P1) may be considered medically necessary with any of the following medical conditions:acrocyanosis of the hands; or

history of recurrent skin maceration with bacterial or fungal infections; or

history of recurrent secondary infections; or

history of persistent eczematous dermatitis despite medical treatments with topical dermatologic or systemic anticholinergic agents.

Treatment of hyperhidrosis is considered not medically necessary in the absence of functional impairment or any of the above medical conditions.

The following treatments may be considered medically necessary for the treatment of severe secondary gustatory hyperhidrosis (see Policy Guidelines section for list of gustatory hyperhidrosis conditions):

aluminum chloride 20% solution

surgical options (ie, tympanic neurectomy) if conservative treatment has failed.

Other treatments are considered investigational as a treatment for severe secondary gustatory hyperhidrosis including, but not limited to:

botulinum toxin

iontophoresis.

Treatments that may be considered medically necessary by focal region include:

Axillary

Aluminum chloride 20% solution

Botulinum toxin for severe primary axillary hyperhidrosis inadequately managed with topical agents, in patients ≥18 y

Endoscopic Transthoracic Sympathectomy (ETS) and surgical excision of axillary sweat glands, if conservative treatment (ie, aluminum chloride or botulinum toxin, individually and in combination) has failed;

Palmar

Aluminum chloride 20% solution

Botulinum toxin type A products for severe primary palmar hyperhidrosis inadequately managed with topical agents, in patients ≥18 y

ETS, if conservative treatment (ie, aluminum chloride or botulinum toxin type A, individually and in combination) has failed;

Plantar

Aluminum chloride 20% solution

Craniofacial

Aluminum chloride 20% solution

ETS, if conservative treatment (ie, aluminum chloride) has failed.

Treatments that are considered investigational by focal region include:

Axillary

Axillary liposuction

Iontophoresis

Microwave treatment

Radiofrequency ablation;

Palmer

RimabotulinumtoxinB

Iontophoresis

Microwave treatment

Radiofrequency ablation;

Plantar

Botulinum toxin

Iontophoresis

Lumbar sympathectomy

Microwave treatment

Radiofrequency ablation;

Craniofacial

Botulinum toxin

Iontophoresis

Microwave treatment

Radiofrequency ablation.

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