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Cosmetic skin treatments

Checked: 23-06-2021 by Rob Adams Next Review: 23-06-2022

Overview

There are some conditions that cause a cosmetic change in the skin, where treatments may be available. However, the NHS does not routinely fund treatments or surgery for cosmetic reasons and BNSSG ICB policies place restrictions on these treatments.

Drugs of low value or for cosmetic treatments are often TLS Red (specialist use only) or ‘non-formulary’ on the BNSSG Joint Formulary. The Formulary status of a drug can be checked via the Formulary webpages. If a drug is not included within the Formulary website, then it is coSkin Camouflage Servicesnsidered non-formulary. Please note that the funding policies listed below may still apply.

It is not possible to list all available skin conditions and treatments where these policies apply. In general, referrals of patients for treatment of benign skin conditions will not be accepted unless criteria have been met, or prior approval or exceptional funding for treatment has been applied for and granted.

Please refer to the following relevant policies:

Diagnostic uncertainty

Where diagnostic uncertainty exists then an opinion can be requested via dermatology advice and guidance.

If the advice given is to refer for cosmetic treatment, then the policies above will still apply and funding may be required before referrals can be accepted.

If a referral is still required for confirmation of diagnosis that cannot be provided by A and G then this may be accepted. However, treatment may still not be offered on the NHS and patient expectation should be managed to avoid disappointment.

Examples

Please see some examples of conditions that are covered by this advice:

Melasma / Chloasma - see PCDS guidelines on diagnosis and treatment of melasma in primary care. Some treatments are only available from secondary care (e.g Pigmanorm). However the ICB is clear that it does not fund cosmetic treatments and secondary care should not initiate treatments outside the Cosmetic Treatment and Surgery Policy.

Vitiligo - see PCDS guidlelines on vitiligo. Treatment in secondary care is not usually required. Please see information on Skin Camouflage options in the community.

Guttate psoriais - see PCDS guidelines on diagnosis and treatment of this self-limiting condition in primary care. Referral for UVB light therapy is not routinely funded.

Polymorphic light eruption - see PCDS guidelines.

Keloid and Hypertrophic scars - see PCDS guidelines. Referral for treatment in secondary care is not routinely funded. However, patients with symptomatic keloid scars that have not responded to initial measures as outlined in the PCDS guidance can be referred to the community dermatology service for consideration of steroid injection. Treatment decisions will be at the discretion of the accepting clinician and are not be available for cosmetic reasons alone. Surgical and laser treatments are not funded.

Scar Revision - Referral for request for scar revision is not routinely available. If a functional problem exists then a referral to physio or MSK may be appropriate initially. Skin Camouflage options are available in the community

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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