Norfolk and Waveney CCGs will not routinely fund removal or surgical intervention of Benign Skin Lesions and other Skin Conditions, including but not limited to:
- Skin tags
- Sebaceous cysts
- Asymptomatic seborrheic keratosis
- Warts of hands and feet (except if immunosuppressed)
- Skin tags (including anal/rectal)
- Physiological androgenetic alopecia (male pattern baldness)
- Asymptomatic dermatofibromata
- Asymptomatic fungal infections of toe nails
- Telangiectasiae, spider naevi
- Asymptomatic lipomata
- Asymptomatic epidermal cysts (sebaceous cysts)
- Molluscum contagiosum
- Acne Scarring
- Acne Vulgaris*
- Skin Resurfacing
- Rosacea *
- Actinic Keratosis *
- Congenital vascular lesions (for cosmetic interventions) *
- Any other minor skin lesions
* Referral to secondary care for consideration of surgical treatments for the following conditions:
- Acne vulgaris: Cases with severe scarring that have not responded to 6 months of systemic therapy and/or need isotretinoin
- Rosacea: Severe cases not responding to 6 months of standard community/ primary care therapy
- Actinic Keratoses: Cases unresponsive to 2 cycles of topical 5-fluorouracil (standard referral) or suspicion of cancerous change (2WW referral)
- Congenital vascular lesions: Cases should be appropriately referred if there is diagnostic doubt and/or need advice and/or the lesions cause bleeding/ ulceration/ obstructive/ functional difficulties.
These skin procedures are not routinely funded on cosmetic grounds alone. Uncomplicated benign skin lesions and other skin conditions should NOT be referred to hospital consultants, community services or GPwSI unless the diagnosis is in doubt.
Referrals to hospital consultants, community services or GPwSI should be made only if:
- There is diagnostic doubt
- Lesions are a manifestation of an underlying syndrome;
- There is risk of malignancy;
- There is documented evidence of significant recurrent infection;
- There is documented evidence of significant recurrent bleeding;
- There are pressure symptoms.
Some GPs may wish to carry out these procedures within their existing GP contract (GMS/PMS).
For patients not meeting the above criteria, an application should be made to the IFR Panel if the referrer considers there are clinically exceptional circumstances.
|Latest change to document
||8 November 2018
||19 February 2019
|Next Review date