However, due to the long term side effects, their use is limited in this population. There tends to be a consensus that the UVB or PUVA light therapies are not beneficial and may aggravate the condition in some instances. There also seems to be a correlation with exacerbation caused by a previous sunburn or from sunlight itself. Isotretinoin and etretinate tend to be the most widely used and tolerated drugs for the treatment of pityriasis rubra pilaris. If they don't work, methotrexate is often considered as the next line of therapy.
Many patients taking methotrexate, however, tend to relapse when treatment is stopped.
The condition can then be improved once again after restarting the medication, but thus indicates chronic treatment. However, topical corticosteroids or either isotretinoin or etretinate are used in conjunction with AZT to obtain a better response. Methotrexate could also be used with AZT is no response is seen with the other treatments. This type of PRP is very difficult to treat and often requires a combination of drugs. Stanozolol, an anabolic steroid, has also been tried.