The disease severity and frequency usually decrease with age. Remissions lasting several months to years may occur. The disease has a seasonal pattern with exacerbations in the summer months, mostly because perspiration and friction can precipitate the appearance of the lesions. Malignant degeneration of the lesions, although reported, is rare. Multiple treatment options are available for Hailey-Hailey disease.
Most patients respond to topical corticosteroids and antibacterial creams.
However, in severe cases, oral antibiotic therapy should be started. Candida, if present, should be eradicated. Systemic corticosteroids should be reserved for severe cases. Superficial ablation through electrodessication, dermabrasion or laser treatment may be beneficial. Chronic and unresponsive lesions have been treated by surgical excision followed by split-thickness skin grafting.