Miller reported treatment of Fox-Fordyce disease with topical clindamycin solution in 1995. Hormonal therapy with high-estrogen oral contraceptives, estrogen creams, and testosterone cream has been reported, sometimes with success and often with failure. Consider therapy with alternative retinoids as they become available. Based on the success of tretinoin, oral retinoids have been used with reported success. Since 1972, therapy with topical retinoids has the most literature support.
Several reports exist on the efficacy of topical tretinoin.
Severe irritation may occur when used in the axillae. Increasing both the time and amount gradually as tolerated would be a safe way to avoid irritation. Low doses of isotretinoin have been efficacious. Although symptoms were relieved at relatively low doses, the condition returned in a few months after cessation of therapy. Confirmation of this study was reported in 1995.