Topical steroid preparations often help outbreaks; use of the weakest corticosteroid that is effective is recommended to help prevent thinning of the skin. Drugs such as antibiotics, antifungals, corticosteroids, dapsone, methotrexate, thalidomide, etretinate, cyclosporine and, most recently, intramuscular alefacept may control the disease but are ineffective for severe chronic or relapsing forms of the disease. Intracutaneous injections of botulinum toxin to inhibit perspiration may be of benefit.[14] Maintaining a healthy weight, oiding heat and friction of affected areas, and keeping the area clean and dry may help prevent flares.[citation needed]
Some he found relief in laser resurfacing that burns off the top layer of the epidermis, allowing healthy non-affected skin to regrow in its place.[citation needed] Secondary bacterial, fungal and/or viral infections are common and may exacerbate an outbreak. Some he found that outbreaks are triggered by certain foods, hormone cycles and stress.
In many cases naltrexone, taken daily in low doses, appears to help.[15][16]