A number of things seem to make the skin worse, particularly heat, sweating and wool or nylon clothing. Some patients find that sun causes the skin disease to flare up. It is sensible to try and avoid these triggers. Some women notice that it worsens around the time of their period.

Itching is very common. Creams like Calmurid, E45 or aqueous cream may relieve some of the irritation. Sometimes corticosteroid creams are helpful if the skin is very itchy and these are often prescribed in a mix with an antibiotic [egTrimovate or Timodine] to prevent skin infection.

The affected skin may smell unpleasant, particularly in moist areas. The smell is part of the skin condition and does not mean that the skin is dirty. It is probably caused by bacteria growing in the rash. Of course careful washing is important but in addition antiseptic solutions for the bath, antiseptic creams or antibiotics may help

Unfortunately none of the creams really have much effect on the overall behaviour of the disease. The retinoids egTigason are Vitamin A derivatives which are taken by mouth and will improve the skin in most patients. If women take retinoids when they are pregnant, the retinoid may damage the developing baby. Therefore retinoids can only be prescribed for women who have been sterilised or who are using an effective contraceptive eg the contraceptive pill. Retinoids also cause drying of the lips, eyes and nose. Patients with mild skin disease often find they would rather live with their disease than put up with these adverse effects.