Granular Parakeratosis Treatment & Management

Updated: Dec 13, 2019
  • Author: Sheevam A Shah, MD; Chief Editor: Dirk M Elston, MD  more...
  • Print

Medical Care

Although some consider granular parakeratosis rare, successful medical treatments have been reported. These have included topical corticosteroids and oral and topical retinoids. [44, 45]

A 2003 report notes that topical calcipotriene and ammonium lactate also effectively treated granular parakeratosis. [26]

Calcineurin inhibitors and topical antifungal agents have been tried with some success.

Isotretinoin [45, 46] and tretinoin [44] have been reported as effective for granular parakeratosis.

Calcipotriene has been used to treat granular parakeratosis. [47, 48] Additional vitamin D-3 analogs, such as maxacalcitol, have been used effectively for treatment. [19]

Owing to the association between granular parakeratosis and hyperhidrosis, one reported case showed use of injectable botulinum toxin to be an effective treatment for axillary granular parakeratosis. [49]

In biopsy specimens from psoriatic patients after and before acitretin, methotrexate, and phototherapy treatments, parakeratosis decreases, implying that these agents could be helpful for granular parakeratosis. [50]


Surgical Care

Rare reports have noted that cryotherapy and laser therapy [51] can effectively treat granular parakeratosis.

Although not a first-line consideration, surgical mastopexy has been shown to be an effective treatment in one refractory case of submammary granular parakeratosis. [4]



Patients should avoid excessive washing of intertriginous areas. They should minimize or avoid the use of roll-on deodorants and antiperspirants. Additionally, they should consider avoidance of antiseptics, household cleaning agents, and laundry detergents containing benzalkonium chloride if they are not responding to other methods.



Once granular parakeratosis resolves and the inciting substances are avoided, granular parakeratosis does not tend to recur. However, sometimes, granular parakeratosis has a chronic and relapsing course. Patients should not use occlusive compounds and should avoid excessive washing of axillary areas, groin, or other affected areas.