Fox-Fordyce Disease after Laser Hair Removal: A Hidden Consequence of Cosmetic Procedures

¹Ross University School of Medicine, Barbados

²Wayne State University School of Medicine, Detroit, MI, USA

³Arizona College of Osteopathic Medicine, Glendale, AZ, USA

⁴Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA

⁵New York Institute of Technology College of Osteopathic Medicine, Glen Head, NY, USA

⁶University of California San Francisco St Mary’s Hospital. San Francisco, CA, USA

⁷Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA

*Corresponding author: Julia Vinagolu-Baur, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA, Phone: 6467262139, Email: [email protected]

Received Date: September 04, 2025

Publication Date: November 12, 2025

Citation: Wahab et al. (2025). Fox-Fordyce Disease after Laser Hair Removal: A Hidden Consequence of Cosmetic Procedures. Dermis. 5(6):55.

Copyright: Wahab et al. © (2025).

ABSTRACT

Background: Fox-Fordyce disease (FFD) is a chronic, pruritic inflammatory disorder of apocrine gland–bearing skin, most often affecting women of reproductive age. Traditionally linked to keratin plugging and ductal obstruction, it remains underdiagnosed. Recent case reports suggest laser hair removal (LHR) may act as an iatrogenic trigger, adding a novel dimension to its pathogenesis. Objective: To synthesize current evidence on the relationship between LHR and FFD, highlighting clinical patterns, possible mechanisms, diagnostic challenges, and management considerations. Methods: A narrative review was conducted using PubMed and Embase, supplemented by dermatology conference proceedings. Search terms included “Fox-Fordyce disease,” “apocrine miliaria,” “laser hair removal,” and “cutaneous complications.” 34 PubMed-indexed sources, case reports, and abstracts were included. Findings were integrated thematically due to the rarity of the condition and variability of study designs. Results: Evidence from case reports and small series indicates that FFD can develop after LHR, with latency periods ranging from weeks to years. Proposed mechanisms include laser-induced follicular injury, altered keratinization, and apocrine duct obstruction, potentially influenced by hormonal factors. Histology parallels idiopathic FFD but may lack mast cell infiltration. Diagnosis is often delayed, particularly in darker skin types where lesions present with variable pigmentation. Management remains inconsistent, spanning topical, systemic, and procedural options, with pulsed dye laser showing emerging therapeutic promise. Conclusion: LHR may be an underrecognized precipitating factor for FFD. Greater clinician awareness, inclusive dermatologic training across skin types, and targeted research into pathogenesis, prevention, and treatment are essential for improving diagnosis and patient outcomes.

Keywords: Fox-Fordyce Disease, Apocrine Glands, Laser Hair Removal, Iatrogenic Dermatology, Follicular Disorders, Cosmetic Procedure Complications.