FD first appeared on the top of my head when I was in my forties. Since then I have tried every known treatment or combination of treatments. Nothing has significantly reduced the outbreaks and persistent itching and bleeding. I just started a thirty day routine of Acitretin, 25mg once a day. Some of the side affects are showing up, but it's too early to say it's working. I had the best results with Accutane about 20 years ago. However, the side affects were not worth it. It's no longer available in the US. Lots of lawsuits. One drug I don't see mentioned in these forums is Dapsone. Earlier this year I did a six month routine taking 50mg twice a day. Although I had virtually no results, you might consider trying it. I feel fortunate that this disease hasn't spread to other parts of my body. My derm doctor said it is unlikely it will at my age. Unfortunately, many have more challenges with this disorder than I.