Fox-Fordyce disease (FFD) or 'apocrine miliaria' is a rare benign skin condition characterized by obstruction of the apocrine sweat gland. Treatment is generally unsatisfactory. A 15-year-old girl presented with intensely pruritic lesions on her axillae, chest and groin. Histology from an axillary skin biopsy confirmed FFD. The patient was commenced on pimecrolimus cream twice daily for three months and then once daily for a further three months. After a month she had marked improvement of her symptoms. By three months, the papules had flattened. The lesions remained healed at follow up nine months after completing therapy. Pimecrolimus is a safe and easy to use option and we suggest that it may be considered as first-line therapy for FFD.