Treatment of folliculitis decalvans (FD) is very challenging as relapses are frequent even after multiple courses of systemic antibiotics. Recent studies suggest the potential use of immunomodulating drugs as hydroxychloroquine (HCQ) to better control the chronic inflammatory status of this disease. Sulfamethoxazole-trimethoprim is an effective treatment for FD and HCQ may be a beneficial adjuvant therapy, especially for less active forms of the disease.