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Pompholyx is an inflammatory vesicobullous disorder of the palms and soles. The condition is difficult to treat because of the peculiarities of the affected skin, namely, the thick horny layer and richness of sweat glands. The cornerstones of topical therapy are corticosteroids, although calcineurin inhibitors seem to be effective as well. Topical photochemotherapy with 8-methoxypsoralen is as effective as systemic photochemotherapy or high-dose ultra violet Type A-1 irradiation. Systemic therapy is often necessary in bullous pompholyx. Corticosteroids are used commonly, although no controlled studies have been published. For recalcitrant cases corticosteroids are combined with immunosuppressants. A new evolving treatment seems to be the intradermal injection of botulinum toxin.