Two children with bullous and non-bullous ichthyosiform erythroderma improved dramatically with tretinoin under occlusion and 15% urea in emollient. Treatment was well tolerated and there were no clinical or biochemical complications after 18 months of therapy. This combination appears to be effective and safe in the treatment of ichthyosiform erythroderma. However, in order to be successful, treatment needs to be incorporated into the family life-style and become part of the patient's daily routine. This treatment regimen should permit the deferment of systemic retinoids and their accompanying toxic side-effects in childhood.