OBJECTIVES:  CHE can lead to considerable sickness absences, but quantitative data regarding CHE-related productivity changes under different treatments are scarce. The German observational study TOCCATA, collected effectiveness and tolerability data of oral alitretinoin in daily practice and concomitantly documented information regarding CHE-related productivity loss, the main subject of this analysis. METHODS: A total of 680 adult CHE patients treated with oral alitretinoin for up to 24 weeks, according to the approved prescribing information, were included. Sickness absence days due to CHE were documented at baseline (over the last 12 months prior to the study and when ongoing at inclusion) and at each monthly follow-up visit (4 weeks retrospectively). This analysis focuses on the proportion of patients with sick leave and days off work due to CHE and correlation of changes in disease severity. RESULTS: 219 (42%) of all 522 patients in employment had sick leaves in the last 12 months (mean: 35 days), 80 (15.4%) patients were on sick leave at inclusion, and this proportion gradually decreased to 7.1% at observation end. In line with this observation, the 80 patients had an average 17.6 consecutive days off work (last 4 weeks at inclusion), however, only 7.6 days off during the four weeks before end of observation. The highest reduction in CHE-related sickness absence was observed between the visits 4 to 12 weeks, which was associated with the clinical CHE improvements seen during this period. CONCLUSIONS: This is the first report of beneficial changes in disease-related sickness absences in CHE patients associated with successful oral alitretinoin treatment. At end of study, the number of patients with sickness absences due to CHE had decreased by approximately 50% compared to baseline.  This observation certainly merits further exploration in different health care settings potentially confirming economic benefits for patients, their employers and the society at large.