From the Guidelines
Hyperkeratosis of the face can be effectively treated with a combination of topical treatments and lifestyle modifications, with the most recent guidelines recommending the use of ultraviolet protection, topical imiquimod, topical 5-fluorouracil, and cryosurgery 1.
Treatment Options
- For mild cases, daily use of keratolytic agents containing salicylic acid (2-5%), urea (10-40%), or alpha hydroxy acids like glycolic acid (5-10%) helps dissolve excess keratin 1.
- Prescription retinoids such as tretinoin 0.025-0.1% applied nightly can normalize cell turnover.
- For more severe cases, your dermatologist may prescribe stronger treatments like tazarotene or oral retinoids like isotretinoin.
Lifestyle Modifications
- Regular gentle exfoliation with a soft washcloth or mild chemical exfoliant 2-3 times weekly helps remove dead skin cells.
- Keeping the skin well-moisturized with ceramide or hyaluronic acid-based products is essential after treatments.
- Protecting your face from sun exposure with SPF 30+ sunscreen is crucial as many treatments increase photosensitivity.
Treatment Outcomes
- These treatments work by either dissolving the excess keratin buildup, normalizing the skin cell turnover process, or reducing inflammation that contributes to hyperkeratosis.
- Most patients see improvement within 4-6 weeks of consistent treatment, though more severe cases may require longer management under dermatological supervision.
Recent Guidelines
- The most recent guidelines from 2021 recommend the use of ultraviolet protection, topical imiquimod, topical 5-fluorouracil, and cryosurgery for the treatment of actinic keratosis, which is often associated with hyperkeratosis 1.
- These guidelines are based on the latest evidence and provide a comprehensive approach to the management of hyperkeratosis and actinic keratosis.
From the FDA Drug Label
For Dermatologic Use: Salicylic Acid 6% is a topical aid in the removal of excessive keratin in hyperkeratotic skin disorders Indications and Usage For debridement and promotion of normal healing of hyperkeratotic surface lesions, Urea gently dissolves the intracellular matrix which results in loosening of the horny layer of the skin and shedding of scaly skin at regular intervals, thereby softening hyperkeratotic areas of the skin.
The treatment for hyperkeratosis on the face may include topical preparations of salicylic acid or urea.
- Salicylic acid can aid in the removal of excessive keratin in hyperkeratotic skin disorders 2.
- Urea can be used for the treatment of hyperkeratotic conditions, promoting normal healing of surface lesions and softening hyperkeratotic areas of the skin 3 3.
From the Research
Hyperkeratosis Face Treatment
- Hyperkeratosis is a condition characterized by thickened skin, which can be congenital or acquired, and typically affects the palms and soles, but can also occur on the face 4.
- The mainstay of therapy for hyperkeratosis includes topical treatments such as keratolytics (urea, salicylic acid, and lactic acid) and retinoids 4.
- Other local therapeutic modalities for hyperkeratosis include physical debridement, topical corticosteroids, and phototherapy (using topical psoralen and ultraviolet A phototherapy) 4.
- Selenium sulfide has been shown to be effective in treating hyperkeratosis, particularly for those patients with involvement of their palms and soles 4.
- For keratosis pilaris, a variant of hyperkeratosis, laser therapy, particularly the QS:Nd YAG laser, has been found to be the most effective form of treatment, while topical treatments such as mineral oil-hydrophil petrolat, tacrolimus, azelaic acid, and salicylic acid can also improve the appearance of the condition 5.
- Urea at high concentration has been found to have antiproliferative, keratolytic, moisturizing, and emollient properties, making it effective in treating hyperkeratosis, especially when severe or localized in specific body areas 6.
- A cosmetic device containing a combination of alpha- and beta-hydroxy acids, urea, and thuja has been found to be effective and well-tolerated in the treatment of seborrheic keratoses, a condition that can be related to hyperkeratosis 7.
- Keratolytic therapy with salicylic acid or urea can be an effective pretreatment for photodynamic therapy (PDT) in the treatment of actinic keratoses, which can be associated with hyperkeratosis 8.