From the FDA Drug Label
Indications and Usage For debridement and promotion of normal healing of hyperkeratotic surface lesions, particularly where healing is retarded by local infection, necrotic tissue, fibrinous or purulent debris or eschar. Urea is useful for the treatment of hyperkeratotic conditions such as dry, rough skin, dermatitis, psoriasis, xerosis, ichthyosis, eczema, keratosis pilaris, keratosis palmaris, keratoderma, corns and calluses, as well as damaged, ingrown and devitalized nails. The most effective treatment for keratosis pilaris mentioned in the drug label is urea (TOP), as it is useful for the treatment of hyperkeratotic conditions including keratosis pilaris 1.
From the Research
The most effective treatment for keratosis pilaris is laser therapy, particularly the QS:Nd YAG laser, as it has been shown to be the most effective form of treatment in recent studies. According to a systematic review published in 2022 2, laser therapy appears to be the most effective form of treatment for keratosis pilaris, with topical treatments such as Mineral Oil-Hydrophil Petrolat, tacrolimus, azelaic acid, and salicylic acid also being effective in improving the appearance of keratosis pilaris.
Some key points to consider when treating keratosis pilaris include:
- Gentle exfoliation and intensive moisturizing are important components of treatment
- Topical treatments such as alpha hydroxy acids (AHAs) like glycolic acid or lactic acid, and products containing urea (10-20%) or salicylic acid (2%) can help remove dead skin cells and reduce the appearance of bumps
- Consistency is key, as improvement typically takes 4-6 weeks of regular use, and the condition often returns if treatment is stopped
- Prescription retinoids like tretinoin 0.025-0.05% may be used for severe cases, applied every other night initially to minimize irritation
- Avoiding hot showers, harsh soaps, and tight clothing can also help prevent irritation and worsening of symptoms
It's worth noting that a study published in 2024 3 found that a moisturizing cream with 20% urea was effective in treating keratosis pilaris, with significant improvements in skin smoothness and texture after 1 and 4 weeks of use. Additionally, a survey of board-certified dermatologists published in 2023 4 found that topical lactic acid was the most commonly used first-line therapy for keratosis pilaris, followed by salicylic acid. However, laser therapy remains the most effective treatment option, and should be considered for patients with severe or recalcitrant cases of keratosis pilaris.