From the Guidelines
Keratosis pilaris can be effectively managed with topical agents, such as keratolytics containing salicylic acid 5%-10% or urea 10%-40%, which help to reduce hyperkeratosis and improve skin texture. The goal of treatment is to soften and remove the excess keratin, reducing the appearance of rough bumps on the skin. Some key points to consider in managing keratosis pilaris include:
- Using gentle, fragrance-free cleansers to avoid irritating the skin [ 1 ]
- Applying moisturizers containing urea, lactic acid, or salicylic acid twice daily to affected areas to help soften and exfoliate the skin
- Gentle exfoliation with a soft washcloth or chemical exfoliants to remove dead skin cells
- Avoiding hot showers, harsh scrubbing, and picking at the bumps as these can worsen the condition
- Considering prescription retinoids or stronger keratolytics for severe cases Keratosis pilaris often improves with age and during warmer months when humidity is higher, but consistent skin care can significantly improve appearance and texture. The condition occurs because excess keratin builds up around hair follicles, creating the characteristic bumps. While there's no permanent cure, topical treatments with keratolytics, such as those containing salicylic acid or urea, are effective in managing keratosis pilaris [ 1 ].
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.
- Keratosis pilaris is a condition that can be treated with urea (TOP), as it is a hyperkeratotic condition.
- The drug is useful for treating keratosis pilaris, among other conditions like dry, rough skin, dermatitis, and psoriasis 2.
From the Research
Definition and Characteristics of Keratosis Pilaris
- Keratosis pilaris (KP) is a common, hyperkeratotic skin condition characterized by small, folliculocentric papules with variable perifollicular erythema 3.
- KP represents a family of follicular disorders, with KP simplex being the most common variant, and other rare subtypes including keratosis pilaris rubra, erythromelanosis follicularis faciei et colli, and keratosis pilaris atrophicans 3.
- Inherited mutations of the FLG gene and ABCA12 gene have been implicated in the etiology of KP 3.
Treatment Options for Keratosis Pilaris
- General cutaneous measures such as hydrating skin, avoiding long baths or showers, and using mild soaps or cleansers are recommended 3.
- Topical keratolytic agents are considered first-line therapy, followed by topical retinoids and corticosteroids 3.
- Laser therapy, particularly the QS:Nd YAG laser, has been shown to be an effective treatment option for KP 4.
- Topical treatments, including mineral oil-hydrophil petrolat, tacrolimus, azelaic acid, and salicylic acid, have also been found to be effective in improving the appearance of KP 4.
- A moisturizing cream with 20% urea has been shown to be well-tolerated and effective in treating KP, with significant improvements in skin smoothness and texture 5.
- Isotretinoin has been used as a treatment option for severe keratosis pilaris, with a detailed regimen described in a recent study 6.
- A survey of board-certified dermatologists found that topical lactic acid is the most commonly used first-line therapy for KP, followed by salicylic acid, while laser therapy is used less frequently due to limitations such as lack of insurance coverage and proper equipment 7.