of the pilosebaceous unit as well as the associated dry
skin. Ongoing esthetic treatments are usually needed
because the disorder persists, and symptoms often recur.
Moisturization. Moisturization is definitely
helpful, and dermatologists often advise patients to
apply generous amounts of humectants several times
per day. These should be lipid-rich and non-drying. 2
Urea and lactic acid are two moisturizing ingredients
recommended by dermatologists. 3 Moisturizer should
be applied just out of the shower or bath while the
skin is still slightly damp.
Exfoliation. Exfoliation helps resurface the skin,
removing dead skin and keratin from the pores.
Exfoliants recommended include alpha hydroxy acids
(AHAs) to increase normal processes of exfoliation
and beta hydroxy acids (BHAs) to help clean debris
from pores. Care must be taken to avoid aggressive
exfoliation; however, because this could increase the
inflammatory component. Recommended exfoliants
include glycolic acid, mixed fruit acids, salicylic acid
or willow bark acid.
Retinoids and steroids. A retinoid such as retinol,
adapalene, tretinoin or tazarotene is recommended for
the treatment of KP. Topical steroids may also be helpful. 4
Lasers. Since the disorder is a cosmetic one,
patients rarely desire aggressive treatment. However,
fractional laser treatments have been helpful, especially
if KP is associated with hyperpigmentation or is
more severe. 6 Care must be taken when using laser
treatments in darker skin types because of the risk of
Clients must be advised to continue both exfoliation
and moisturization at home to keep KP at bay. Showers
should be relatively brief with tepid water. A humidifier
may help with dry skin prevention.
The prognosis in keratosis pilaris is good with or
without treatment. Patients usually seek treatment if
they dislike the appearance of the bumps on their skin
or if they have more inflammation or itching. Many
times, symptoms decrease after the age of 30 although
Exfoliation helps remove dead skin and keratin from the pores.
Charlene DeHaven, M.D., is the clinical director
of Innovative Skincare. She is board certified in
internal and emergency medicine and is a fellow
of the American College of Emergency Medicine.
it is also common to have some symptoms throughout
life. Esthetic treatments and topicals are very helpful
and provide the only treatment necessary. However,
because symptoms tend to recur, treatments often must
continue for years.
1. B Mevorah, A Marazzi and E Frenk, The prevalence of accentuated
palmoplantar markings and keratosis pilaris in atopic dermatitis, autosomal
dominant ichthyosis and control dermatological patients, Br J Dermatol
112( 6) 679-685 (1985)
4. S Hwang and RA Schwartz, Keratosis pilaris: A common follicular
hyperkeratosis, Cutis Sep 82( 3) 177-180 (2008)