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Keratosis pilaris: Diagnosis and treatment


How do dermatologists diagnose keratosis pilaris?

To diagnose this condition, your dermatologist will examine your skin, looking closely at the skin that shows signs of keratosis pilaris.

How do dermatologists treat keratosis pilaris?

This skin condition is harmless, so you don’t need to treat it.

If the itch, dryness, or the appearance of your skin bothers you, treatment can help. A dermatologist can create a treatment plan that addresses your concerns. The following describes what a treatment plan may include:

Relieve the itch and dryness: A creamy moisturizer can soothe the itch and dryness. Most moisturizing creams used to treat keratosis pilaris contain one of the following ingredients:

  • Urea

  • Lactic acid

For best results, apply your moisturizer:

  • After every shower or bath
  • Within 5 minutes of getting out of the bath or shower, while your skin is still damp
  • At least 2 or 3 times a day, gently massaging it into the skin with keratosis pilaris

Diminish the bumpy appearance: To diminish the bumps and improve your skin’s texture, dermatologists often recommend exfoliating (removing dead skin cells from the surface of your skin). Your dermatologist may recommend that you gently remove dead skin with a loofah or at-home microdermabrasion kit.

Your dermatologist may also prescribe a medicine that will remove dead skin cells. Medicine that can help often contains one of the following ingredients:

  • Alpha hydroxyl acid

  • Glycolic acid

  • Lactic acid

  • A retinoid (adapalene, retinol, tazarotene, tretinoin)

  • Salicylic acid

  • Urea

For best results when using a medicine to exfoliate your skin:

  • Use the amount your dermatologist recommends
  • Apply it only as often as your dermatologist recommends
  • Stop using the medicine for a few days if your skin becomes dry or irritated

The medicine you use to exfoliate your skin may also contain a moisturizer, which can help with the itch and dryness.

To treat the bumps, some patients may need to apply a corticosteroid to the areas with keratosis pilaris. This medicine helps soften the bumps and reduce redness.

Lasers may work when moisturizer and medicine fail: A laser or light treatment may be used to treat keratosis pilaris. Your dermatologist may recommend one type of laser to reduce the swelling and redness. Another type of laser may improve your skin’s texture and reduce discoloration, including the brown spots that may appear when the bumps clear.

To get the best results from the laser treatments, your dermatologist may add a few microdermabrasion sessions to your treatment plan.

Key facts about treatment

When treating keratosis pilaris, it helps to keep the following in mind:

  • Clearing takes time. If you fail to see improvement after following your treatment plan for 4 to 6 weeks, tell your dermatologist.
  • Some patients need to try a few treatments before they find one that works.
  • To continue seeing results, you’ll need a maintenance plan.

About the maintenance plan

Treatment cannot cure keratosis pilaris, so you’ll need to treat your skin to keep the bumps under control. Your maintenance plan may be as simple as using the medicine twice a week instead of every day. Another option may be to switch to a non-prescription moisturizing cream.

What is the outcome for people with keratosis pilaris?

For many people, keratosis pilaris goes away with time, even if you opt not to treat it. Clearing tends to happen gradually over many years. There is no way to know who will see keratosis pilaris clear.


References
Alai AN. “Keratosis pilaris medical care.” Medscape. Last updated June 19, 2014.

Ciliberto H, Farshidi A, et. al. “Photopneumatic therapy for the treatment of keratosis pilaris.” J Drugs Dermatol. 2013 Jul 1;12(7):804-6.

Ibrahim O, Khan M, et. al. “Treatment of keratosis pilaris with 810-nm diode laser: Randomized clinical trial.” JAMA Dermatol. 2014 Nov 5. [Epub ahead of print].

Lee SJ, Choi MJ, et. al. “Combination of 595-nm pulsed dye laser, long-pulsed 755-nm alexandrite laser, and microdermabrasion treatment for keratosis pilaris: retrospective analysis of 26 Korean patients.” J Cosmet Laser Ther. 2013 Jun;15(3):150-4.

Park J, Kim BJ, et. al. “A pilot study of Q-switched 1064-nm Nd:YAG laser treatment in the keratosis pilaris.” Ann Dermatol. Aug 2011; 23(3): 293–298.

Saelim P, Pongprutthipan M, et. al. “Long-pulsed 1064-nm Nd:YAG laser significantly improves keratosis pilaris: a randomized, evaluator-blind study.” J Dermatolog Treat. 2013 Aug;24(4):318-22.

Yang G, Bordeaux J, et. al. “Prospective right/left comparison of azeleic acid and cetaphil for treatment of keratosis pilaris.” J Am Acad Dermatol. 2012 Apr;66(4) Supp. 1: AB167.

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