Treatment of keratosis pilaris and its variants: a systematic review

Abstract

Introduction

Keratosis pilaris (KP) is a common, benign skin condition of follicular hyperkeratosis. Although KP is asymptomatic, the cosmetic appearance of KP can lead to psychosocial distress among patients. New emerging treatments are increasingly being utilized. Yet, there is little to no summative data on the treatments of KP and its subtypes.

Objective

To summarize existing literature on treatments for KP and its subtypes.

Methods

A comprehensive search was performed using Pubmed/MEDLINE, Embase and Web of Science databases. The search identified 1150 non-duplicated articles, and 47 articles were included in the review. The primary outcomes measured were KP treatment type and the degree of improvement following therapy.

Findings

Our findings demonstrate that the most supported form of treatment for KP is laser therapy, particularly the QS:Nd YAG laser. Topical treatments – including Mineral Oil-Hydrophil Petrolat, tacrolimus, azelaic acid, and salicylic acid – are also effective at least for improving the appearance of KP.

Conclusion

While the measured treatment outcomes varied among studies, laser therapy appears to be the most effective form of treatment. Use of topicals also improved KP lesions.

Keywords:

• Keratosis pilaris
• keratosis pilaris atrophicans
• laser therapy
• skin of color

Acknowledgements

The authors would like to thank the staff librarian for their help with the literature search.

Disclosure statement

Dr. Steven Feldman has received research, speaking and/or consulting support from a variety of companies including Galderma, GSK/Stiefel, Almirall, Leo Pharma, Boehringer Ingelheim, Mylan, Celgene, Pfizer, Valeant, Abbvie, Samsung, Janssen, Lilly, Menlo, Merck, Novartis, Regeneron, Sanofi, Novan, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and National Psoriasis Foundation. He is founder and majority owner of www.DrScore.com and founder and part owner of Causa Research, a company dedicated to enhancing patients’ adherence to treatment. None of the remaining authors have any conflicts of interest to disclose.

Author contributions

All authors made contributions to the development and creating of this systematic review. JM designed literature search, data extraction and manuscript write-up. SL contributed by independently screening, reviewing and extracting data from each included article and has also helped with manuscript write-up. WH contributed by ensuring accuracy of data and aided in manuscript write-up and revision. SF and ST revised the manuscript for final approval.