TREATMENT OF KERATOSIS PILARIS: A NARRATIVE LITERATURE REVIEW OF TOPICAL, PROCEDURAL, AND VARIANT-SPECIFIC THERAPIES
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.5806Keywords:
Keratosis Pilaris, Keratosis Pilaris Rubra Faciei, Keratosis Pilaris Atrophicans, Follicular Keratosis, Topical Therapy, Keratolytics, Retinoids, Laser Therapy, Light-Based Therapy, Nd:YAG Laser, Pulsed Dye Laser, Intense Pulsed LightAbstract
Keratosis pilaris (KP) is a common disorder of follicular keratinization characterized by keratotic perifollicular papules with variable erythema and, in some patients, dyspigmentation. Although benign, KP may generate substantial cosmetic concern and psychosocial burden. Therapeutic management remains challenging because available interventions often produce incomplete and temporary improvement, and the evidence base is limited by small sample sizes, heterogeneous study designs, short follow-up, and inconsistent outcome measures. This narrative literature review synthesizes current evidence on treatment of KP, emphasizing topical keratolytics, retinoids, anti-inflammatory agents, laser- and light-based therapies, and emerging approaches. A separate section addresses keratosis pilaris atrophicans (KPA) and keratosis pilaris rubra faciei/rubra (KPRF/KPR), which warrant a distinct therapeutic approach because erythema, inflammation, and scarring risk may predominate over texture alone. Overall, treatment is difficult and rarely curative; however, a careful, phenotype-directed, stepwise approach can yield clinically meaningful improvement in roughness, erythema, and pigmentary change.
Aim: The purpose of this review is to present a comprehensive overview of the therapeutic approaches used in the treatment of keratosis pilaris. It outlines the roles of topical agents, procedural therapies, and emerging interventions, and reviews both commonly used treatments with broader clinical experience and newer or less well-established modalities supported by limited evidence. It also addresses variant-specific management of keratosis pilaris rubra/rubra faciei and keratosis pilaris atrophicans, in which erythema, inflammation, and scarring risk may influence treatment selection.
Material and methods: A literature search was conducted in PubMed and Google Scholar using the keywords “keratosis pilaris,” “keratosis pilaris rubra faciei,” and “treatment.” Additional relevant articles were identified through reference screening. Original studies, review articles, and other clinically relevant sources on therapeutic approaches and treatment outcomes were considered for this narrative review.
Conclusions: Keratosis pilaris and its erythematous variants can be challenging to treat, currently available therapies may provide meaningful clinical improvement, particularly when selected according to the predominant phenotype and patient-specific concerns. Further high-quality studies are needed to refine treatment strategies and strengthen the evidence base for individualized management.
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