Treatment of keratosis pilaris and its variants: a systematic review.

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.

Ayurveda management of keratosis pilaris - a case report.

OBJECTIVES: Keratosis pilaris (KP) is the condition of the skin with extensive keratin follicular plugging. It may be associated with the erythema. The upper arm extensor area, shoulders, back of neck and thighs, as well as face and the upper trunk are the areas of presentation. Available medications for KP give only symptomatic relief, while some produce serious side effects. There is no proven universal treatment for the disease that can provide complete recovery. Ayurveda management of KP is not yet reported. CASE PRESENTATION: A 26-year-old male patient, presented with main complaints started with papular lesions over his right shoulder, chest and upper back along and later with pustular lesions in the past 2 weeks. The condition was associated with redness, mild swelling and itching. The case was diagnosed as Keratosis pilaris based on its presentation, site, and pathogenesis. Also by analyzing the extent of vitiation of dosas (morbidities), the Vata kapha pitta hara line of treatment was adopted, which was accomplished in two phases i. e. Sodhana Cikitsa and Samana Cikitsa. CONCLUSION: Both internal and external treatments along with diet restrictions were found effective in arresting the pathogenesis and recovery in a short period. All the symptoms associated with the condition were completely cured with no signs of re-occurrence.

Innovative 1064-nm Nd:YAG Laser Significantly Improves Keratosis Pilaris, A Randomized, Double-Blind, Sham-Irradiation-Controlled Trial.

BACKGROUND AND OBJECTIVE: Keratosis pilaris (KP) is a common follicular disorder for which various topical agents and energy-based devices have been used with some efficacy. To evaluate the efficacy of a novel 1064-nm Nd:YAG laser for the reduction of skin roughness, erythema, and hyperpigmentation in KP subjects. STUDY DESIGN/MATERIALS AND METHODS: Twenty-three subjects with untreated KP on the upper outer arms participated in a randomized, single-blind fashion. One arm of each subject was divided into upper and lower parts. One part was randomized to be treated with an innovative 1064-nm Nd:YAG laser, while the other part received sham irradiation. Subjects received four consecutive treatments at 4-week intervals. Antera3D was used to measure skin roughness, erythema, and hyperpigmentation at baseline and 4 weeks after the last treatment. Moreover, clinical outcomes were also evaluated by subjects' Global Improvement Score (GIS) and subjects' satisfaction grading scores. RESULTS: Twenty-three subjects completed the study. There was statistically significant reduction of skin roughness measured by Antera3D compared with control group (P < 0.001). There were statistically significant improvements of skin roughness, erythema, hyperpigmentation, and overall appearances graded by subjects' Global Improvement Score (P < 0.001 all). Subjects' satisfaction scores were graded significantly better in treatment parts (P < 0.001). No adverse events including burning, bulla, erosion, post-inflammatory hyper/hypopigmentation, and scar formation developed in any subjects throughout the study period. CONCLUSION: This innovative 1064-nm Nd:YAG laser has proved to significantly and safely reduce skin roughness in Thai KP subjects compared with control after four sessions. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Intense Pulsed-light Therapy Significantly Improves Keratosis Pilaris: A Randomized, Double-blind, Sham Irradiation-controlled Trial.

Background: Keratosis pilaris (KP) is a common benign follicular disorder for which various topical and laser treatments have been used, with limited efficacy. Objective: We evaluated the efficacy of intense pulsed light (IPL) therapy for the reduction of skin roughness, erythema, and hyperpigmentation in Thai subjects with KP. Material and Methods: Twenty-four Thai patients with untreated KP on the upper outer arms were enrolled in a randomized, double-blind study. Only one arm of each subject was included and divided into upper and lower parts (25 cm2 per each part). One part was randomized to be treated with IPL using 645 to 950-nm cutoff filter and fluences of 15 to 18 J/cm2, while the other part was treated with sham irradiation. Subjects received four consecutive treatments at four-week intervals. Antera3D was used to measure skin roughness, erythema, and hyperpigmentation at baseline and four weeks after the last treatment. Moreover, clinical outcomes were also evaluated by subject Global Improvement Scores (GIS) and subject satisfaction grading scores. Results: Twenty-three subjects completed the study. There was statistically significant reduction of skin roughness, measured by Antera3D, compared to control group (p<0.001). However, the reduction of skin erythema was not significantly different between two groups (p=0.660). Skin hyperpigmentation significantly increased in the control group compared with intervention group (p=0.01). There were statistically significant improvements in skin roughness, erythema, hyperpigmentation, and overall appearance, graded by subject Global Improvement Scores (p<0.001). Subject satisfaction scores were significantly better in treatment parts (p<0.001). No adverse events, including burning, bulla, erosion, postinflammatory hyper/hypopigmentation, and scar formation developed in any subjects throughout study period. Conclusion: IPL has demonstrated the ability to significantly and safely reduce skin roughness in subjects with KP compared to control after four sessions.

Effectiveness of photopneumatic technology: a descriptive review of the literature.

Usage of photopneumatic technology has recently increased for treatment of different skin conditions such as acne, keratosis pilaris (KP), and rosacea. Photopneumatic devices combine gentle negative pressure with broad band pulsed light simultaneously to attack multiple targets in the skin for better treatment outcomes. In this literature review, we evaluate the efficacy of photopneumatic therapy on treatment of acne, keratosis pilaris (KP), and rosacea.