The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature
Dampa E, et al.
Published in Cureus
Methodology
Narrative literature review of topical keratolytics (alpha hydroxy acids, beta hydroxy acids and urea) for keratosis pilaris, covering pathophysiology, mechanism of action and reported clinical effectiveness.
Key Findings
This narrative review describes keratosis pilaris as a common benign disorder of follicular keratinisation causing rough papules and variable redness on the upper arms, thighs and buttocks, medically harmless but a frequent source of cosmetic distress. The underlying process is follicular hyperkeratosis with retention keratosis and abnormal shedding, often alongside dry skin and barrier dysfunction linked to atopic dermatitis, ichthyosis vulgaris and filaggrin defects. Alpha hydroxy acids, beta hydroxy acids and urea are all reported to show potential benefit as first-line symptom-directed treatment by loosening keratin plugs and improving hydration. The author states the evidence base is limited by small samples, inconsistent outcome measures, limited blinding, short follow-up and no separation of texture-dominant from red phenotypes.
Conclusions
Topical keratolytics are reasonable first-line symptom-directed options for keratosis pilaris, but the evidence base is small, heterogeneous and short-term.
Limitations
A single-author narrative review with no systematic search, no pooled data and no comparative effect sizes; as the review itself notes, the underlying trials are small, largely unblinded and short, with no long-term maintenance data.
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