# Keratosis Pilaris - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507 (https://pmc.ncbi.nlm.nih.gov/articles/PMC12860576/): "In a randomized clinical study (split-side design) comparing 10% lactic acid to 5% salicylic acid applied twice daily for 12 weeks, both agents produced significant lesion reductions, with greater mean lesion reduction for lactic acid (66%) than salicylic acid (52%) by the end of treatment." · Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507 - Verified date: 2026-08 ## Verified against - Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507 (https://pmc.ncbi.nlm.nih.gov/articles/PMC12860576/): "In a randomized clinical study (split-side design) comparing 10% lactic acid to 5% salicylic acid applied twice daily for 12 weeks, both agents produced significant lesion reductions, with greater mean lesion reduction for lactic acid (66%) than salicylic acid (52%) by the end of treatment." - Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507 - Keratosis Pilaris - disease-level clinical article (keratosis-pilaris-clinical.txt) ## Treatment metadata - Urea — topical - Lactic acid — topical - Salicylic acid — topical ## Complete treatment card ```text KERATOSIS PILARIS Sources: Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507 (https://pmc.ncbi.nlm.nih.gov/articles/PMC12860576/): "In a randomized clinical study (split-side design) comparing 10% lactic acid to 5% salicylic acid applied twice daily for 12 weeks, both agents produced significant lesion reductions, with greater mean lesion reduction for lactic acid (66%) than salicylic acid (52%) by the end of treatment." · Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507 Review status: REVIEWED against Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507 (https://pmc.ncbi.nlm.nih.gov/articles/PMC12860576/): "In a randomized clinical study (split-side design) comparing 10% lactic acid to 5% salicylic acid applied twice daily for 12 weeks, both agents produced significant lesion reductions, with greater mean lesion reduction for lactic acid (66%) than salicylic acid (52%) by the end of treatment.", Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507, Keratosis Pilaris - disease-level clinical article (keratosis-pilaris-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Patients present with red, bumpy skin that is neither painful nor itchy - The condition most often shows up in teenagers and tracks with atopic dermatitis - Patients often seek care more because of how the lesions look than because of any symptoms they cause - It begins in early childhood and is at its most widespread through the teenage years - It is harmless and so common it counts as a normal variant, and it is the commonest follicular keratosis there is - It usually settles with time, and emollients, exfoliants, anti-inflammatories, phototherapy and laser are the options if it does not SIGNS - what you find (3) - The asymptomatic eruption typically involves the outer surfaces of the upper arms and thighs, plus the buttocks, though the face, trunk, and lower arms/legs can be involved too [rash] - Exam shows numerous small inflammatory bumps centered on hair follicles in the typical distribution - Redness and swelling can appear around lesions if the patient has been picking at them to squeeze out the keratotic plug [redness] TESTS (3) - Diagnosis rests on history and physical exam alone - Biopsy is not usually needed to make the diagnosis - Dermatoscopy can help confirm the diagnosis by showing follicular hair-shaft abnormalities - thin, short, coiled, or buried shafts - along with scaling and redness IF NOT THIS - what else fits (2) - Keratosis pilaris is distinguished from folliculitis, atopic dermatitis, milia, acne vulgaris, and scurvy - It keeps company with atopic dermatitis, ichthyosis vulgaris, obesity, diabetes and malnutrition, and with Down and Noonan syndromes Source StatPearls "Keratosis Pilaris" - disease-level clinical article Status traced to the source above Rx: Main treatment | Lactic acid | Salicylic acid MAIN TREATMENT 1. UREA [1st line] Adult Urea 20% cream applied once daily to affected areas. Improvement in skin texture is typically visible within 1 to 4 weeks of once-daily application. - Continuous / maintenance as needed Peds Not established in paediatric patients; use under medical advice. Source Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507 Why The review reports 10-30% urea in common clinical use, 10% for mild disease and 20-30% for pronounced hyperkeratosis, with 20% once daily improving texture by one week and holding at four. Urea is both keratolytic and a humectant, which is why it suits a condition that is dry skin plus a plugged follicle. Caution NOTHING CURES IT. The review is explicit that treatment is cosmetic, has to continue, and does not alter the natural course - it commonly improves by itself with age. This is the entry's main use: it is extremely common and extremely over-treated. Antibiotics, strong steroids and acne treatments do not help it. Mild stinging is the usual side effect, and higher strengths sting more, especially on broken or eczematous skin. Scrubbing and picking make the redness worse, not better. Egypt URECARE 10% CREAM 30 GM EGPI 23.00 EGP UREMEL 100ML CREAM MELANO PHARMA... 240.00 EGP UREPAR 10% FOOT CREAM 200 ML EGYPTIAN CO. ... 264.00 EGP UREPAR 10% BODY CREAM 200 ML EGYPTIAN CO. ... 357.00 EGP LACTIC ACID 2. LACTIC ACID [2nd line] Adult Lactic acid 10% cream applied twice daily to affected areas for 12 weeks (produced 66% mean lesion reduction at 12 weeks versus 52% for salicylic acid 5%). x 12 weeks, then ongoing maintenance as needed Peds Many individuals experience partial improvement with age. Paediatric safety and specific concentration guidance are not established in this review. Source Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus 2025;17(12):e100507 (https://pmc.ncbi.nlm.nih.gov/articles/PMC12860576/): "In a randomized clinical study (split-side design) comparing 10% lactic acid to 5% salicylic acid applied twice daily for 12 weeks, both agents produced significant lesion reductions, with greater mean lesion reduction for lactic acid (66%) than salicylic acid (52%) by the end of treatment." Why An alpha hydroxy acid, and the better performer of the two keratolytics compared head to head in the review. Both showed improvement by week 4 continuing to week 12. Caution Same rule as urea: cosmetic, ongoing, and it does not change the natural course. Alpha hydroxy acids increase sun sensitivity - sun protection while using it. Avoid on broken, inflamed or freshly shaved skin. The one Egyptian topical product, CLEAR FACE 10%, has no route recorded in the register, so it shows a route warning. The pack itself says topical solution and the strength is the one the review studied. Egypt CLEAR FACE 10%W/W TOPICAL SOLUTION ALEXANDRIA > MILLENIUM PHARMA-EGYPT 5.00 EGP -> ? different route - not topical SALICYLIC ACID 3. SALICYLIC ACID [2nd line] Adult Apply salicylic acid 6% lotion topically to affected areas Peds Adults, children and the elderly: apply twice daily to the affected area. Source Keratosis Pilaris - disease-level clinical article (keratosis-pilaris-clinical.txt) Why Topical keratolytic agent used to exfoliate and improve skin texture in keratosis pilaris. Caution Strictly contraindicated in diabetic patients, peripheral vascular disease, or peripheral neuropathy due to risk of tissue necrosis and foot ulceration. Protect surrounding normal skin with petroleum jelly or zinc oxide ointment prior to application. Do not apply on broken, inflamed, or infected skin. Collodion is flammable - no smoking or naked flame until it has dried. Egypt SALICYLIC ACID COLLODION 12% PAINT B.P.2001 UNIPHARMA CO. > UNIPHARMA 3.00 EGP -> ? different route - not topical SALICYLIC ACID SOAP (WEISER) 45 GM WEISER 15.00 EGP -> ? different route - not topical Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)