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Eruptive Vellus Hair Cysts Medication

  • Author: Cory A Dunnick, MD; Chief Editor: William D James, MD  more...
 
Updated: May 21, 2014
 

Medication Summary

The goals of pharmacotherapy for eruptive vellus hair cysts (EVHCs) are to reduce morbidity and to prevent complications.

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Topical Skin Products

Class Summary

Modulate keratinocyte differentiation and decrease oil production.

Ammonium lactate (Am Lactin, Lac-Hydrin, Geri-Hydrolac)

 

Contains lactic acid, an alpha-hydroxy acid that has keratolytic action, thus facilitating release of comedones. Alpha-hydroxy acids cause disadhesion of corneocytes and thin the stratum corneum. Use 12% cream or lotion.

Urea (Carmol, Keralac, Kerafoam, Umecta, Aluvea)

 

Topical humectant. Promotes hydration and removal of excess keratin. Urea is a small molecule that osmotically binds water. Use 10% or 20% cream.

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Retinoid-like Agents

Class Summary

These agents stimulate cellular retinoid receptors and help normalize keratinocyte differentiation and are comedolytic. In addition, they have anti-inflammatory properties.

Tazarotene (Tazorac, Avage)

 

Retinoid prodrug whose active metabolite modulates differentiation and proliferation of epithelial tissue; may also have anti-inflammatory and immunomodulatory properties. Available as 0.05% and 0.1% cream and gel.

Tretinoin topical (Retin-A, Renova, Avita)

 

Topical retinoid that significantly alters the differentiation of keratinocytes. Inhibits microcomedo formation and eliminates lesions. Makes keratinocytes in sebaceous follicles less adherent and easier to remove. Available as 0.025%, 0.05%, and 0.1% creams. Available also as 0.01% and 0.025% gels.

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Contributor Information and Disclosures
Author

Cory A Dunnick, MD Associate Professor, Director of Contact Dermatitis Clinic, Director of Medical Student Education, Department of Dermatology, University of Colorado Denver School of Medicine

Cory A Dunnick, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, Women's Dermatologic Society, American Contact Dermatitis Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Harry Dao, Jr, MD Assistant Professor, Department of Dermatology, Baylor College of Medicine

Harry Dao, Jr, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References
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Clinical photo of eruptive vellus hair cysts showing involvement on the patient's chest.
Histopathology of an eruptive vellus hair cyst showing a middermal cyst with squamous epithelium.
A close-up view of the contents of an eruptive vellus hair cyst showing cross-sections of vellus hairs and laminated keratinous material.
Eruptive vellus hair cysts in the axilla.
The patient seen here is expanding his cheek with air to better demonstrate multiple eruptive vellus hair cysts on the face.
 
 
 
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