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Pediatric Keratosis Pilaris Treatment & Management

  • Author: Derek H Chu, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Aug 30, 2016

Medical Care

Education, reassurance, and gentle skin care are the cornerstones of therapy for keratosis pilaris.[12] This is particularly true for young children.

The noninflamed horny papules usually remit with age and increasing time. They are generally resistant to most forms of short-term therapy.

Tepid showers instead of hot baths, along with the use of mild soaps and a home humidifier, are generally encouraged.

An emollient cream may help to alleviate the rough texture of the skin in mild cases. A topical keratolytic agent such as lactic acid, salicylic acid, or urea preparations may be beneficial in more extensive cases. Several reports note good results with 2-3% salicylic acid in 20% urea cream.

Lesions with significant inflammation may improve with the use of midpotency topical steroid preparations. Inflammation is usually reduced markedly by 7 days, at which point the steroid should be discontinued.

Topical retinoid therapy (adapalene, tretinoin, tazarotene) has been used with varying degrees of success.[13]

Topical immunomodulators, such as topical tacrolimus and pimecrolimus, have been used to treat keratosis pilaris.[14]

Long-pulsed laser treatments, particularly with the pulsed dye laser, have been shown to significantly improve keratosis pilaris in pediatric patients.[15, 16]

Contributor Information and Disclosures

Derek H Chu, MD Clinical Assistant Professor, Department of Dermatology, Stanford University School of Medicine

Derek H Chu, MD is a member of the following medical societies: American Academy of Dermatology, American Academy of Pediatrics, American Medical Association, Society for Pediatric Dermatology

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.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Andrea Leigh Zaenglein, MD Professor of Dermatology and Pediatrics, Department of Dermatology, Hershey Medical Center, Pennsylvania State University College of Medicine

Andrea Leigh Zaenglein, MD is a member of the following medical societies: American Academy of Dermatology, Society for Pediatric Dermatology

Disclosure: Received consulting fee from Galderma for consulting; Received consulting fee from Valeant for consulting; Received consulting fee from Promius for consulting; Received consulting fee from Anacor for consulting; Received grant/research funds from Stiefel for investigator; Received grant/research funds from Astellas for investigator; Received grant/research funds from Ranbaxy for other; Received consulting fee from Ranbaxy for consulting.


Mark A Crowe, MD Assistant Clinical Instructor, Department of Medicine, Division of Dermatology, University of Washington School of Medicine

Mark A Crowe, MD is a member of the following medical societies: American Academy of Dermatology and North American Clinical Dermatologic Society

Disclosure: Nothing to disclose.

Steven J Escobar, MD Staff, Division of Pulmonary and Critical Care Medicine, Naval Medical Center, San Diego

Steven J Escobar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

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  15. Saelim P, Pongprutthipan M, Pootongkam S, Jariyasethavong V, Asawanonda P. Long-pulsed 1064-nm Nd:YAG laser significantly improves keratosis pilaris: a randomized, evaluator-blind study. J Dermatolog Treat. 2012 Mar 4. [Medline].

  16. Schoch JJ, Tollefson MM, Witman P, Davis DM. Successful Treatment of Keratosis Pilaris Rubra with Pulsed Dye Laser. Pediatr Dermatol. 2016 Jul. 33 (4):443-6. [Medline].

Keratosis pilaris occurs most commonly on the lateral upper arms and upper thighs.
The lesions of keratosis pilaris are evenly spaced, consistent with the follicular origin of this disorder.
Close examination of keratosis pilaris shows keratotic papules associated with hair follicles. Keratinocytes at the follicular orifice are retained, producing keratin plugs.
Bacteria associated with the follicular papules of keratosis pilaris may cause some lesions to become erythematous or pustular.
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