Lichen Spinulosus Medication

Updated: Aug 14, 2017
  • Author: Christopher R Gorman, MD; Chief Editor: William D James, MD  more...
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Medication Summary

The goal of treatment for lichen spinulosus is to improve the cosmetic disfigurement caused by the disorder.


Keratolytic Agents

Class Summary

Topical lactic acid creams have provided the most successful therapy to date. Salicylic acid gel and urea containing lotions also have been reported to help soften the horny papules. Gentle abrasion with a pad, soft brush, or luffa pad can be tried to remove the horny spines.

Ammonium lactate (Lac-Hydrin, Geri-Hydrolac)

Ammonium lactate contains lactic acid, an alpha-hydroxy acid with keratolytic action, thus facilitating release of comedones. It is available in 12% and 5% strengths. The 12% form may cause irritation on the face. Ammonium lactate causes disadhesion of corneocytes. It is found in a variety of topical emollient lotions. It may be combined with 10-20% urea cream or be used with salicylic acid gel.

Salicylic acid topical (Salacyn, Salvax, Keralyt, Gordofilm, SalAc)

Salicylic acid topical is a beta-hydroxy acid reported to soften papules. By dissolving intercellular cement substance, it produces desquamation of the horny layer of skin, while not affecting the structure of viable epidermis. It comes as a cream, lotion, or gel.

Urea (Carmol, Atrac-Tain, Nutraplus, Uramaxin, Uramaxin, Gormel, Nutraplus, Rea-Lo)

Urea promotes hydration and removal of excess keratin. It softens hyperkeratotic areas by dissolving the intracellular matrix, which loosens the horny layer of the skin.


Topical Retinoid

Class Summary

These agents stimulate cellular retinoid receptors and help normalize keratinocyte differentiation and are comedolytic. In addition, they have anti-inflammatory properties. The third-generation retinoids include topical adapalene and tazarotene.

Adapalene (Differin)

Adapalene inhibits microcomedo formation. It decreases cohesiveness of keratinocyesin sebaceous follicles, which allows for easy removal. It has anti-inflammatory properties. Adapalene is available as a cream, lotion, or gel.