Keratosis pilaris: a systematic review of the literature and strategies for optimal treatment

Keratosis pilaris is a benign and prevalent dermatological condition, clinically characterized by erythematous and hyperpigmented papules with a rough texture. Its appearance on exposed areas, such as the extensor surfaces of upper arms, can lead to psychosocial distress. Despite the range of available topical and laser therapies, no standardized approach exists for selecting one treatment over another. This updated systematic review aims to provide innovative strategies for the therapeutic management of common keratosis pilaris. Twenty-seven articles published between 2011 and 2024 were included. The selected studies comprised monotherapies (topical or laser), comparative analyses, and combination treatments. Lactic and glycolic acids were the preferred topicals, demonstrating efficacy in the treatment of keratosis pilaris. The Nd:YAG laser yielded consistently favourable outcomes. Among ablative lasers, the CO2 laser showed efficacy, while the erbium:YAG appeared promising due to fewer adverse effects. The management of keratosis pilaris involves a multimodal strategy centred on patient education, topical treatments and laser therapies. To address the diverse clinical features of the condition, we propose a stepwise, stratified therapeutic approach.