Keratosis Pilaris: Should You Consider Oral Retinoids? - Dermatology

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Keratosis pilaris (KP) is a common, benign skin condition characterized by small, rough bumps that typically appear on the upper arms, thighs, cheeks, and buttocks. It is caused by the buildup of keratin, a protein that protects the skin, which forms a plug that blocks hair follicles. While KP is not harmful and does not require treatment, many individuals seek options to improve the appearance of their skin.

In your case, you've mentioned that you have been using topical treatments such as 15% glycolic acid and almond acid lotion without significant improvement. You also noted that you have been diagnosed with KP, which is often hereditary. The dermatologist you consulted suggested considering oral retinoids, specifically isotretinoin (commonly referred to as oral A acid), which is typically used for more severe forms of acne but can also be effective for other keratinization disorders.

Oral retinoids can be very effective in treating conditions related to abnormal keratinization, including severe cases of KP. They work by reducing the production of keratin and promoting cell turnover, which can help prevent the formation of those keratin plugs. However, oral retinoids come with potential side effects, including dryness of the skin and mucous membranes, potential liver toxicity, and teratogenic effects (risk of birth defects if taken during pregnancy). Therefore, they are usually reserved for more severe cases or when topical treatments have failed.

Given that you are already using topical retinoids on your face and have been advised to continue with them, it may be beneficial to maintain this regimen while monitoring your skin's response. Topical retinoids can be effective for KP as well, and they generally have a better safety profile compared to their oral counterparts. Additionally, combining topical retinoids with other treatments, such as exfoliating acids or moisturizers, may enhance their effectiveness.

If you are concerned about the recommendation for oral retinoids, it is essential to have a thorough discussion with your dermatologist. You should express your concerns regarding the need for blood tests and monitoring while on oral retinoids, as these are crucial for ensuring your safety during treatment. Your dermatologist can help you weigh the benefits and risks of starting oral retinoids versus continuing with topical treatments.

In summary, while oral retinoids can be effective for keratosis pilaris, they are not the only option available. Given your current treatment with topical retinoids and your concerns about the oral medication, it may be wise to continue with the topical regimen and reassess your condition over time. If you do not see improvement or if your KP worsens, you can revisit the option of oral retinoids with your dermatologist, who can provide personalized advice based on your specific situation. Always prioritize open communication with your healthcare provider to ensure that your treatment plan aligns with your health needs and concerns.