1. Three treatment visits with an 810-nm diode laser for patients with ketosis pilaris improved the surface irregularities of the skin.
Evidence Rating Level: 2 (Good)
Study Rundown: Keratosis pilaris (KP) is a disorder associated with red and bumpy skin usually involving the proximal extremities. While topical emollients are currently the mainstays of treatment, they are limited in effectiveness. Lasers are a newer treatment option. Specifically, the 532-, 585- and 595-nm vascular lasers have shown some efficacy at reducing redness but do not significantly change skin texture. Longer wavelength lasers have not been used to address the textural component of the disease. These authors sought to assess the utility of the 810-nm laser in the treatment of KP. They found that three treatment visits with this laser effectively improved skin texture, though erythema largely remained the same. While this study’s split body, rater-blinded, randomized control trial minimized potential biases, the study’s results were not easily generalizable to Fitzpatrick skin types IV-VI as they were excluded, albeit due to a risk of post-inflammatory hyperpigmentation.
Relevant Reading: Lupus Miliaris Disseminus Faciei Treatment With the 1450-nm Diode Laser
In-Depth [randomized controlled trial]: The study population consisted of 18 patients with KP that had Fitzpatrick type I-III skin. Patients were randomized to receive three laser treatment visits to their left or right arm; the arm that was not treated was considered a control. Both arms received topical petrolatum afterwards. After the last visit, redness and roughness/bumpiness were assessed and compared to the initial visit by 2 blinded dermatologists using a 0 (least severe) to 3 (most severe) rating scale. The median redness score assigned by blinded raters was 2.0 for the arm that was treated and for the control arm. The median roughness/bumpiness scores for the treatment vs. control arm were 1.0 and 2.0, respectively. The texture difference between the treatment and control arm (1.0) was found to be statistically significant (p=.004). There were no serious adverse events from the laser treatments, although two participants developed post-inflammatory hyperpigmentation and chose to withdraw from the study.
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