Follicular keratosis

Characteristics of follicular keratosis

Follicular keratosis, also known as perifollicular keratosis, is an extremely common condition that can affect anyone regardless of age or gender. It manifests as small, reddish or flesh-colored papules located near the hair follicles, giving the appearance of goosebumps. The disease can occur on any part of the body where hair grows, but follicular keratosis most commonly affects the face, arms, thighs and buttocks. Untreated keratosis can lead to the problem of ingrown hairs and even inflammation and seborrheic dermatitis. It is also particularly dangerous for people with atopic, acne-prone and seborrheic skin, as it can lead to acne, atopy and eczema. Although the condition is often mild, it can be an aesthetic problem.

Causes of excessive follicular keratosis

Follicular keratosis is caused by excessive secretion of keratin that accumulates at the hair follicles, blocking their outlet. Keratin accumulates in the top layer of the epidermis and sebaceous glands creating blackhead-like lesions. In many cases perifollicular keratosis is the body’s response to irritation, rubbing, too high or low temperatures, dry air, lack of moisture, improper care or sunlight. The cause of keratosis pilaris may also be improper diet – poor in vitamin A. Other possible causes of this disease include genetic factors.

What are the types of keratosis?

Follicular keratosis can take different forms and degrees of severity. The most common distinctions are:

Non-inflammatory bullous keratosis – or so-called goosebumps, manifesting as rough, rough skin covered with flesh-colored papules.
Keratosis rubra – takes the form of red, inflamed papules that may be accompanied by erythema.
"Fish scale" – occurs due to skin damage and takes the form of psoriasis-like lesions – dry crusts, lichens, warts.
Non-inflammatory keratosis – the most common type of keratosis manifesting as unsightly pores contaminated by oxidized keratin.
Inflammatory keratosis – characterized by small purulent pustules that can lead to scarring and discoloration.
Subcutaneous pustules – is a response to improper treatment of the skin, especially the skin of the face and neckline. The pustules are located under the skin and are accompanied by erythema.

Diagnosis and treatment of follicular keratosis

The correct diagnosis of keratosis perifolliculare is extremely important because this condition can be very similar to other skin dermatoses such as acne vulgaris, comedones and rosacea, seborrheic and atopic dermatitis or psoriasis. However, with the necessary knowledge and experience and the appropriate tools, such as a dermatoscopy and videodermatoscopy, our physicians are able to correctly diagnose this disease entity.

The key element in the treatment of follicular keratosis is systematic exfoliation of accumulated keratin. This is possible primarily through peeling – both acid-based and hydropeeling. In our clinic, we choose treatments with the use of acids with the best efficiency of ENERPEEL® company – that is, with glycolic acid of 30% concentration, and TCA acid of 25% or 40% concentration.

Glycolic acid restores proper course of keratinization process by accelerating exfoliation of epidermal cells. As a result, the skin becomes brighter and its color becomes even. Glycolic acid eliminates mild to moderate keratoses and blackheads, marks and scars after inflammation and unblocks pores.

TCA (trichloroacetic acid) has a slightly stronger effect, so it is recommended in case of advanced keratosis perifolliculata. During treatment with this acid, a controlled chemical burn occurs so that the substance can penetrate deeper into the skin. For a few days after the treatment, the skin is exfoliated – thanks to this, TCA acid treats advanced perifollicular keratosis, restoring smoothness and even skin tone.

In our Clinic we also successfully use hydropeeling HydraFacial – a type of non-invasive crystal-free microdermabrasion, the effects of which have been clinically confirmed. Hydropeeling cleanses and exfoliates the skin while providing maximum hydration. It is a four-step treatment that includes deep cleansing of the skin during water microdermabrasion, exfoliation, which is the application of an appropriate mixture of chemical peelings, extraction, which is cleansing the skin of all impurities, including excess keratin, and infusion, during which a mixture of individually selected beneficial substances is injected into the skin. Thus, HydraFacial not only allows to combat keratosis perifolliculata, but improves the overall skin condition.

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