Clinical and dermoscopic evaluation of fractional carbon dioxide laser in management of keratosis pilaris in Egyptian type skin

BACKGROUND: Numerous treatment modalities for keratosis pilaris have been tried with limited success. AIM: To determine the efficacy, safety, and tolerability of fractional CO2 laser in the treatment of KP. PATIENTS AND METHODS: This prospective, single-blinded split-body placebo-controlled comparative study was conducted on 60 patients with bilateral KP of arms (group A) and thighs (group B). One side randomly received fractional CO2 laser treatment (power 12 W, time on 3 ms, PPI 5) in the form of two sessions four weeks apart. The contralateral control side was treated with a topical keratolytic (10% urea). Standardized digital clinical and dermoscopic photographs were obtained at each visit. RESULTS: Significant improvement has been demonstrated clinically and dermoscopically in both arm and thigh lesions after fractional CO2 laser. In group A, excellent improvement was noted in 10 patients (33.3%), good improvement in 18 patients (60%), and moderate improvement in 2 patients (6.7%) at the second visit. In group B, minimal improvement was noted in 2 (6.7%) patients, moderate improvement in 16 patients (53.3%), and good improvement in 12 patients (40%) at the second. Control sides showed minimal improvement on the arm lesions only. No side effects were reported in both groups. The mean pain score in group A was not significantly different from that group B (P = .057). Patient satisfaction was significantly higher in the laser-treated side arm lesions (P < .001). CONCLUSION: Fractional CO2 laser was associated with significant clinical and dermoscopic improvement of keratosis pilaris lesions in Egyptian patients.