A 1064-nm picosecond laser for the treatment of keratosis pilaris: a randomized, prospective, comparative study

Keratosis pilaris is a common skin disorder characterized by small keratotic papules on the proximal extremities; yet, very few treatment options are currently available, with mostly unpredictable and unsatisfactory results. Picosecond laser has been proven to be effective for the treatment of pigmented skin lesion and skin rejuvenation but has not been studied for the treatment of KP. This study aimed to evaluate the efficacy and safety of picosecond laser for the treatment of KP. Fifteen patients diagnosed with keratosis pilaris on both upper arms were enrolled, but twelve patients completed the study successfully. All patients were treated with a 1064-nm picosecond laser only one side of the upper arm randomly for three sessions at 4-week interval. Clinical assessment was evaluated by two dermatologists through taken digital photograph. The objective outcomes were assessed using Antera3D. Patient satisfaction score on overall improvement, pain score and adverse effects were also evaluated. The results demonstrated statistically significant of the change in median of overall improvement at week 4, week 8, and week 12 with p-value of 0.003, 0.013, 0.006 respectively on the picosecond laser treated side, while the control side showed no significant improvement (p>0.05). The side effects included mild to moderate erythema, burning sensation, itching, and pinpoint bleeding. One patient (8.33%) had post-inflammatory hyperpigmentation on picosecond laser treated side at week 12. No hypopigmentation, infection or scarring was observed throughout the study. In conclusion, a 1064-nm picosecond laser can be served as a safe modality and efficacious for keratosis pilaris treatment.