kp in 2 year old

My almost 2 year old daughter has keratosis pilaris on the back of her arms and legs.  I am a physician, not a dermatologist, and asked my sister who is a dermatologist what I should do, but now want another opinion.  She recommended using eucerin plus with AHA in it.  It seemed to improve her legs, but now one of her arms is much worse.  Have been using it for one month.  We always put cetaphil on top of it.  I have been reading about Cerave cream and other options like coconut oil online, but it is all from random people.  I know that it is only a minor problem, but any recommendations would be appreciated.  I have kp that has pretty muched resolved in my late 30s, but did try am lactin after I had my older son and had bad kp on my arms that did not help at all.  I know it is not curable, but would like to try to improve it some, and the eucerin with AHA seems to have worsened it or maybe it is just progressing on that one arm.  Thanks for your help.

[Bharat Chawda, MD]

Dear lee300,

You have provided a good description of your daughter’s skin problem. I appreciate it.

Keratosis pilaris usually manifests at 2-3 years of age, remains until the age of 20, and then subsides gradually.

Treatment of KP primarily consists of using moisturizers as you have been doing. Along with this one can also use a mild keratolytic such as 2-3% salicylic acid ointment or tretinoin cream. Lactic acid,

urea, adapalene or tazarotene are also recommended in certain cases. Eucerin plus with AHA helps in exfoliation and moisturization but it is pretty mild. Cerave is just a moisturizer which would

be as good as Eucerin. Cetaphil again is a moisturizer with no exfoliation . I would recommend the use of a mild keratolytic as mentioned above. Tretinoin would be a better choice at this age.

The whole idea is to do mild exfoliation along with moisturization. Since your sister is a dermatologist, I think you can discuss these possibilities with her and use them under her guidance.

Hope this answers your query. If you have any additional concerns, I would be happy to address them.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Bharat Chawda

[Treyandriseleysmom]

My nephew has pretty nasty psoriasis on his elbows when he was a few years old and we used to apply hydrocortisone cream at night and in the morning which seemed to be the only thing and not to mention the least expensive thing that worked.

[lee300]

What about using lac hydrin over tretinoin for a two year old?  Would this not be safer?  Is lac hydrin stronger than using eucering with AHA?  Also, should we try to scrub the area some or just gently wash with our hands?  Thanks for your help.

[Bharat Chawda, MD]

Dear lee300,

Lac hydrin contains lactic acid which is very mild as compared to tretinoin or any other alpha hydroxy acids. Yes, it would be safer than tretinoin.

I would suggest you not to scrub the area as in long term it would lead to hyper-pigmentation. Do not use a loofah to scrub either. A gentle wash is always good.

Hope this answers your query. If you have any additional concerns, I would be happy to address them.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Bharat Chawda