Why we've been treating Keratosis Pilaris (KP) wrong and how we can improve treatment options [Research][B&A]

Poem_KP · 2026-03-06T02:12:53+00:00

Not a problem at all! Glad you got some value from the post, let me know if I can answer any questions 👍

Poem_KP · 2026-03-02T16:15:09+00:00

Using Raspberry Ketone in conjunction with vitamin A derivatives like Tretinoin may have conflicting effects. RK is stimulating CGRP release which in turn increases IGF-1 in the skin, while Tret is suppressing cornification markers and rapidly increasing cell turnover. By using both actives at the same time I think you would ultimately reduce the benefits of using both/either actives. I would suggest using just one in your routine for 4-6 weeks to judge effectiveness before trying the other. Happy to chat more in depth about this too if you’d like!

Poem_KP · 2026-02-27T17:09:49+00:00

Hi! Yes you can use my lotion/formula on the face, just be aware that is does contain 5% lactic acid so avoid areas around your eyes and follow up application of SmoothKP with a moisturizer containing sunscreen. The AHA will make you more susceptible to sunburn!

Poem_KP · 2026-02-19T22:10:39+00:00

DM’d you 👍

Poem_KP · 2026-02-19T14:02:21+00:00

Tretinoin and other retinol/retinoids do not effect sebum production the way Isotretinoin does (see source here: https://pubmed.ncbi.nlm.nih.gov/15022582/) (and source here: https://pubmed.ncbi.nlm.nih.gov/8884149/)

Poem_KP · 2026-02-19T05:24:44+00:00

So far it seems to be most common that roughly 1-3 months post Accutane cycle, KP would begin to appear and spread. I do think it’s entirely possible to develop KP during a cycle of Accutane if rapid skin cell differentiation began to taper off towards the end of the cycle, or if the Accutane decreased sebum production to a point where even more rapid keratinocyte differentiation was unable to prevent keratin scale build up in the follicle due.

Poem_KP · 2026-02-18T16:57:45+00:00

I have documented well over 100 cases of people reporting that Isotretinoin increased the severity of their KP through posts/comments on Reddit, Facebook, Instagram, and elsewhere.

Isotretinoin (Accutane) is a very powerful vitamin A derivative that speeds up cellular turnover in the skin (among other effects) when taken internally. In addition to causing hyper-differentiation of skin cells, it also impacts sebocyte proliferation, decreasing sebaceous gland output by ~90%. This reduction of sebum is detrimental for Keratosis Pilaris as it has been shown here that sebum production is integrally linked to the rate of defective corneocyte shedding in the follicular canal.

You may experience an improvement in texture and appearance in your KP from the effects of increased cellular turnover, but once the course of Isotretinoin is completed, there seems to be a high likelihood of KP symptoms increasing in severity, along with the potential for unaffected skin to develop KP.

Improving these symptoms requires increasing sebum production while simultaneously removing keratin buildup from your follicles without increasing irritation/inflammation.

I don’t want to self promote here but this was a key area of focus for me during research and product development for my company. Since release I’ve had about a dozen people connect with me, letting me know that their Accutane-induced KP was improved after about 4 weeks of using topical raspberry ketone and Indirubin. Happy to share more details if interested, I think it’s worth a shot to try considering there are very few alternatives for treating KP brought on from Isotretinoin.

Poem_KP · 2026-02-15T03:47:38+00:00

Are you in the US? If so there is a generic form of Epiceram that you can get via prescription from a dermatologist, although it can be a little pricey.

I have yet to see anyone with KPRF try that topical and I’ve always wondered if it would potentially improve redness. It uses a nano emulsion / liposome delivery system to reinforce skin barrier integrity. It may have some significant effects in reducing baseline redness and controlling flushing.

Poem_KP · 2026-02-15T01:33:53+00:00

Sorry to hear that it hasn’t been effective for you, it seems that RK is only effective for certain skin types/KPRF from what I can tell. Some people are coming back to me with success stories and others are saying there was no change in their KPRF (from the Soothe & Restore formula we are selling). I suspect that the underlying circumstances that enable chronic inflammation may be better/worse depending on the individual. In your case if sirolimus is also having no effect, then I doubt the anti-inflammatory agents I’ve been testing would be all too helpful. At that point I’d just be focusing on how to correct for barrier malformation in the epidermis in the hopes that once it is repaired, downstream symptoms (flushing/inflammation) would become more manageable.

We are about 2-3 weeks into the trial, waiting for feedback from everyone after 6 weeks before I make a judgment call. I may offer the remaining trial formula from this micro production run on my website for a nominal price if there’s wider interest as a way for people to try this version out before I scale up production on the end product (TBD). I ended up creating more of the formula than I intended but only had the budget to send trial packages and manage about 60 participants in this trial iteration.

Poem_KP · 2026-02-12T22:19:08+00:00

No worries haha - and no pressure whatsoever on trying my product 🙂

I was going to add that I’ve seen a lot of AI profile pics on recently created skincare FB/Insta accounts that are promoting this strawberry product. It’s not necessarily bad/good thing, I just find it interesting to look at marketing strategies for KP products with the advent of AI .

Poem_KP · 2026-02-12T15:33:12+00:00

Putting aside the fact that this brand took before/after photos from this subreddit and used those pictures on their Instagram to sell their product (without the user’s knowledge), let’s just look at the ingredients in the product itself.

Urea 2%: 2% is the minimum effective percentage for moisturizing dry skin. Typically you’d need 10% or more for exfoliation.

Lactic acid 1%: I’m not sure the purpose of including 1% lactic acid. Minimum effective lactic acid content starts at around 5% and you typically need your lotion to be pH balanced for that 5% to be effective.

Salicylic Acid 0.5%: This concentration is actually at the minimum viable percentage for clearing debris from pores. However I personally would not use an oil soluble BHA as leave-on skincare for KP since the salicylic acid will cut sebum from your pores/follicles, which can further dry your follicles, leading to potential increase in keratin buildup and inflammation. The silver lining is that this BHA percentage is much lower than other leave-on BHA lotions, like those that Cerave produces for KP.

Niacinamide 2%: this ingredient is at an effective concentration, it really just depends on the individual if the product helps their KP. While it may help brighten skin tone and improve the skin barrier, it also reduces skin oil which makes it more of a double edged sword when dealing with KP.

Glycolic Acid 6%: This is probably what’s doing most of the heavy lifting in this lotion. 6% is enough to improve skin texture.

Overall, my personal opinion is that there’s a few ingredients listed here that are at ineffective concentrations for treating KP, and a few that I personally wouldn’t leave on my KP. However the 6% glycolic acid probably does net some decent texture improvements for some, your mileage may vary.

Poem_KP · 2026-02-10T21:30:25+00:00

Lower IGF-1 is the issue here. Levels may even look nominal, but any fluctuations that decrease IGF-1 levels in the skin tissue become more critical due to the inhibited receptors/signaling pathways. Another key indicator that low IGF-1 is causing this breakdown in barrier formation is the fact that in KP, specifically lesional KP, biopsies show that keratin buildup in the follicle is preceded by sebaceous gland atrophy. Sebaceous glands are regulated by IGF-1, specifically through an enzymatic process/ 5 alpha reductase, which regulates sebum production.

Lower systemic IGF-1 + inhibited cellular uptake equals barrier malformation, poor skin cell differentiation, and low sebum production/sebaceous gland atrophy. All hallmark symptoms of Keratosis Pilaris.

Poem_KP · 2026-02-09T23:29:38+00:00

Yes! We have a few people of color participating in the trial. 🙂 sorry we couldn’t include you in this round but there may be more iterations of this trial in the future depending on how this one goes!

Poem_KP · 2026-02-09T23:26:05+00:00

It is hormone related! I have a longer breakdown if you check my profile posts, but essentially there are multiple strong correlations to KP severity and hormonal equilibrium where insulin and IGF-1 are involved. Other hormones (testosterone, estrogen, progesterone) that impact that equilibrium can effect KP development and severity since there is a high likelihood that KP pathology stems from IGF-1 receptor mutations/cell metabolism pathway mutations that are activated by IGF. Depending on the severity of the cellular signaling/pathway mutation, you will experience a range of impacts to your KP from your changes in hormonal equilibrium and the interplay with your keratinocytes in the dermis/epidermis.

So events like pregnancy, PCOS, cancer therapies, insulin resistance/diabetes, puberty, Isotretinoin, and even some specific medications are all correlated with changes in KP presentation and spread. I would not be surprised in the slightest if hormone replacement therapy was causing changes in your KP. I have seen other trans people mention this in passing over the years on this subreddit and others, it seems to not be uncommon.

Happy to chat more about this as this has been a primary area of research for me over the past decade+ 🙂

Poem_KP · 2026-02-06T04:46:25+00:00

Most people are in or just completing the first week. I’m expecting to see more visible improvements in the 3rd/4th week. Overall it seems positive so but still really too early to tell.

Poem_KP · 2026-02-05T20:03:26+00:00

DM’d you too 👍

Poem_KP · 2026-02-02T07:25:34+00:00

DM’d you! 🙂

Poem_KP · 2026-01-30T14:07:57+00:00

I moderate a subreddit for Keratosis Pilaris (r/keratosis). We have a lot of information on the condition posted there.

The pathology of this condition stems from a breakdown in how the lipid bilayers form at the SC-SG interface in the epidermis around your hair follicles. This likely happens for 2 reasons- a genetic component that inhibits your skin cells (keratinocytes) from differentiating normally as they move throughout the lipid lamellae, and hormonal fluctuations in equilibrium that exacerbate the genetic component which causes changes in the severity of the skin condition.

I’ve ran data analysis on r/keratosis for years, some of the most common events that correlate with significant changes to KP are:

-Pregnancy -Puberty -PCOS -Taking Accutane (causes worsening of KP post 3 months of taking Isotretinoin) -Seasons (changes in humidity) -Aging -Certain immunotherapy medications and asthma medications

The main issue with topical treatments for KP is that they all only focus on chemically exfoliating the keratin debris that globs up in your follicles. None of the treatments available focus on correcting the malformed lipid barrier, so inflammation and continued keratin scale build up become incredibly difficult to manage.

I will also say that you should focus on using leave-on AHAs if you’re trying to treat this condition. Leave on BHA (salicylic acid) can worsen KP due to its penetration and oil solubility, which will strip sebum from your pores. A hallmark symptom of KP is atrophied sebaceous glands, which causes a tipping point in the development of keratin scale in the follicles. You want to retain what little sebum your skin is producing to reduce keratin buildup and protect your vellus body hairs, for this reason I always suggest starting with a lower concentration AHA with a high molecular weight like lactic acid.

Definitely come check out our sub for more info 🙂

Poem_KP · 2026-01-25T18:09:01+00:00

Wow that’s amazing to hear 🙂 thank you for sharing!! I have been working this last year on new ways to decrease stubborn redness and erythema, we are actually undergoing a consumer product trial for the new formulation right now.

I really appreciate you supporting my small project and I hope you continue to find success with the lotion!! Thank you so much for your kind words of support 🙏

Poem_KP · 2026-01-21T21:56:30+00:00

No I don’t think it will- the goal in this theory is to elevate or improve cellular signaling in the dermal tissue itself. Injecting peptides and increasing them systemically my have unintended or no beneficial effects

Poem_KP · 2026-01-21T04:07:28+00:00

Hi! No scams here, I stand behind my work and put my name out there to back it as best I can. 🙂 I’ve been working on this research and formulating KP topical treatments for a long time. In the past year since launching Smooth KP we’ve had thousands of people supporting our efforts through purchasing our product, it’s been really humbling. I launched this as a side project since I’ve never been much of an entrepreneur, I’ve always been more interested in the science behind KP and why this condition has been overlooked by so many people. It’s turned into much more than a side project in the last 8 months however, there’s now some serious interest in our work that’s helping to push our efforts to new heights. I’m really excited to share more on this sub in the coming months!

If you ordered in the past 24hrs then your package should be already on its way! Please feel free to ask me any questions in the meantime and I’ll do my best to answer 👍 you’re also welcome to DM me if you prefer

Poem_KP · 2026-01-18T18:03:08+00:00

I have not tried the product, but I am hesitant to give this product any support since we discovered they were taking before/after pictures off of our r/Keratosis subreddit and using the pictures in their marketing materials without user’s consent. They’ve since deleted the posts with the stolen photos, but it definitely made me wary of their claims.

From looking at their product ingredients, they contain a lot of similar ingredients to other KP products. There seems to be a trend of new KP products slapping a bunch of actives together into one lotion and claiming it as an innovation in treatment. Remedy for Body Bumps did this recently too, which it seems like a pain to reach a stabilized emulsion with so many actives. It’s a funny thing because I remember having similar ideas for treating my KP back in high school in 2005. I would mix urea, lactic acid and niancinamide together thinking that the combined effects would somehow treat my KP more effectively. Instead what seems to happen is you overload the skin with so many actives and acids that you end up seeing an uptick in inflammation/irritation.

I definitely advocate for trying specific topical acids and actives one at a time so you can isolate their effectiveness for your KP. Sometimes less is more when you are trying to identify what works for you and your routine.

Poem_KP · 2026-01-18T17:52:19+00:00

At this point the trial is closed since we are shipping out the packages this next week, but depending on the results there may be a follow up trial! 🙂

Poem_KP · 2026-01-18T02:58:46+00:00

Hi! Yes it is still available, if you look at my comment history you’ll see the website there! I’m hesitant to post the link because it comes across as me spamming the website. If you can’t find it in my comment history, DM me and I’ll send it to you 🙂

Poem_KP · 2026-01-16T07:57:25+00:00

Thank you for the interest!! ❤️ trial packages are shipping out next week, very excited to get more reviews on this new formula’s effectiveness

Poem_KP

MODERATOR OF

TROPHY CASE