What You Should Know About Keratolytics

Medications designed to dissolve skin flakes and scales

Keratolytics are medications designed to dissolve skin flakes and scales. Removing these scales not only improves the appearance of the skin and minimizes dandruff, it also helps other topical medications to penetrate the skin better.

In addition to dandruff, keratolytics help treat a multitude of skin conditions, including calluses, acne, and psoriasis.

Types of Keratolytics

Common keratolytics include salicylic acid, urea, and lactic acid. Most keratolytics are available over the counter. Ask your pharmacist for recommendations of products containing these ingredients.

Salicylic acid

Salicylic acid is an agent used to treat common skin conditions such as acne, psoriasis, and dandruff. It is found naturally in willow bark and wintergreen leaves, but is also synthesized artificially.

Salicylic acid works as a keratolytic by breaking down connections between dead cells on the surface of the skin, much like an exfoliant.

It is usually applied to the skin surface as a cream or lotion in formulations of 0.5% to 10% for acne and psoriasis, or as much as 40% to treat warts and corns.

Because salicylic acid breaks down the barrier of the skin, it allows other agents to penetrate the skin more easily. Be sure to use salicylic acid-containing treatments only as directed, and do not apply to skin that is red, broken, irritated or infected.

Urea

Urea is an organic compound known to soften and soothe the skin. It also has hydrating and anti-itching properties, and helps other medications to penetrate the skin.

Topical application of urea in a cream or gel has been shown to effectively treat atopic dermatitis (eczema), xerosis (dry skin), and psoriasis, among other skin conditions, as well as brittle nails.

Urea is very safe and is used in skin formulations in concentrations as high as 50%. Occasionally, people experience a burning or stinging sensation when using products containing urea, but this is rare.

Lactic acid

Lactic acid is a molecule that your body produces naturally when it uses carbohydrates for energy and oxygen supply is low, like during a hard workout. It's also found in sour milk.

As a keratolytic, lactic acid exfoliates the skin, while also helping to stimulate skin cell renewal and keeping the skin hydrated.

Over-the-counter creams and lotions that contain lactic acid help to relieve symptoms of psoriasis and keratosis pilaris, a common skin condition that appears as bumpy "chicken skin."

Lactic acid may make your skin more sensitive to the sun. As with any medication, use lactic acid-containing creams or lotions as directed.

Olive oil

You also can use olive oil to remove scales. To help with dandruff flakes, olive oil can be applied to the scalp and left on overnight under a shower cap. In the morning, wash out the oil (this can be done with a keratolytic shampoo) and brush or comb out the the softened skin flakes.

Dandruff on a woman's shoulder
pimonpim / iStock / Getty Images 

Conditions Keratolytics Treat

Keratolytics are helpful in treating a number of skin conditions, including common skin troubles such as dandruff, acne, and calluses. A few of the conditions keratolytics can help with are outlined below.

Dandruff

Dandruff is a symptom of a condition known as seborrheic dermatitis. Marked by red, greasy skin covered with flaky, white or yellow scales, seborrheic dermatitis often affects the scalp, but can also show up in other areas that are rich in oil glands, such as your eyebrows, the sides of your nose, and groin area.

Salicylic acid is a common ingredient in dandruff shampoos that you can buy over the counter. Well-known dandruff shampoos that use salicylic acid include Selsun Blue and T/Sal by Neutrogena.

Acne

Acne, those unfortunate blemishes that haunt nearly everyone's teenage years, is another common skin condition that keratolytics can help with.

Shedding skin, overactive oil glands, or an overgrowth of bacteria clog up pores of the skin, causing acne. Salicyclic acid, eases inflammation and unclogs pores, helping to clear up acne-prone skin.

You can find over-the-counter salicylic acid treatments in strengths of 0.5% to 2% as topical gels and creams.

Calluses

Calluses is the buildup of hard, thickened skin caused by repeated rubbing or constant pressure on the skin. Typically, calluses show up on the bottoms of the feet and palms of the hands.

As softening and emollient agents, salicylic acid and urea can help with calluses. Look for creams or lotions that have these keratolytics in them.

Psoriasis

Psoriasis is a chronic condition in which the immune system causes the body to make skin cells too quickly. The extra cells pile up, leading to visible patches of thick, silvery scales that tend to itch.

Salicylic acid, urea, and lactic acid keratolytics can all help to relieve symptoms of psoriasis. The salicylic acid will help to reduce inflammation, while urea and lactic acid will help to soften and remove the scales.

Be sure to follow the directions as indicated when using a medication containing salicylic acid, as too much can make psoriasis symptoms worse.

Keratosis pilaris

Keratosis pilaris is a harmless skin condition that looks like tiny bumps. The bumps can be red or white and are sometimes described as little pimples or chicken skin. They show up because dead skin cells are clogging up pores on the skin where hair grows.

Keratosis pilaris doesn't need to be treated, but it can make your skin feel dry and itchy. Moisturizers and lotions that contain urea and lactic acid, such as AmLactin and Urix40, can help relieve these symptoms.

You can also gently exfoliate the area, such as with a loofah or washcloth, or use a cream like Salex lotion that contains salicylic acid. The salicylic acid will help to slough away dead skin cells.

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