Where there is too much keratin plugging the pore, such as in per cent keratosis pilaris, an exfoliating agent such as salicylic acid, lactic acid or urea may help. Salicylic acid will soften keratin, with effects dependent on concentration, although too high a concentration can burn normal skin.4,28

A number of toiletry products such as face washes include salicylic acid but topical OTC medicines containing just salicylic acid are mainly licensed for conditions such as warts, verrucae, corns and calluses. Salicylic Acid Ointment BP is indicated for the treatment of hyperkeratotic and scaling conditions.27

The British Association of Dermatologists’ guide to specials medicine products notes that salicylic acid 2 per cent with sulfur 2 per cent in aqueous cream can be helpful for facial seborrhoeic dermatitis.28

The mild keratolytic properties of benzoyl peroxide in combination with antibacterial and antifungal properties of potassium hydroxyquinoline sulfate is licensed for acne, acne-like eruptions and folliculitis. Benzoyl peroxide may help with pseudofolliculitis barbae suppressing follicular hyperkeratosis.24,27

Selenium sulphide may reduce corneocyte production by having a cytostatic effect on epidermal and follicular epithelium cells. It also has an anti-seborrhoeic activity.27