Urea Cream for Keratosis Pilaris: What the Study Shows and How Acids Compare

By Peptide Skincare Editorial Team · Published November 3, 2026 · Updated November 1, 2026 · 15 min read

Start with our pillar guide: What Is the Skin Barrier? The Science of Hydration, Ceramides and Occlusives, or browse all Skincare Fundamentals articles.

Urea cream for keratosis pilaris has one dedicated study in our sources: in a 4-week open-label study completed by 30 adults, 20% urea used once daily significantly improved skin smoothness, with no significant adverse events. Without a comparison group, it can't show that urea beats lactic acid, dermatologists' most-used first-line option.

Evidence: Early / preliminary.

Key takeaways

A 4-week, open-label, noncomparative study of 30 adults found that once-daily 20% urea cream improved smoothness from baseline at 1 and 4 weeks (P≤0.001) (McCormick et al., 2024).
A randomized 3-month trial reported a mean reduction of the lesions from baseline of 66% with 10% lactic acid cream and 52% with 5% salicylic acid cream (Kootiratrakarn et al., 2015).
In a dermatologist survey, 43.63% of respondents named lactic acid as their most-used first-line therapy, and 20.72% named salicylic acid (Greenzaid et al., 2023).
High-concentration (50% or 70%) glycolic acid applied to a test area improved keratosis pilaris in a study that recruited 25 participants, but 9 people checked at 5 years showed no significant difference from baseline (Tian et al., 2021).
A 2025 literature review found the topical evidence limited by small samples, mixed outcome measures, limited blinding and short follow-up (Dampa, 2025).

What does urea cream for keratosis pilaris actually do?

Urea cream for keratosis pilaris targets dryness and rough plugs of keratin, the tough protein in the outer skin. That rationale is sound, but no study in our sources measures how urea changes the plugs themselves.

Keratosis pilaris (KP) forms when keratin builds up around hair follicles and skin cells don't shed normally. It is often linked with dry skin and weak skin barrier function (Dampa, 2025). The result is small, rough bumps with variable redness, most often on the upper arms, thighs and buttocks.

Keratolytics are ingredients that loosen the bonds between dead skin cells. They aim to soften plugs, help skin shed and improve hydration in the stratum corneum, the skin's outer layer (Dampa, 2025). Urea is part of the skin's natural moisturizing factors and has concentration-dependent humectant (water-attracting), emollient (softening) and exfoliating properties (McCormick et al., 2024). Evidence: Early / preliminary.

Does urea cream for keratosis pilaris work?

Urea cream for keratosis pilaris looks promising, but the direct evidence is one small uncontrolled study. People using a 20% cream had smoother skin than at baseline, and there was no untreated or comparison group to show how much of that change came from the cream.

Thirty adults aged 18 to 65 completed the study after a 5-day washout, a period without the usual products before testing. They applied a moisturizing cream formulated with 20% urea once daily to KP areas for 4 weeks (McCormick et al., 2024). Clinicians graded texture at baseline, 1 week and 4 weeks.

Smoothness and texture changed significantly from baseline at both follow-up visits (P≤0.001). After 4 weeks, most participants reported satisfaction with how their skin felt, more confidence and less embarrassment. No significant adverse events were reported. Funding isn't stated in the abstract, but 3 of its 6 authors are listed at Galderma Laboratories, a skincare company, on the publisher's page.

Open-label means participants knew what they were using, which can influence self-ratings. Noncomparative means there was no placebo or other cream for reference. The 2025 review says urea, alpha hydroxy acids and beta hydroxy acids all show potential benefit, but that the overall evidence is constrained (Dampa, 2025). Evidence: Early / preliminary.

What strength of urea cream for keratosis pilaris has been tested?

The only strength tested in a dedicated study in our sources is 20%. No trial compares urea percentages head to head for KP, so we can't say that 10%, 20% or any other strength works best.

Urea's properties depend on concentration, but that general statement doesn't identify an ideal KP strength (McCormick et al., 2024). A higher percentage may sound stronger, yet no study in our sources shows that it clears KP better. Texture and base ingredients also haven't been compared for urea.

A 2025 review lists urea among the topical ingredients used to ease KP symptoms, and it also says there have been very few clinical studies (Kaur et al., 2025). Evidence: Early / preliminary.

Does lactic acid for keratosis pilaris work better?

We don't know, because no trial in our sources compares lactic acid with urea. Lactic acid does have broader support, including randomized data and wider use among dermatologists.

In the randomized trial, patients applied 10% lactic acid or 5% salicylic acid cream twice daily for 3 months (Kootiratrakarn et al., 2015). The mean reduction of the lesions from baseline, assessed clinically, was 66% and 52%, respectively. Skin conductance, a measure of surface hydration, rose in both groups and stayed improved at follow-up 4 weeks after treatment ended. Side effects were limited to mild local irritation.

The abstract gives no sample size, funding source or statistical test between the two creams. That means the 14-point gap can't be read as proof that lactic acid beat salicylic acid.

Mean lesion reduction from baseline after 3 months of twice-daily cream Source: Kootiratrakarn et al., Dermatol Res Pract, 2015 (randomized; sample size and between-group test not reported in abstract)

Show data table

Treatment	Mean lesion reduction (%)
10% lactic acid	66%
5% salicylic acid	52%

The 66% result can't be set against the urea study either. One assessed lesions over 3 months, while the other graded smoothness over 4 weeks.

Two reviews favor lactic acid. A 2025 systematic review of 27 articles named lactic and glycolic acids as the preferred topicals (Beyron, 2025). A 2022 review ranked lactic acid, salicylic acid and the 1064-nm Nd:YAG laser as seemingly the most effective and safe options for people 12 and older, while calling for high-quality long-term trials (Suástegui-Rodríguez et al., 2022).

Ammonium lactate, a pH-balanced source of L-lactic acid, also comes up in KP. A 2026 review lists KP among the conditions where clinical evidence supports it, but the record states no sponsor and gives no KP trial numbers, and the publisher page we could access doesn't show a funding or company-ties statement (Benjamin, 2026). Evidence: Limited.

How does urea for KP compare with lactic, glycolic and salicylic acid?

Urea for KP has less direct evidence than lactic or salicylic acid, while the glycolic acid data come from high-concentration (50% or 70%) acid applied to a test area, not home products. These results come from different study designs and outcomes, so the table below is not a ranking.

Ingredient	What was tested	Result	Tolerability	Main limits
Urea	20% cream once daily, 4 weeks, n=30 (McCormick)	Smoothness improved from baseline at 1 and 4 weeks (P≤0.001)	No significant adverse events	Open-label, no comparison group
Lactic acid	10% cream twice daily, 3 months (Kootiratrakarn)	66% mean lesion reduction from baseline	Mild local irritation	n not reported in abstract
Glycolic acid	50% or 70% applied to a test area, 4 sessions over 60 days, 25 recruited (Tian)	Effectiveness, by percentage of keratotic papules, went from 8% at day 20 to 60% at day 80	Described as relatively safe	High concentration; no difference from baseline at 5 years in 9 people
Salicylic acid	5% cream twice daily, 3 months (Kootiratrakarn)	52% mean lesion reduction from baseline	Mild local irritation	n not reported in abstract

The glycolic acid study treated a 50 cm² test area on days 0, 20, 40 and 60 (Tian et al., 2021). Effectiveness was reported as the percentage of keratotic papules in the test site, and melanin and skin lightness changed significantly from day 40. Skin hemoglobin on days 60 and 80 was statistically different from baseline; the abstract doesn't give a direction. The abstract describes no control group, and the authors declared no conflicts. If you're considering an in-office peel, our chemical peel aftercare guide covers recovery by depth.

Salicylic acid also served as the comparison in a 28-day, open-label randomized study of 60 people aged 18 to 35 (Liu et al., 2026). Participants used a salicylic acid body lotion or a papain scrub plus plant-oil lotion, and papule counts fell over time in both groups. There was no significant main group effect on water loss through the skin (p=0.287). Authors include staff from Shandong Huawutang Biotechnology Co. and the testing company EviSkin, although the paper declares no conflicts.

A planned 72-person trial will compare a similar scrub-and-lotion approach with 0.1% retinoic acid cream over 4 weeks (Du et al., 2026). Three of its authors are at Shandong Huawutang Biotechnology Co., and it has no results yet. If you're combining exfoliating acids, see whether salicylic and glycolic acid can be used together.

Key human studies of topical and peel treatments for keratosis pilaris

McCormick et al., J Drugs Dermatol, 2024	30 completed	4 weeks	20% urea cream once daily	Smoothness improved from baseline at 1 and 4 weeks (P≤0.001)
Kootiratrakarn et al., Dermatol Res Pract, 2015	Not reported in abstract	3 months plus 4-week follow-up	10% lactic acid vs 5% salicylic acid cream twice daily	Mean reduction of the lesions 66% vs 52% from baseline
Tian et al., World J Clin Cases, 2021	25 recruited; 9 at 5 years	80 days plus 5-year follow-up	50% or 70% glycolic acid applied to a test area on days 0, 20, 40 and 60	60% effectiveness at day 80; no significant difference from baseline at 5 years
Liu et al., J Cosmet Dermatol, 2026	60	28 days	Scrub plus plant-oil lotion vs salicylic acid body lotion	Papule counts fell over time in both groups

McCormick et al., J Drugs Dermatol, 2024Sample size: 30 completed · Length: 4 weeks · Dose: 20% urea cream once daily

Result: Smoothness improved from baseline at 1 and 4 weeks (P≤0.001)

Open-label, noncomparative study. 3 of 6 authors at Galderma Laboratories (publisher page); funding not reported in abstract. Evidence: Early / preliminary.

Kootiratrakarn et al., Dermatol Res Pract, 2015Sample size: Not reported in abstract · Length: 3 months plus 4-week follow-up · Dose: 10% lactic acid vs 5% salicylic acid cream twice daily

Result: Mean reduction of the lesions 66% vs 52% from baseline

Randomized comparison. Mild local irritation only. Funding not reported in abstract. Evidence: Limited.

Tian et al., World J Clin Cases, 2021Sample size: 25 recruited; 9 at 5 years · Length: 80 days plus 5-year follow-up · Dose: 50% or 70% glycolic acid applied to a test area on days 0, 20, 40 and 60

Result: 60% effectiveness at day 80; no significant difference from baseline at 5 years

No control group described in abstract. No conflicts declared. Evidence: Early / preliminary.

Liu et al., J Cosmet Dermatol, 2026Sample size: 60 · Length: 28 days · Dose: Scrub plus plant-oil lotion vs salicylic acid body lotion

Result: Papule counts fell over time in both groups

Open-label randomized study. Authors include staff from Shandong Huawutang Biotechnology Co. and EviSkin; no conflicts declared. Salicylic acid strength not reported in abstract. Evidence: Limited.

These studies used different outcomes, so their results can't be ranked against each other.

Evidence: Limited.

How was urea cream for keratosis pilaris used in studies?

This section describes what the trials did, not instructions for you. Before starting or changing a skin treatment, talk to a doctor, dermatologist or pharmacist, especially if you have sensitive skin or use other treatments.

Urea: participants in the 20% urea study applied the cream once daily to areas of KP for 4 weeks after a 5-day washout (McCormick et al., 2024).
Lactic and salicylic acid: the randomized trial had patients apply 10% lactic acid or 5% salicylic acid cream twice daily for 3 months (Kootiratrakarn et al., 2015).
Skin care basics: a 2023 review recommends hydrating skin, avoiding long baths or showers and using mild soaps or cleansers (Kodali et al., 2023).
Study length: results were measured over 4 weeks to 3 months, and a dermatologist survey reports that lesions often recur after stopping treatment.

No study in our sources tests urea plus an acid, the best time of day to apply either, or whether either works better on damp skin. Any layering or alternating schedule is clinic convention. For general product order, see our skincare routine order guide.

What KP studies measured, and when

Week 1
First urea checkpoint
Smoothness had changed significantly from baseline with 20% urea (McCormick).
Week 4
Urea study ends
Smoothness remained significantly changed, and most participants reported satisfaction (McCormick).
Week 12
Acid study endpoint
Mean lesion reduction reached 66% with lactic acid and 52% with salicylic acid (Kootiratrakarn).
Within 3 months of stopping
Recurrence reported
Over 60% of surveyed dermatologists saw lesions return after salicylic acid or over-the-counter moisturizer ended (Greenzaid).

How surveyed dermatologists approach keratosis pilaris

Use lactic acid as first-line therapy: 43.63%; Most-used first-line option
Use salicylic acid as first-line therapy: 20.72%; Second most used
Use laser therapy: 8.76%; Insurance and equipment limit use
Saw recurrence within 3 months: >60%; After stopping salicylic acid or OTC moisturizer

Greenzaid et al., J Drugs Dermatol, 2023 (16-question survey; number of respondents and funding not reported in abstract) PubMed record

A survey shows what clinicians do and perceive, not what a controlled trial proves. Evidence: Limited.

Is urea cream for keratosis pilaris safe?

In the only dedicated study, 20% urea cream was generally well tolerated, with no significant adverse events among 30 adults over 4 weeks (McCormick et al., 2024). That is too small and too short to establish long-term safety.

No study in our sources tests urea on irritated or broken KP skin, in children or during pregnancy or breastfeeding. If your skin already stings or feels raw, our guide to repairing a damaged skin barrier explains the wider issue, and a dermatologist can check what is happening.

KP can also look like other conditions, including lichen spinulosus, phrynoderma, ichthyosis vulgaris and trichostasis spinulosa (Kodali et al., 2023). That matters if the bumps don't match the usual pattern or don't respond to treatment. Evidence: Early / preliminary.

What can a dermatologist offer if topicals don't work?

Dermatologists can consider prescription topicals, lasers or other procedures. A 2023 review places topical retinoids and corticosteroids after keratolytics, with lasers and microdermabrasion for KP that doesn't respond to topicals (Kodali et al., 2023).

A 2022 systematic review of 47 articles named laser therapy, particularly the Q-switched Nd:YAG laser, as the most supported treatment, although outcomes varied among studies (Maghfour et al., 2022). A 2020 systematic review covered 17 light and laser studies with 175 patients and called these devices promising, while noting that KP still lacks an effective long-term treatment (Kechichian et al., 2020).

An injected non-cross-linked hyaluronic acid compound has also been tested in a split-body, investigator-blinded randomized trial with 4 sessions at 4-week intervals (Li et al., 2024). At 24 weeks after treatment, 71.43% of patients reported lasting improvement in roughness and 35.71% in redness. The abstract gives no sample size, and 3 of its 7 authors work in the medical department of a company, Imeik Technology, though the authors declared no conflicts. Evidence: Limited.

Where the evidence stops

Urea has no controlled KP trial in our sources. The dedicated study had no comparison group.
No urea vs lactic acid trial exists in our sources. The same is true for glycolic and salicylic acid.
No urea strengths have been compared for KP. We can't name a best percentage.
Long-term maintenance is largely unknown. The 2025 review describes sparse maintenance data (Dampa, 2025).
Texture and redness are rarely separated. The same review notes limited differentiation between these KP types, and the urea abstract reports no redness result.
No standard treatment approach exists. A 2025 systematic review says there is no standardized way to choose one treatment over another (Beyron, 2025).
The role of acids may be underestimated. A 2021 narrative review says their known impact is underestimated and that they work mainly by breaking down dead skin cells that clog follicles, but it reports no pooled effect size (Reddy et al., 2021).

FAQ

Does urea cream help keratosis pilaris?

It may. In a 4-week open-label study that 30 adults completed, a 20% urea cream used once daily significantly improved skin smoothness from baseline, but the study had no comparison group, so the result is preliminary.

What percentage of urea is best for keratosis pilaris?

No one knows, because no trial in our sources compares urea strengths head to head for keratosis pilaris. The only strength tested in a dedicated study was 20%, so that study cannot show whether a lower or higher strength works better.

How long does urea for KP take to work?

In the 30-person 20% urea study, smoothness had improved significantly from baseline at both the 1-week and 4-week visits. The study ended at 4 weeks, so longer-term results are unknown.

Is lactic acid better than urea for keratosis pilaris?

No trial in our sources compares the two directly, so nobody can say that one works better. Lactic acid has more support overall, including a 3-month randomized trial, two reviews that name it among preferred or most effective options, and wider use by dermatologists, while urea has one uncontrolled 4-week study.

Can you use urea and lactic acid together for KP?

No study in our sources tests urea and lactic acid together for keratosis pilaris. Any schedule that combines or alternates them is clinic convention, not trial evidence.

Will keratosis pilaris come back if I stop treatment?

It often does. In a dermatologist survey, over 60% of respondents saw lesions recur within 3 months of stopping salicylic acid or over-the-counter moisturizer, although no study in our sources measures recurrence after stopping urea.

Does urea cream help KP redness?

We don't know. The 20% urea study graded skin smoothness and texture, and its abstract reports no redness result, while a 2025 review says research rarely separates texture-dominant from redness-dominant keratosis pilaris.

Can children use urea cream for keratosis pilaris?

The urea study enrolled only adults aged 18 to 65, so it provides no data on children. Keratosis pilaris is more common in children and teenagers, so a pediatrician or dermatologist is the right person to ask.

References

Dampa E. The Effectiveness of Topical Keratolytics (Alpha Hydroxy Acids/Beta Hydroxy Acids/Urea) in Treating Keratosis Pilaris: A Review of the Literature. Cureus. 2025. Literature review; no financial support or conflicts declared. https://pubmed.ncbi.nlm.nih.gov/41631232/
McCormick E, et al. Evaluation of a Moisturizing Cream with 20% Urea for Keratosis Pilaris. J Drugs Dermatol. 2024. Open-label, noncomparative clinical study, n=30 completed, 4 weeks; 3 of 6 authors (Pham, Meckfessel, Emesiani) listed at Galderma Laboratories, L.P. on the publisher page; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/38206153/
Liu F, et al. An Innovative Formula for Keratosis Pilaris Treatment-A Randomized Controlled Study Based on the "Exfoliation-Dissolution-Repair" Concept. J Cosmet Dermatol. 2026. Open-label randomized study, n=60, 28 days; authors include staff from Shandong Huawutang Biotechnology Co. and EviSkin; no conflicts declared. https://pubmed.ncbi.nlm.nih.gov/41439609/
Du YJ, et al. Efficacy and safety of the Exfoliate-Dissolve-Repair skin care approach in the treatment of keratosis pilaris: a randomized controlled clinical trial study protocol. Trials. 2026. Trial protocol, planned n=72, 4 weeks; 3 authors at Shandong Huawutang Biotechnology Co.; no competing interests declared. https://pubmed.ncbi.nlm.nih.gov/41736049/
Greenzaid J, et al. Keratosis Pilaris: Treatment Practices of Board-Certified Dermatologists. J Drugs Dermatol. 2023. 16-question survey; number of respondents not reported; funding and company ties not reported in the abstract, and no disclosure statement on the accessible publisher page. https://pubmed.ncbi.nlm.nih.gov/37801530/
Suástegui-Rodríguez I, et al. Keratosis Pilaris Treatment: Evidence from Intervention Studies. Skinmed. 2022. Evidence review; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/35976015/
Maghfour J, et al. Treatment of keratosis pilaris and its variants: a systematic review. J Dermatolog Treat. 2022. Systematic review, 47 articles; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/32886029/
Beyron A. Keratosis pilaris: a systematic review of the literature and strategies for optimal treatment. Eur J Dermatol. 2025. Systematic review, 27 articles; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/41277649/
Kodali N, et al. Keratosis pilaris: an update and approach to management. Ital J Dermatol Venerol. 2023. Review; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/37166753/
Tian Y, et al. Clinical outcomes and 5-year follow-up results of keratosis pilaris treated by a high concentration of glycolic acid. World J Clin Cases. 2021. Clinical study, 25 recruited, 9 assessed at 5 years; no conflicts declared. https://pubmed.ncbi.nlm.nih.gov/34222434/
Reddy S, Brahmbhatt H. A Narrative Review on the Role of Acids, Steroids, and Kinase Inhibitors in the Treatment of Keratosis Pilaris. Cureus. 2021. Narrative review; no competing interests declared. https://pubmed.ncbi.nlm.nih.gov/34692268/
Kechichian E, et al. Light and Laser Treatments for Keratosis Pilaris: A Systematic Review. Dermatol Surg. 2020. Systematic review, 17 studies, 175 patients; funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/32804891/
Kootiratrakarn T, et al. Epidermal permeability barrier in the treatment of keratosis pilaris. Dermatol Res Pract. 2015. Randomized comparison, 3 months plus 4-week follow-up; n and funding not reported in abstract. https://pubmed.ncbi.nlm.nih.gov/25802513/
Benjamin L. INDIVIDUAL ARTICLE: Ammonium Lactate in Clinical Practice: Optimizing Treatment of Xerotic and Hyperkeratotic Skin Conditions. J Drugs Dermatol. 2026. Review; funding and company ties not reported in the abstract or on the accessible publisher page. https://pubmed.ncbi.nlm.nih.gov/42826155/
Kaur K, et al. Keratosis Pilaris Unveiled: Insights into its Origin, Management Strategies and Research Frontiers. Indian J Dermatol. 2025. Review; no conflicts declared. https://pubmed.ncbi.nlm.nih.gov/40918705/
Li Y, et al. Efficacy and safety of non-cross-linked hyaluronic acid compound in the treatment of keratosis pilaris: A split-body randomized clinical trial. J Cosmet Dermatol. 2024. Split-body, investigator-blinded RCT, 4 sessions, follow-up to 24 weeks; n not reported in abstract; 3 of 7 authors (Wang, Zou, Wu) from the medical department of Imeik Technology (a company); no conflicts declared. https://pubmed.ncbi.nlm.nih.gov/39177015/

Disclosure: This article is for general information only. It is not medical advice. Peptide Skincare has no affiliate links in this article and received no payment from any manufacturer mentioned. Keratosis pilaris is harmless but can look like other conditions; see a dermatologist if bumps are painful, spreading or not improving.

For educational purposes only; not medical advice. See our disclaimer and research method.