Treatments for Keratosis Follicularis Spinulosa Decalvans

Keratosis follicularis spinulosa decalvans (KFSD) is an inflammatory scalp disorder. Hair follicles become clogged with hardened keratin plugs, resulting in progressively worsening hair loss. KFSD is an inherited condition, and it usually becomes evident during childhood.⁽²²⁾

Hair loss resembles patchy alopecia and may include eyebrows and eyelashes. Scalp hair loss is usually more prevalent in the vertex area. To prevent permanent scarring hair loss, treatment should begin in childhood. Pustule flare-ups often become infected with bacteria and need to be treated.^(23, 145)

Therapy Options for KFSD

KFSD is difficult to treat and outcomes are mixed.⁽²³⁾

Treatments that have shown success in some people include:

• Intralesional steroid shots⁽²³⁾
• Laser therapy⁽⁴⁶⁵⁾
• Oral antibiotics^(22, 145)
• Systemic drugs (e.g., dapsone)⁽¹⁴⁵⁾
• Systemic retinoids^(23, 145)
• Topical retinoids⁽²²⁾
• Topical steroids (mid to high potency)^{(22, 23, 145)}