Keratosis Pilaris Rubra Faciei: Assessing the Unmet Therapeutic Need.

BACKGROUND

Keratosis pilaris rubra faciei (KPRF) is a clinical variant of keratosis pilaris characterized by prominent facial erythema and follicular papules that can cause significant aesthetic concern. The condition is underrecognized, frequently self-diagnosed, and lacks established evidence-based treatment guidelines.

OBJECTIVE

To characterize the demographics, diagnostic pathways, treatment experiences, and psychosocial impact among individuals with KPRF and to explore perceived responses to commonly used therapies, including topical sirolimus.

METHODS

A 24-item survey was distributed to members of a Reddit-based KPRF support group. Survey domains included demographics, diagnostic history, symptom triggers, treatments trialed, and mental health impact. Descriptive statistics were calculated using RStudio.

RESULTS

Seventy-nine respondents completed the survey. Most were men (73.4%) aged 18 to 30 years (70.9%) and resided outside the United States (69.6%). Symptom onset typically occurred before age 18, though diagnosis was frequently delayed; 38% reported self-diagnosis with social media input. The face was the most affected site (98.7%). Nearly all participants (98.7%) reported a negative impact on mental health. Common treatments included pulsed dye laser, topical keratolytics, retinoids, and topical sirolimus. Among participants who used compounded topical sirolimus, 75% reported improvement during treatment.

LIMITATIONS: The primary limitations of this study include the relatively small sample size and potential response bias inherent in self-reported survey data.

CONCLUSION

KPRF is associated with delayed diagnosis, frequent reliance on social media for information, and substantial psychosocial burden. Self-reported improvement with topical sirolimus highlights the need for controlled studies and greater clinical awareness of this underrecognized condition.