Keratosis Pilaris

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Images of Keratosis Pilaris

Overview

Keratosis pilaris is a common skin condition in which individual hair follicles get plugged, causing small bumps. The bumps look and feel like "goose bumps" or chicken skin. It usually appears on the upper arms and legs. When it appears on the face it can be mistaken for acne. However, acne creams will not make the keratosis pilaris better and might aggravate the bumps. A common mistake that many people make is to try and scrub the bumps away, but this can make the condition worse. A doctor can recommend creams that can improve the keratosis pilaris, and it often goes away on its own.

Who's at risk?

Keratosis pilaris can affect anyone, though it is more common in children, teens, women and in people with any other kind of sensitive skin, such as eczema or ichthyosis vulgaris. Many people note that the condition is aggravated during the winter, when the air is cold and dry.

Signs and Symptoms

The most common locations for keratosis pilaris include:

  • Backs of the upper arms
  • Fronts of the thighs
  • Buttocks
  • Cheeks, especially in children
Tiny (1–2 mm) white to gray bumps occur, centered in the hair follicle. Sometimes, a thin red ring may surround the white bump, indicating inflammation. The bumps all look very similar to one another, and they are evenly spaced on the skin surface.

Rarely, people with keratosis pilaris may complain of mild itching.

Keratosis pilaris tends to improve in warmer, more humid weather, and it may worsen in colder, drier weather.

Self-Care Guidelines

There is no cure for keratosis pilaris, though its appearance can be improved. It is often helpful to keep the skin moist (hydrated) and to use mild, fragrance-free cleansers, with daily applications of moisturizer.

Creams and ointments are better moisturizers than lotions, and they work best when applied just after bathing, while the skin is still damp. The following over-the-counter products may be helpful:

  • Preparations containing alpha-hydroxy acids such as glycolic acid or lactic acid
  • Creams containing urea
  • Over-the-counter cortisone cream (if the areas are itchy)
Do not try to scrub the bumps away with a pumice stone or similar harsh exfoliant; these approaches may irritate the skin and worsen the condition. Similarly, try to avoid scratching or picking at the bumps, as these actions can lead to bacterial infections or scarring.

When to Seek Medical Care

Keratosis pilaris is not a serious medical condition and has no health implications. However, if self-care measures are not improving the appearance of the skin and it continues to bother you, see a dermatologist or another physician who may be able to recommend more aggressive treatments.

Treatments Your Physician May Prescribe

Many people with keratosis pilaris notice improvement over time. However, it is generally regarded as a long-lasting (chronic) skin condition. Treatments are aimed at controlling the rough bumps, not curing them. Keratosis pilaris bumps will come back if therapy is stopped.

To treat the bumps of keratosis pilaris, the physician may recommend a topical cream or lotion containing:

  • Prescription-strength alpha- or beta-hydroxy acids (glycolic acid, lactic acid, salicylic acid)
  • Prescription-strength urea
  • A retinoid such as tretinoin or tazarotene
  • High concentrations of propylene glycol
For keratosis pilaris that is itchy or inflamed, the doctor may recommend the short-term use of a topical corticosteroid to reduce the inflammation.

Trusted Links

Clinical Information and Differential Diagnosis of Keratosis Pilaris

References

Bolognia, Jean L., ed. Dermatology, pp.205-206. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp.486, 714, 1216. New York: McGraw-Hill, 2003.