KERATOSIS PILARIS: OVERVIEW
Keratosis pilaris: This harmless skin condition causes tiny, rough-feeling bumps on the skin.
What is keratosis pilaris?
Keratosis pilaris is a common skin condition, which appears as tiny bumps on the skin. Some people say these bumps look like goosebumps or the skin of a plucked chicken. Others mistake the bumps for small pimples.
These rough-feeling bumps are actually plugs of dead skin cells. The plugs appear most often on the upper arms and thighs (front). Children may have these bumps on their cheeks.
Keratosis pilaris is harmless. If the itch, dryness, or the appearance of these bumps bothers you, treatment can help. Treatment can ease the symptoms and help you see clearer skin.
Treating dry skin often helps. Dry skin can make these bumps more noticeable. In fact, many people say the bumps clear during the summer only to return in the winter. If you decide not to treat these bumps and live in a dry climate or frequently swim in a pool, you may see these bumps year round.
Keratosis pilaris: The rough-feeling bumps can appear in many colors, including skin colored and white.
Keratosis pilaris: Signs and symptoms
This common skin condition causes tiny bumps that can:
- Feel rough and dry like sandpaper
- Resemble the skin of a plucked chicken or goosebumps
- Become more noticeable in winter or a dry climate
- Itch
- Appear in different colors, including the same color as your skin, white, red, pinkish purple (on fair skin), and brownish black (on dark skin)
Some people have a few flesh-colored bumps. Others have noticeable bumps that look like pimples or a rash.
Where keratosis pilaris appears
These bumps can appear anywhere on your skin, except on your palms and soles. Bumps on the arms are common. Most people will see these bumps appear in the following areas:
Children: Upper arms, thighs (front), and cheeks
Teens and adults: Upper arms, thighs (front), and buttocks
Some people develop so many bumps on their skin that the bumps extend to their lower legs and forearms.
Who gets keratosis pilaris?
People of all ages and races have this common skin condition. For most people, it begins at one of the following times:
- Before 2 years of age
- During the teenage years
Because keratosis pilaris usually begins early in life, children and teenagers are most likely to have this skin condition. Fewer adults have it because keratosis pilaris can fade and gradually disappear.
The bumps may clear by the time a child reaches late childhood or adolescence. Hormones, however, may cause another flare-up around puberty. When keratosis pilaris develops in the teenage years, it often clears by one’s mid-twenties.
Keratosis pilaris can also continue into one’s adult years. Women are a bit more likely to have keratosis pilaris.
What increases a person’s risk of getting keratosis pilaris?
You are more likely to develop it if you have one or more of the following:
- Close blood relatives who have keratosis pilaris
- Asthma
- Dry skin
- Eczema (atopic dermatitis)
- Excess body weight, which makes you overweight or obese
- Hay fever
- Ichthyosis vulgaris (a skin condition that causes very dry skin)
- Melanoma and are taking vemurafenib (Zelboraf®), a targeted therapy medicine approved to treat melanoma that has spread
When treating melanoma with vemurafenib
If you develop small, rough bumps while taking vemurafenib, you’ll likely see them within the first 8 weeks of starting the drug. The bumps may worsen as your dose increases; however, the skin tends to clear completely when you stop taking vemurafenib.
If the bumps on your skin bother you, applying one of the following can help while you are taking vemurafenib:
- Ammonium lactate cream or lotion (12%): Apply it as directed by your dermatologist.
- A moisturizer: A cream or ointment works best. Apply it after bathing and gently massage it into the skin with keratosis pilaris 2 or 3 times a day.
What causes keratosis pilaris?
Keratosis pilaris is not contagious. We get keratosis pilaris when dead skin cells clog our pores.
A pore is also called a hair follicle. Every hair on our body grows out of a hair follicle, so we have thousands of hair follicles. When dead skin cells clog many hair follicles, you feel the rough, dry patches of keratosis pilaris.
How do dermatologists diagnose keratosis pilaris?
To diagnose this condition, your dermatologist will examine your skin — looking closely at the skin that shows signs of keratosis pilaris.
How do dermatologists treat keratosis pilaris?
This skin condition is harmless, so you don’t need to treat it.
If the itch, dryness, or the appearance of your skin bothers you, treatment can help. A dermatologist can create a treatment plan that addresses your concerns. The following describes what a treatment plan may include:
Relieve the itch and dryness: A creamy moisturizer can soothe the itch and dryness. Most moisturizing creams used to treat keratosis pilaris contain one of the following ingredients:
- Urea
- Lactic acid
Diminish the bumpy appearance: To diminish the bumps and improve your skin’s texture, dermatologists often recommend exfoliating (removing dead skin cells from the surface of your skin). Your dermatologist may recommend that you gently remove dead skin with a loofah or at-home microdermabrasion kit.
Your dermatologist may also prescribe a medicine that will remove dead skin cells. Medicine that can help often contains one of the following ingredients:
- Alpha hydroxyl acid
- Glycolic acid
- Lactic acid
- A retinoid (adapalene, retinol, tazarotene, tretinoin)
- Salicylic acid
- Urea
The medicine you use to exfoliate your skin may also contain a moisturizer, which can help with the itch and dryness.
To treat the bumps, some patients may need to apply a corticosteroid to the areas with keratosis pilaris. This medicine helps soften the bumps and reduce redness.
Lasers may work when moisturizer and medicine fail: A laser or light treatment may be used to treat keratosis pilaris. Your dermatologist may recommend one type of laser to reduce the swelling and redness. Another type of laser may improve your skin’s texture and reduce discoloration, including the brown spots that may appear when the bumps clear.
To get the best results from the laser treatments, your dermatologist may add a few microdermabrasion sessions to your treatment plan.
Key facts about treatment: When treating keratosis pilaris, it helps to keep the following in mind:
- Clearing takes time. If you fail to see improvement after following your treatment plan for 4 to 6 weeks, tell your dermatologist.
- Some patients need to try a few treatments before they find one that works.
- To continue seeing results, you’ll need a maintenance plan.
About the maintenance plan: Treatment cannot cure keratosis pilaris, so you’ll need to treat your skin to keep the bumps under control. Your maintenance plan may be as simple as using the medicine twice a week instead of every day. Another option may be to switch to a non-prescription moisturizing cream.
What is the outcome for people with keratosis pilaris?
For many people, keratosis pilaris goes away with time — even if you opt not to treat it. Clearing tends to happen gradually over many years. There is no way to know who will see keratosis pilaris clear.