Introduction
Keratosis pilaris refers to a skin disorder that is common during pregnancy. However, it can also be seen in teenagers and babies. This condition usually worsens during the winter season and low-humid conditions, or during pregnancy and after childbirth. Variations in hormonal homeostasis (balance) during pregnancy can result in various skin conditions. Keratosis pilaris is also due to hormonal changes during pregnancy.
What Is Keratosis Pilaris?
Keratosis pilaris is a hyperkeratotic (thickening of the outer layer of the skin that is made of keratin, a protective protein) skin condition. It is characterized by tiny, painless bumps that present as skin-colored lesions surrounded by erythema (redness). These lesions often appear as a group of lesions on the upper arms, cheeks, thighs, and buttocks. The exact reason for the occurrence of keratosis pilaris is not known. These lesions are formed by dead skin cells that plug the hair follicles and appear red or brown in color. These lesions are not contagious, and they usually do not cause pain, itching, or discomfort. These lesions cannot be cured but can be prevented from getting worse.
What Are the Symptoms Associated With Keratosis Pilaris?
The common diagnostic symptom of this skin condition is its appearance. These visible tiny bumps resemble goosebumps or the skin of a chicken. The keratotic bumps can occur anywhere on the skin region with hair follicles and do not appear on the soles of the feet or the palms of the hands. Keratosis pilaris is common on the upper arms and thighs and can extend to the forearms and lower legs. Other associated symptoms include the following:
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Pinkness or redness around the bumps.
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Hard and rough bumps that feel like sandpaper.
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itchy and irritable skin.
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Bumps can be skin-colored, white, red, brown, pink, or black.
What Are the Causes Associated With Keratosis Pilaris?
The exact reason for keratosis pilaris is not known, but it can be due to the formation of ortho keratotic plugs (buildup of keratin) that blocks the pores and the opening of hair follicles, resulting in the formation of bumps that blocks the growing hair. A small hair emergence can be seen inside the bump. Though the exact etiology remains unknown, it is thought to be associated with genetic diseases and atopic dermatitis (a skin condition that causes patches of dry, itchy, and inflamed skin). In addition, studies have shown that hormonal imbalances can cause the development of keratosis pilaris. The subtypes of keratosis pilaris are sometimes a part of genetic diseases associated with neuro-cardio-facial-cutaneous syndromes, intellectual disability, RASopathies (mutations that alter the cellular proteins), ectodermal dysplasia (a condition that affects the teeth, hair, nails, sweat glands, facial structures, and other external structures of the body) and certain myopathies.
How Does Keratosis Pilaris Develop?
Excessive production of the skin protein keratin results in the formation of tiny, raised bumps in the skin, surrounded by redness. The color of keratin is the same as the skin tone of the individual. The excess keratin surrounds and blocks the hair follicles in the pore. This results in the formation of hard plugs called hyperkeratotic plugs. Many bumps contain ingrown hair as a result of hyperkeratinization that prevents the exit of the growing hair.
Why Is It Common in Pregnant Women?
Pregnancy hormones may trigger excessive sweating, leading to heat rashes or skin irritation. In addition, hormonal variations during pregnancy result in flare-ups of keratosis pilaris. Also, pregnant women with dry skin are prone to develop this condition. However, it can affect anyone susceptible to this condition. It is commonly seen in children and teenagers and often develops during late infancy or adolescence. Also, it subsides in the mid-20s, and in most cases, they are completely resolved by the age of 30. It is common in children, women, teenagers, and those with the following conditions:
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Dry skin.
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Ichthyosis (a condition in which the skin does not shed its dead cells).
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Eczema (a condition in which the skin is red, itchy, dry, and irritated).
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Hay fever (a seasonal disease that causes fever, irritation, inflammation of the nose, and other symptoms).
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Obesity.
How Is Keratosis Pilaris Diagnosed?
The diagnosis of keratosis pilaris depends on medical history and physical examination. It also includes the factors such as the age, appearance of the lesion, and the area affected. There is no specific test to diagnose keratosis pilaris. The healthcare provider diagnoses this condition based on the appearance of the skin and the symptoms described by the patient.
How Is Keratosis Pilaris Treated?
Keratosis pilaris is a harmless condition that cannot be cured and usually resolves on its own with age. Some treatment measures can help alleviate the appearance of the lesion, but it is usually treatment-resistant and improvement takes time.
Dermatologists may recommend a moisturizer to soothe dry skin and improve its appearance. Various prescription creams can help remove dead skin cells and prevent the blocking of hair follicles. Moisturizing treatments with urea and lactic acid can help soften the dry skin and dead cells, and remove them. Other treatment methods such as microdermabrasion (a minimally invasive procedure that is performed to remove the outer layer of the skin), chemical peels (a procedure in which high-strength chemical exfoliants are used to remove the outer layer of the skin), and retinol creams are used to remove the dead skin. Other experimental procedures, such as photopneumatic therapy (a light-based therapy) and vascular laser therapy (lasers are used to reduce the lesions and the erythema) are also available. However, the treatment during pregnancy focuses only on gentle methods to remove dead cells, dirt, and excess oil from the skin's surface.
How to Prevent Keratosis Pilaris?
Keratosis pilaris cannot be prevented, but a gentle skincare routine can prevent flare-ups and minimize the appearance of lesions. An oil-free moisturizer can help moisturize the skin and prevent the clogging of pores that cause the development of keratosis pilaris. Regular exfoliation with gentle scrubs can also help remove dead skin. Hydrating lotions help hydrate dry skin and also improve cell turnover.
Conclusion
Keratosis pilaris is a skin disorder that is common in pregnant women and people of young age. Though it cannot be cured, it resolves on its own in some cases. The skin changes during pregnancy can be an overwhelming period of rapid change. Many treatment options for keratosis pilaris are unsafe during pregnancy, and it is essential to discuss with the healthcare provider to know about gentle methods that treat dryness and skin bumps.
