What Is Keratosis Pilaris?
Keratosis pilaris is a benign skin disorder characterized by dry, rough patches and small bumps, mainly on the cheeks, upper arms, thighs, or buttocks. These bumps usually do not hurt or itch. Keratosis pilaris is sometimes called “chicken skin” because it resembles goosebumps. It commonly occurs in babies, toddlers, children, and teenagers, and the condition often worsens around puberty. However, it usually fades by age 30. Keratosis pilaris is not contagious. It is a harmless one of several types of skin bumps and growths. This condition is often considered a variant of normal skin. However, it cannot be cured or prevented. But moisturizers and prescription creams can help improve the skin appearance.
How Common Is Keratosis Pilaris?
Keratosis pilaris is a common condition. It is considered a skin type instead of a medical condition. About 50 % to 80 % of teenagers and 40 % of adults develop the condition at some point in their lifetime.
What Causes Keratosis Pilaris?
The bumps in keratosis pilaris are collections of keratin. These bumps are often confused for clusters of small pimples. Instead, keratosis pilaris bumps occur when keratin blocks the openings of the hair follicles, causing dry, rough patches and small bumps. It is still unclear why keratin builds up in some people with keratosis pilaris and not others. It may be associated with a genetic disease or skin conditions like atopic dermatitis. Keratosis pilaris may be related to vitamin A deficiency.
What Are the Symptoms of Keratosis Pilaris?
The main characteristic feature of keratosis pilaris is the appearance of patches of small, rough, painless, discolored bumps on the skin.
The other signs and symptoms include:
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Dry or itchy skin, especially on the face, forearms, chest, back, thighs, and buttocks.
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Irritation of the bumps makes them more discolored and observable (frictional lichenoid dermatitis).
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Rough, sandpaper-like skin where bumps appear, resembling goose flesh.
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Worsening of the bumps in dry air and low humidity, like in the winter seasons.
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Other cutaneous conditions can sometimes cause these symptoms, such as dry, itchy skin. These include eczema, psoriasis, allergies, and fungal infections.
What Are the Risk Factors for Keratosis Pilaris?
Keratosis pilaris can affect people of any age, but it is more common in babies, toddlers, children, and teenagers. In addition, some people with certain conditions are at a higher risk of developing this condition.
These include:
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Family history of keratosis pilaris.
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Fair or light-skinned.
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Skin conditions, such as eczema or ichthyosis vulgaris.
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Asthma.
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Hypothyroidism.
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Cushing’s syndrome.
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Down syndrome.
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Obesity.
How Is Keratosis Pilaris Diagnosed?
The healthcare provider typically diagnoses keratosis pilaris with a simple physical examination of skin that shows signs of keratosis pilaris. Keratosis pilaris is easily recognized, so no laboratory testing is necessary. The location and characteristic features of the bumps can help the provider identify the condition. But if the healthcare provider is unsure, they may recommend an allergy test or a biopsy.
How Is Keratosis Pilaris Treated?
Keratosis pilaris is harmless and usually clears up on its own gradually. So usually, no treatment is needed. For most people, the bumps go away on their own or become less noticeable by age 30. Some people may also notice that the bumps disappear in summer and only become noticeable in winter. In the meantime, one may use moisturizers, creams, and other products available to help improve the skin's appearance. If these self-care measures do not help, the doctor may prescribe any of the following treatments:
1. Medications:
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Over-The-Counter Moisturizing Lotions: Dry skin can worsen keratosis pilaris. Applying over-the-counter creams or lotions can help keep the skin hydrated and minimize and soften the bumps. Moisturizers containing ammonium lactate, alpha hydroxyl acids, lactic acid, and salicylic acids are the best to treat rough, bumpy skin and people with keratosis pilaris. Apply these moisturizers several times daily, especially after showering while the skin is still damp, to lock in the moisture. However, the acids in these moisturizers can cause stinging, redness, or skin irritation, so they are not recommended for young children.
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Medicated Creams: The healthcare provider may recommend prescription-strength moisturizers. Creams with ingredients such as urea, alpha hydroxy acids, salicylic acid, and glycolic acid can help improve the symptoms of keratosis pilaris. In addition, medicated Vitamin A creams (topical retinoids) can help decrease the keratin buildup that causes keratosis pilaris. However, overuse of these medicated creams can irritate the skin.
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Exfoliation: Gently wash the affected areas of the skin while showering or bathing with a loofah, washcloth, or exfoliating gel or scrub in small, circular motions. Avoid scrubbing too hard as it irritates the skin and worsens the symptoms.
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Laser Therapy: A laser or light treatment may help improve the skin's discoloration and texture and reduce swelling and redness associated with keratosis pilaris. The dermatologist sometimes may add a few microdermabrasion sessions to the treatment plan to get the best results.
2. Lifestyle Changes and Home Remedies:
Self-help practices do not prevent keratosis pilaris or make it disappear. But these practices help enhance the appearance of the affected skin. In addition, a few simple things can help keep the skin comfortable:
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Use warm water and take shorter showers (10 minutes or less) as hot water and long showers or baths remove natural oils from the skin.
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Avoid using harsh, drying soaps, and be gentle to the skin. For example, gently pat the skin with a towel after showering or bathing to retain moisture.
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Apply over-the-counter creams containing urea, lactic acid, alpha hydroxy acid, or salicylic acid to loosen and remove dead skin cells.
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While the skin is still moist from bathing, generously apply a moisturizer containing lanolin, petroleum jelly, or glycerin. These ingredients help soothe dry skin and lock in moisture. Reapply the moisturizer to the affected skin many times a day daily.
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Because low humidity makes skin dry, use a humidifier to add moisture to the air inside the home.
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Avoid wearing tight clothes. Protect the affected skin from friction by wearing loose clothes.
What Is the Outcome for People With Keratosis Pilaris?
Most cases of keratosis pilaris usually clear around the mid-20s and completely disappear by age 30 without treatment. With treatment, people start seeing improvement within four to six weeks. Keratosis pilaris is not preventable. But avoiding dry skin by following a gentle skincare regimen can help improve the appearance of keratosis pilaris.
When to See a Doctor?
See a health care provider if people do not see improvement four to six weeks after initiating a treatment plan or if the keratosis pilaris affects their self-esteem or quality of life.
Conclusion
Keratosis pilaris is often a temporary skin condition that goes away over time. It usually does not cause any symptoms. But if a person experiences discomfort like itchy or dry skin, or if it affects their self-esteem, reach out to a healthcare provider. Treatment for keratosis pilaris involves medications, lifestyle modifications, and home-based remedies. See a health care provider if no improvement is seen in four to six weeks after initiating a treatment plan.
