Keratosis Pilaris
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Overview
Keratosis pilaris is a common, benign skin condition characterized by the appearance of multiple small firm skin colored bumps on the lateral aspect of the upper arms and sometimes thighs. There can be surrounding redness. The bumps can resemble goose bumps and are sometimes referred to by the lay population as “chicken skin”. They can cause the skin to have a sandpapery feel when touched. These bumps can also be seen on the face along the outer cheeks in children. The asymptomatic bumps occur due to the harmless buildup of keratin in hair follicles. The condition usually improves with age and is a trait that is often seen in multiple family members. About 10% of the population carries this trait but there is an increased incidence in people with eczema (atopic dermatitis).
Diagnosis
The diagnosis of keratosis pilaris is easily made by a dermatologist based on its appearance. No biopsy is necessary. The diagnosis is further supported by obtaining a history of other family members with a similar condition.
Management
Treatment is not necessary but is often sought because of the rough feel, the bumpy appearance of the skin or the accompanying redness. The appearance and texture can be improved with the use of a topical moisturizing lotion that contains filaggrin-like peptides and ceramides (Cetaphil Restoraderm) or topical keratolytics such as moisturizing lotions that contain citric acid, alpha hydroxy acid (e.g. Eucerin plus lotion or cream), ammonium lactate (e.g. AmLactin 5% lotion or cream) or urea (e.g. Ureacin 10% lotion). These lotions are readily available over the counter without a prescription. Roughness and bumps reduce significantly after about 2 weeks with regular twice daily use. If improvement is not seen with these medicated moisturizers, a higher strength of these ingredients or prescription topical retinoids, which are commonly used for acne treatment, can be applied. Gentle physical exfoliation can also be performed for resistant lesions through in-office microdermabrasion. It is important to know that lotions need to be used regularly to keep the condition under control; if the lotions are stopped the bumps will become prominent with a delay of about 2 weeks. Redness usually reduces at the same time as the skin becomes smooth but if it persists, pulsed dye laser treatment may be pursued. Several sessions spaced 4 weeks apart are often necessary to completely remove redness. Results are long lasting.
Coping
Most people are assured by understanding the benign nature of the condition. However, when the appearance of these bumps or surrounding redness is disturbing, treatment may be started. Many will treat during the warmer months of the year when they wear short sleeves or in anticipation of an important event. In such cases, treatment should begin at least 2 weeks prior to the date. Some people will employ aggressive measures to remove the bumps of keratosis pilaris such as through use of a loofah sponge or through picking. Not only are they rarely effective, they are discouraged due to the risk of skin irritation.
Prevention
Keratosis pilaris is an inherited trait, therefore prevention is not possible at this time.
Keratosis Pilaris Blog
Please feel free to use the blog below to share information about Keratosis Pilaris, or to ask Dr. Ringpfeil a question that might be of interest to others.
Leave a Comment or a Question
I am 26 yrs old and have been treated for KP for years unsuccessfully. I have read about the Icolasz laser being successful in this treatment. Would be able to perform this laser treatment on me? I live in Richmond, but will be in northern Maryland where my family lives and would definitely make the trip. I have not been able to locate someone who is familiar with this in Richmond. (My sister went to Villanova so we are very familiary with the area.) Thank you.
Unfortunately, I have no experience with the efficacy of Isolaz on keratosis pilaris and therefore do not offer it. In contrast, pulsed dye laser treatments to reduce redness in conjunction with Cetaphil Restoraderm daily to soften the skin seems to be working much better than any of the keratosis pilaris kits or combinations with retinoids.
I have keritosis pilaris on the backs for my upper arms and my thighs. I’ve tried many products like KP Duty and Lac-Hydron, etc. My skin is smoother but the redness remains. Is there something to get rid of the redness?
Thank you.
Keratosis pilaris is a benign genetic trait affecting the skin of 10% of the population. It can occur in childhood but most often becomes apparent in adolescence. It shows as rough, red or pink hair follicles on the back of the arms, which are most commonly affected, although the back, thighs, and sides of the cheeks may also show these changes. Treatment is cosmetic as it is typically asymptomatic. Eucerin plus cream with 4% alpha hydroxy acid, LacHydrin or AmLactin cream with 12% lactic acid may be used and if effective will smoothen the skin after 2 weeks. If not sufficiently softened after 2 weeks, formulations containing 17% glycolic acid or higher such as keratosis pilaris kit by Glytone or other vendors and even Problem Dry Skin by Neostrata can be applied. The key in reducing the rough hair follicles is continuous treatment. Once treatment is discontinued, the trait recurs.
In some people, redness or pinkishness around hair follicles persist despite meticulous and continuous treatment, which has rendered the skin very smooth. Under these circumstances, redness reduction through pulsed dye laser treatments is appropriate. It appears that you fit the latter approach.