Keratosis pilaris

Keratosis pilaris is a common and harmless skin condition that involves the appearance of numerous small, rough bumps on the skin. Treatment to control or minimise symptoms may involve a range of skin care therapies.

The condition can occur any time from infancy into adulthood but is most prevalent during teenage years (affecting 50–80% of adolescents). Keratosis pilaris occurs more commonly in females than males and is often associated with eczema and/or dry skin.

Keratosis pilaris is not connected to any serious disease or ill health. For most people the condition subsides in adulthood. The exact cause of keratosis pilaris is unknown but a genetic origin is likely as it tends to run in families (30–50% of those affected will have a family history of the condition).

Symptoms

Keratosis pilaris causes numerous small bumps about the size of a grain of sand. These feel rough and look like permanent goosebumps or “chicken skin”. They usually do not hurt or itch. The bumps may be skin coloured, red, or brown. Often a small coiled hair is noticeable within the bump.

The outer aspect of the upper arm is the area most commonly affected by the condition but it can also affect the thighs, face, and buttocks. Less commonly, the forearms and upper back are affected.

Keratosis pilaris is thought to result from the build-up of keratin (a hard protein that protects skin) and surplus skin cells around a hair follicle, which forms a plug that blocks the opening of the hair follicle. Often a hair that gets trapped beneath the keratin plug. The condition is usually more severe in winter and during periods of low humidity.

Treatment

There is no cure for keratosis pilaris but it can be controlled. Many people achieve particularly good temporary improvement by following a regular skin care programme but treatment needs to be ongoing and usually requires a combination of therapies. Treatment options include:

• Moisturising creams to soften the skin – creams that contain exfoliators, such as urea, salicylic acid, lactic acid, or alpha hydroxy acids, which help to remove dead skin cells, may be most effective
• Prescription creams or gels containing retinoids, which increase the turnover of cells preventing keratin plugs forming in hair follicles. However, these are not suitable for young children and pregnant women
• Photodynamic therapy, pulse dye laser or intense pulsed light – this may reduce the redness but not the roughness
• Chemical peels, dermabrasion and microdermabrasion
• Laser-assisted hair removal
• Surgical extractions
• Exfoliating with pumice stone or a loofah
• Using non-soap cleansers.

References

Aiai, A.N. (2019). Keratosis pilaris (Web Page). Medscape Drugs and Diseases. New York, NY: WebMD LLC. http://emedicine.medscape.com/article/1070651-overview [Accessed: 08/05/20]
Oakley, A. (2015), Keratosis pilaris (Web Page). Hamilton: DermNet New Zealand. https://www.dermnetnz.org/topics/keratosis-pilaris/ [Accessed: 08/05/20]
O'Toole, M.T. (Ed.) (2017). Mosby's Dictionary of Medicine, Nursing & Health Professionals (10th ed.). St. Louis, MI: Elsevier.

Last Reviewed – July 2020

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