How to Treat Keratosis Pilaris

Keratosis pilaris is a highly common inherited follicular disorder manifested by the appearance of rough bumps on the skin and hence popularly referred to as "chicken skin" or "goose bumps".

Originally, they appear on the back and outer sides of the upper arms, but can also occur on thighs and buttocks or any body part except glabrous skin (like the palms or soles of feet). Worldwide, keratosis pilaris afflicts an estimated 40 to 50 percent of the adult population and approximately 50 to 80 percent of all adolescents. Varying in degree, keratosis pilaris can range from minimal to severe.

Keratosis pilaris tends to occur as excessive keratin, a biological fibrous protein in the skin found normally in human hair, nails and callus, accumulates around hair follicles (process called hyperkeratinization).

Keratosis pilaris is unattractive, and it most often appears as a group of small hard bumps that are seldom sore or itchy. Though patients with keratosis pilaris experience this condition year round, it's during the colder months when moisture levels in the air are lower that the condition can become worse and the 'goose bumps' will look and feel more marked in color and texture.

There are various different types of keratosis pilaris, including keratosis pilaris rubra (red, pronounced bumps), alba (rough, bumpy skin with no irritation), rubra faceii (red dots on the cheeks) and related conditions.

Keratosis pilaris alba is the more usual type and is characterized by small gray-white papules with a slight inflammatory component.

Keratosis pilaris rubra has an important inflammatory component, and thus sufferers present small red papules. This type is most perceptible during the winter months.

Cells that contain keratin are constantly being shed and replaced by new ones. The condition called dandruff results when the scalp sheds such cells. Hormonal influence may occur because a high frequency and intensity of keratosis pilaris is noted during adolescence and in women with hyperandrogenism. In severe cases, the pores can become blocked and produce acne. The clogged pores resemble comedones of keratinized plugs surrounding the hair follicle.

Treatment of Keratosis Pilaris

Many sufferers find keratosis pilaris lesions cosmetically unsightly and therefore seek treatment. Occasionally, they may become secondarily infected because of scratchy tight-fitting clothing or abrasive self-therapy, in which case treatment of the infection is necessary. An important inflammatory component may be present and may be alleviated with topical steroid therapy. Treatment of the noninflamed papules can be difficult because they have proven resistant to most modes of therapy.

Treatment alternatives for keratosis pilaris focus on exfoliating or softening the dermis to minimize blocked pores. Treatment initially begins with adherence to nonpharmacologic measures and compliance with daily living functions that will not worsen the condition. An important first step is to use a mild cleansing agent with abrasive properties, often termed scrub, but one that is not drying (for sensitive skin). The goal is to clean and open the pores of the dermis. Other measures to prevent excessive dryness include taking tepid, quick showers and applying a humidifier, especially during the winter months when low humidity dries out the skin.

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- Grace Empson