Keratosis Pilaris

What is keratosis pilaris?

Keratosis pilaris is a common skin condition that causes small, sandpaper-like bumps to appear on the upper arms, buttocks and thighs. It may make your skin look like you have “goose bumps.” The bumps are often the color of your skin, but may also look red or inflamed. They may itch, but they don’t hurt. If you have keratosis pilaris on your face, it may look like acne, and you may look flushed. The skin on your face may be dry and chapped.

The area of your skin that is affected by keratosis pilaris may become darker (hyperpigmentation) or lighter (hypopigmentation) than the surrounding skin. This can happen if you scratch or pick at the bumps, but it usually goes away with treatment.

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Who gets keratosis pilaris?

Keratosis pilaris can occur at any age and affect anyone, but it usually appears during the first 10 years of life. It generally affects women more often than men. It can worsen during pregnancy and after childbirth, or during puberty. Keratosis pilaris may disappear or improve with age.

Many people who have keratosis pilaris have a family history of it. About 40% of adults and 50% to 80% of adolescents have it.

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What causes keratosis pilaris?

Keratosis pilaris occurs when the protein (keratin) in dead skin cells plugs hair follicles (tiny duct-like openings) and causes the bumps to form. It is not caused by a fungus, bacteria or a virus. Keratosis pilaris is not contagious. It occurs more often in dry, winter months, and tends to improve in warmer months when humidity is higher.

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Tips to help improve the appearance of your skin:

Wash your skin gently. Avoid scrubbing the affected area of your skin. Use warm (not hot) water and a mild soap (some brand names: Cetaphil, Lubriderm, Purpose). Avoid deodorant or soaps with a strong fragrance.
Pat dry (don’t rub) your skin after showering or bathing.
Apply a moisturizer twice daily. Moisturizers that contain urea (some brand names: Eucerin, Lubriderm) are especially helpful because they soften dry, rough skin.
Use a humidifier to increase the humidity of your environment.

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How can my doctor tell if I have keratosis pilaris?

Your doctor will be able to tell if you have keratosis pilaris by looking at your skin and talking to you about your symptoms. Your doctor will examine your skin and rule out other medical conditions.

Some of the questions your doctor may ask you include:

When did you first notice the symptoms?
Do you have them all the time or do they come and go?
What seems to relieve your symptoms?
What seems to make them worse?
Does anyone in your family have a similar problem?

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How is keratosis pilaris treated?

There is no cure for keratosis pilaris, but certain medicines and home remedies can help (see side box). If home remedies aren’t effective, your doctor may suggest the following:

Lactic acid lotions to reduce roughness and soften the tiny plugs
Alpha hydroxy, or glycolic, acid lotions to reduce scaling and help the skin retain moisture
Urea creams to moisturize and soften the skin and help loosen dead skin cells
Salicylic acid lotion to soften and loosen dry, scaly or thickened skin
Topical corticosteroids to reduce itching
Topical retinoids, such as tretinoin, adapalene and tazarotene, to promote cell turnover and prevent hair follicles from plugging

You can’t prevent keratosis pilaris, but you can minimize your symptoms by following your doctor’s suggestions. It may be weeks to months before you see results, so be patient. Also, keep your treatment plan going even if the bumps go away. Keratosis pilaris often returns when treatment is stopped.

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