How To Treat Keratosis Pilaris Bumps

What is Keratosis Pilaris

Keratosis pilaris is a common skin condition that causes dry, rough patches and tiny bumps, usually on the upper arms, thighs, cheeks or buttocks. Some say these bumps look like goosebumps or the skin of a plucked chicken. Others mistake the bumps for small pimples.

Keratosis pilaris is harmless. The bumps generally don’t hurt or itch and the condition is often considered a variant of normal skin. It can’t be cured or prevented. But you can treat it with moisturizers and prescription creams to help ease the symptoms and improve the appearance of the skin.

Symptoms

Keratosis pilaris can occur at any age, but it’s more common in young children. Signs and symptoms include:

  • Painless tiny bumps, typically on the upper arms, thighs, cheeks or buttocks
  • Dry, rough skin in the areas with bumps
  • Worsening when seasonal changes cause low humidity and skin tends to be drier
  • Sandpaper-like bumps resembling goose flesh
  • Appear in different colors, including the same color as your skin, white, red, pinkish purple (on fair skin), and brownish black (on dark skin)

These bumps can appear anywhere on your skin, except on your palms and soles. Bumps on the arms are common. Most people will see these bumps appear in the following areas:

Children: Upper arms, thighs (front), and cheeks

Teens and adults: Upper arms, thighs (front), and buttocks

Some people develop so many bumps on their skin that the bumps extend to their lower legs and forearms.

Causes

Keratosis pilaris results from the buildup of keratin — a hard protein that protects skin from harmful substances and infection. The keratin forms a scaly plug that blocks the opening of the hair follicle. Every hair on our body grows out of a hair follicle, so we have thousands of hair follicles. When dead skin cells clog many hair follicles, the result is patches of rough, bumpy skin.

It is not known exactly why keratin builds up. But it may occur in association with genetic diseases or with other skin conditions, such as atopic dermatitis. Dry skin tends to worsen this condition and make these bumps more noticeable. In fact, many people say the bumps clear during the summer only to return in the winter. If you decide not to treat these bumps and live in a dry climate or frequently swim in a pool, you may see these bumps year round.

Who Gets Keratosis Pilaris

People of all ages and races have this common skin condition. For most people, it begins at one of the following times:

  • Before 2 years of age
  • During the teenage years

Because keratosis pilaris usually begins early in life, children and teenagers are most likely to have this skin condition. Fewer adults have it because keratosis pilaris can fade and gradually disappear.

The bumps may clear by the time a child reaches late childhood or adolescence. Hormones, however, may cause another flare-up around puberty. When keratosis pilaris develops in the teenage years, it often clears by one’s mid-twenties.

Keratosis pilaris can also continue into one’s adult years. Women are a bit more likely to have keratosis pilaris.

What Increases a Person’s Risk of Keratosis Pilaris

You are more likely to develop it if you have one or more of the following:

  • Close blood relatives who have keratosis pilaris
  • Asthma
  • Dry skin
  • Eczema (atopic dermatitis)
  • Excess body weight, which makes you overweight or obese
  • Hay fever
  • Ichthyosis vulgaris (a skin condition that causes very dry skin)
  • Melanoma and are taking vemurafenib (Zelboraf®), a targeted therapy medicine approved to treat melanoma that has spread

Diagnosis

You generally won’t need to see a doctor or esthetic professional for keratosis pilaris. If you do visit a professional, s/he will be able to diagnose the condition by looking at the affected skin. No testing is needed.

Treatment

Gradually, keratosis pilaris usually clears up on its own. In the meantime, you can make it look a lot better; the basic premise of treatment is hydrating the skin and using exfoliating ingredients to remove the dead skin cells. And while treatments range from lotions to scrubs and more, don’t hesitate to make an appointment with a licensed esthetician, or board-certified dermatologist if you’re unsure about what options are best for you.

  • Creams to remove dead skin cells. Creams containing alpha hydroxy acid, lactic acid, salicylic acid or urea help loosen and remove dead skin cells. They also moisturize and soften dry skin. Depending on their strength, these creams (topical exfoliants) are available over-the-counter or with a prescription. Your esthetician or doctor can advise you on the best option and how often to apply. The acids in these creams may cause redness, stinging or skin irritation, so they aren’t recommended for young children.
  • Creams to prevent plugged follicles. Creams derived from vitamin A (topical retinoids) work by promoting cell turnover and preventing plugged hair follicles. Tretinoin (Retin-A, Renova, Avita) and tazarotene (Avage, Tazorac) are examples of topical retinoids. These products can irritate and dry the skin. Also, if you’re pregnant or nursing, your doctor may suggest delaying topical retinoid therapy or choosing another treatment.

Using medicated cream regularly may improve the appearance of the skin. But if you stop, the condition returns. And even with treatment, keratosis pilaris tends to persist for years.

Lifestyle and Home Remedies

Self-help measures won’t prevent keratosis pilaris or make it go away. But they may improve the appearance of the affected skin.

The first rule of keratosis pilaris is, do not pick at your KP. While it can be tempting to treat KP bumps like you would a pimple. Picking leads to scarring and can eventually lead to hyperpigmentation. You will also want to avoid drying your skin out further than you need to: Minimize soap on the affected area as that can be harsh on the skin, avoid hot showers, and moisturize damp skin immediately after shower.

The key to managing the bumps is by exfoliating, but it’s crucial to use chemical exfoliants instead of physical ones. Look for treatments that will break down the skin’s superficial barrier. This means stocking up on acids and other products that help your skin exfoliate like it should, and break down the skin-cell bumps that have built up around your hair follicles. Lactic acid, urea, salicylic acid, and retinoids. It is possible to overexfoliate, however; you’ll know you overdid it when your skin gets red and irritated. That’s why it’s best to start slowly, and only use one acid at a time.

If you’re new to the wild world of retinol, it’s important to begin slowly. For KP bumps on your face, we suggest starting with a very light percentage topical retinoid as you don’t want to get too dry. Some people prefer to take days off between retinol applications; others prefer layering a retinoid product between two applications of a hydrator to buffer any side-effects. As far as KP patches on your body, you can be more aggressive; try diluting a retinoid in a lactic acid moisturizer for a one-two punch.

Because people with KP tend to have dry skin, and retinols and acids dry your skin even further, it’s crucial to combat that dryness with plenty of moisture. Contrary to popular belief, moisturizers don’t technically moisturize your skin directly, but rather they lock existing moisture into the skin. Drinking plenty of water is always helpful, as are the heavy-duty moisturizers other people might refer to as “winter” products.

Cutting out inflammatory food groups like gluten and dairy can also help by reducing inflammation as well as the activation of your immune system.

Here are some additional recommendations.

  • Use warm water and limit bath time. Hot water and long showers or baths remove oils from the skin. Limit bath or shower time to about 10 minutes or less. Use warm, not hot, water.
  • Be gentle to the skin. Avoid harsh, drying soaps and those with strong fragrance (the perfumes used in these products can dry out the skin). Gently remove dead skin (exfoliate) with a MicrodermaMitt or loofah and SAL3 Soap. Vigorous scrubbing or removal of hair follicle plugs may irritate the skin and aggravate the condition. After washing or bathing, gently pat or blot the skin with a towel so that some moisture remains.
  • Try medicated creams. Apply an over-the-counter cream that contains urea (Excipial, Eucerin), lactic acid (AmLactin, CeraVe), alpha hydroxy acid, salicylic acid or glycolic acid (Glytone Exfoliating Body Lotion, Cane and Austin Retexturizing Body Pads). These creams help loosen and remove dead skin cells. They also moisturize and soften dry skin. Put on this product before moisturizer.
  • Moisturize. While the skin is still moist from bathing, apply a moisturizer that contains lanolin (Lansinoh, Medela). Thicker moisturizers work best, such as First Aid Beauty Ultra Repair Cream, Eucerin and Cetaphil. Reapply the product to the affected skin several times a day.
  • Use a humidifier. Low humidity dries out the skin. A portable home humidifier (Levoit, Tekjoy) or one attached to your furnace will add moisture to the air inside your home.
  • Avoid friction from tight clothes. Protect affected skin from the friction caused by wearing tight clothes.

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