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Keratosis Pilaris: Causes, Symptoms & Treatment

Keratosis pilaris is a common, harmless skin condition causing small, rough bumps on the skin. It most often affects the upper arms, thighs, and cheeks.

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Things worth knowing about "Keratosis pilaris"

Keratosis pilaris is a common, harmless skin condition causing small, rough bumps on the skin. It most often affects the upper arms, thighs, and cheeks.

What is Keratosis Pilaris?

Keratosis pilaris (also known as lichen pilaris or colloquially as "chicken skin") is a very common, benign skin condition. It occurs when excess keratin – a structural protein found in the skin – builds up inside hair follicles, forming small, rough plugs. This gives the skin a sandpaper-like texture. The condition is neither contagious nor medically dangerous, and it does not carry any serious health risks.

Causes

The exact cause of keratosis pilaris is not fully understood, but the following factors are known to play an important role:

Genetic predisposition: The condition frequently runs in families and follows an autosomal dominant inheritance pattern.
Excess keratin production: An overproduction of keratin clogs hair follicles and leads to the characteristic bumps.
Dry skin: Cold weather, low humidity, and dry indoor air can worsen symptoms.
Atopic conditions: Individuals with atopic dermatitis (eczema) or asthma have a higher likelihood of developing keratosis pilaris.

Symptoms

The symptoms of keratosis pilaris are typically easy to recognize and include:

Small, rough, raised bumps on the skin that may appear whitish, reddish, or skin-colored
Sandpaper-like skin texture, most noticeable when touched
Occasional mild redness or irritation around the bumps
Dry, sometimes flaky skin in affected areas
Mild itching in some cases

The most commonly affected areas are the outer upper arms, thighs, buttocks, and, in children, the cheeks.

Diagnosis

Keratosis pilaris is typically diagnosed through a clinical skin examination by a dermatologist. The characteristic appearance of small follicular bumps is usually sufficient for a clear diagnosis. Additional investigations such as a skin biopsy are rarely necessary and are only performed in cases of diagnostic uncertainty.

Treatment

Keratosis pilaris cannot be cured, but symptoms can be significantly improved with the right approach:

Moisturizing

Regular use of emollient creams and lotions is the most important basic measure. Products containing urea, glycerin, or lactic acid are especially effective at deeply moisturizing the skin and helping to dissolve keratin plugs.

Keratolytic Agents

Creams and lotions containing ammonium lactate, salicylic acid, or alpha hydroxy acids (AHAs) help gently exfoliate dead skin cells and keep hair follicles clear.

Retinoid Creams

In more persistent cases, a dermatologist may recommend prescription-strength retinoid creams, which help normalize skin cell turnover and reduce follicular plugging.

Gentle Exfoliation

Regular, gentle mechanical exfoliation using a soft body sponge or brush can help remove dead skin cells. Harsh scrubbing should be avoided, as it can further irritate the skin.

Laser Treatment

For significant redness or cosmetically bothersome changes, laser therapy performed by a dermatologist may be considered to reduce redness and improve the overall appearance of the skin.

Course and Prognosis

Keratosis pilaris is a chronic but harmless condition. In many individuals, symptoms improve naturally during adulthood. With consistent skin care and targeted treatment, the appearance of affected skin can be noticeably improved. Symptoms may be more pronounced during winter months or in environments with dry indoor air.

References

Berk, D.R. & Bayliss, S.J. (2012). Keratosis pilaris: An overview. Pediatric Dermatology, 29(4), 425-428. Available via PubMed.
Leung, A.K.C., Barankin, B., Lam, J.M. & Leong, K.F. (2023). Keratosis pilaris: An updated review. Drugs in Context, 12, 2023-4-3.
American Academy of Dermatology (AAD). Keratosis pilaris: Overview and treatment recommendations. Available at: www.aad.org

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