What is Keratosis Pilaris?

According to skin care expert, René Serbon, Keratosis Pilaris (commonly referred to as KP) is a keratolytic skin disorder.

Most often seen on the outer upper arms, but can occur on the thighs and cheeks, and less frequently on the forearms and upper back. The condition presents as numerous rough follicular spots that can be skin colored, red, or brown.

The bumps generally don’t hurt or itch. The transition of vellus hair to terminal hair may be an aggravating factor to why this condition often develops in teenage year indicative of a hormonal trigger such as androgen.

Vellus hair, twisted into a spiky keratolytic plug, emerge from the dilated opening of the pilosebaceous duct, can become discolored with pigment or inflammation or both.

In layman's terms - KP is that red, bumpy skin that is annoying at best and is often referred to as, "chicken skin."

At What Age Does KP Appear?

KP is also most evident during teenage years, however; it can be present in babies and persist into adulthood usually disappearing by age 30. It can be particularly prevalent in those who are overweight.

My youngest son has had KP on his arms since birth. Anyone who has ever touched his arms, always remarks on the bumps.

Is KP Genetic?

When I was in my teens and first realized that my skin was not like my friends, I began to notice my mom's skin was exactly the same. And some of her siblings also had this bumpy skin.

Now a mom myself, I have come to understand that KP is familial. My son's have it, as well as atopic dermatitis and eczema.

Serbon explained to me, "There is a genetic predisposition. In individuals with a history of eczema, atopic dermatitis or ichthyosis a genetic filaggrin gene deficiency might be present."

She also told me, "People with a very fair skin and red hair, e.g. Celtic background are also prone." And this makes sense. While we don't have red hair, both their father and myself are Irish (my mom's side of the family is Irish as well.)

Can You Get Keratosis Pilaris on Your Face?

While the bumps are commonly on your upper arms, thighs, and buttocks, it can also present on your face, although it is not as common.

What Are the Symptoms of KP?

As described above, the symptoms largely surround the presentation of numerous small rough bumps on the skin, is typically dry, and can occur in patches. The biggest complaint of those who have KP is the appearance of their skin.

Although, the majority of the medical literature describe sufferers of KP as symptom-free, others support that itching can occur and, less commonly, redness and swelling can be a potential problem. Especially if you are not proactively exfoliating and moisturizing your skin regularly.

Note, that there are times of the year or certain climates that can cause KP to worsen (ie: in weather that promotes dryness it can worsen, in weather that promotes moisture it tends to subdue). KP is not associated with pain or progression of symptoms (ref: Keratosis pilaris, 2).

Should one suspect that they have KP, but see an uncomfortable worsening or progression of symptoms, be sure to consult your physician to determine if there is a need to see a dermatologist or if the doctor feels that any of the associated skin conditions that may co-occur with KP are present.

“Keratosis pilaris is often described in association with other dry skin conditions such as ichthyosis vulgaris, xerosis, and, less commonly, with atopic dermatitis, including conditions of asthma and allergies” (ref: Alai, 1).

Are There Times of the Year When KP is More Prominent?

In the winter months or times of low humidity there is fast trans epidermal water loss (TEWL), Keratosis pilaris tends to be more severe.

Does KP Ever Go Away?

Dr. Hannah Sivak, PhD Founder of Skin Actives Scientifis, says yes. "As we age, the skin gets thinner and KP goes away." Serbon agrees, stating that it persists into adulthood and usually disappears by age 30.

At 45, my KP has yet to disappear, although it is not nearly as bad as it was in my teens and twenties.

But what can those of us do until it actually resolves itself decades from when it started?

Keratosis Pilaris Treatment

First and foremost, Serbon recommends reducing sun exposure to reduce keratinization.

Enzyme treatments, lotions that contain lactic acid or ammonium lactate and daily use of vitamin A in creams or lotions help to reduce KP, according to Serbon.

For those who have KP on their face, Dr. Sivak recommends products with ingredients such as alpha hydroxy acids, salicylic acid (also called "beta hydroxy"), and vitamin A.

There are surgical treatments that can be done to treat KP, although it's not something I will address in this article.

At home therapies are not a cure, however they can help to reduce KP flare ups and will help to minimize the appearance of it. These are otherwise known as home remedies or over the counter treatments.

Physical and Chemical Exfoliation

To smoothe out skin and help to "unplug" the keratin build up in the hair follicle, you need to exfoliate a few times per week.

For Face: Skin Actives Alpha-Beta Exfoliant Solution: Chemical is not a bad word here, as alpha and beta hydroxy acids exfoliate skin. This is a great way to to keep follicles (and pores) on your face, exfoliated of build up. I don't have KP on my face personally, but I use this exfoliant to keep blackheads on my nose and chin at bay.

For Body: A Girl's Gotta Spa! Energizing Citrus Salt Scrub: Manually exfoliate and smooth your arms and legs by massaging affected areas with Dead Sea Salt. You also get the added bonus of hydration from sunflower and safflower seed oils.

Creams to Exfoliate

Creams containing alpha hydroxy acid, lactic acid, salicylic acid or urea help loosen and remove dead skin cells.

For Face: Paula's Choice Skin Perfecting 8% AHA Lotion Exfoliant: With 8% glycolic acid mixed with plant-soothing botanicals, skin is exfoliated without scrubbing and nourished at the same time.

For Body: AmLactin Lotion: This lotion has lactic acid in it, so it both exfoliates and hydrates skin.

Lotions to Keep Skin Hydrated

After removing the build-up of dead skin cells from the hair follicles, it's important to keep skin moisturized at all times, as it is the lack of moisture that creates the dry skin that lends to the cycle of build up.

It's especially important to be dilligent with this two-step process if you live in a dry climate and during seasonal dryness (like Fall and Winter.)

For Face: heritage & terre Prickly Pear Seed Oil: While not a lotion, this serum nourishes like a dream. 2-3 drops of this cold-pressed Moroccan cactus oil is all it takes to keep skin hydrated because it is very high in linoleic acid.

For Body: A Girl's Gotta Spa! Energizing Citrus Body Lotion: Olive oil, shea butter and cocoa butter create a trifecta of hydration (and pairs perfectly with the body scrub.) Olive oil is an emollient and has fatty acids (oleic, palmitic, and linoleic) that work wonderfully on the skin. Shea and Cocoa Butter are both humectants and emollients. Your skin will never be left feeling dry.

Sylveco Birch Moisturizing Body Balm - This lotion contains grapeseed oil (an emollient), aloe, Vitamin E and betulin from the bark of birch trees. It's both soothing and hydrating.

Sidenote: I used this lotion from Sylveco on my teen son, who has atopic dermatitis on his elbows, with amazing results - stay tuned for that review!

kosmatology Goody-Goody Grapefruit Lotion Bar: If you've been reading this blog since its inception in 2005, it all began with a lotion bar. This one from kosmatology comes in a handy twist-up tube with ingredients like shea butter, coconut oil, and olive oil in Candelilla wax.

All of the above won't prevent or make this skin condition go away. It will only improve the appearance and help you to manage it better.

If moisturizing and other self-care measures don't help, your doctor may prescribe medicated creams.

Things to Avoid if You Have KP

This article is in no way meant to diagnose and treat a skin condition. Speak to your dr., who will know your whole health history.

References:

1. Alai A., MD, FAAD. “Keratosis Pilaris Treatment and Management.” emedicine.
2. “Keratosis pilaris.” WebMD.
3. René Serbon, Skin Expert.
4. Dr. Hannah Sivak, PhD Founder of Skin Actives Scientifis.

Co-written with Courtney Smith, BSN.