Keratosis Pilaris – Symptoms, Causes and Treatment

Keratosis pilaris is a very common benign skin condition appearing as small, whitish bumps on the upper arms and thighs, especially of children and young adults. Individual lesions of keratosis pilaris arise when a hair follicle becomes plugged with keratin, a protein found in skin, hair, and nails. Keratosis pilaris is most obvious during the teenage years. It may also be present in babies and persist into adult life. However, it is uncommon in elderly people. Keratosis pilaris is particularly prevalent in those who are overweight, or have celtic backgrounds, atopic dermatitis or ichthyosis. Keratosis pilaris tends to be more severe during the winter months or other times of low humidity when skin dries out. Although unsightly at times, it is completely harmless.

Many people are bothered by the goose flesh appearance of keratosis pilaris, but it doesn’t have long-term health implications and occurs in otherwise healthy people. Keratosis pilaris usually resolves without treatment. But if you’re concerned about the appearance of your skin, your doctor can help you determine the best course of treatment, which includes self-care measures and medicated creams.

Symptoms

The symptoms of keratosis pilaris are based on the development of small white papules the size of a grain of sand on the upper arms, thighs, and occasionally the buttocks and face. The papules occur around a hair follicle and are firm and white. They feel a little like coarse sandpaper, but they are not painful and there usually is no itching associated with them. They are easily removed and the material inside the papule usually contains a small, coiled hair.

Keratosis pilaris is seen most commonly during childhood and presents as small, rough, raised lesions (papules). These papules are described as “spiny and keratotic” and are typically skin colored. The papules are usually found on the outer surface of the upper arms and thighs, although it may occur elsewhere on the body. The roughness is accentuated by dry skin and the condition is often worse in the winter. It tends to be inherited and may be associated with atopic dermatitis.

Keratosis pilaris can also appear on the face, where it closely resembles acne. The small size of the bumps and its association with dry, chapped skin distinguish keratosis pilaris from pustular acne. Unlike elsewhere on the body, keratosis pilaris on the face may leave small scars. Though quite common with young children, keratosis pilaris can occur at any age. It may improve, especially during the summer months, only to later worsen. Gradually, keratosis pilaris resolves on its own.

Causes

Keratosis pilaris is benign, self-limiting, and often disappears with age. It is more common in patients who tend to have very dry skin, or who have atopic dermatitis (eczema). It seems to run in families. In mild cases, small bumps, similar in appearance to “goose bumps,” are found on the backs of the upper arms. The texture is that of very coarse sandpaper.

Most people with keratosis pilaris don’t know they have it. While KP resembles goosebumps, it is characterized by the appearance of small, rough bumps on the skin. Primarily, it appears on the back and outer sides of the upper arms, but can also occur on thighs and buttocks or any body part except palms or soles.

Treatment

Treatment of keratosis pilaris is not necessary, and unfortunately often has disappointing results. With persistence, most people can get very satisfactory improvement. Initial treatment should be intensive moisturizing. Try a cream such as Acid mantle, Vaseline or Complex 15 after bathing, and re-apply the cream again several times daily.