Keratosis pilaris is a very common and harmless condition where the skin becomes rough and bumpy, as if covered in permanent goose pimples.
There's no cure, but if it is bothering you there are measures you can take to improve the rash, such as using soap-free cleansers and gently exfoliating. There is no need to see your GP unless keratosis pilaris is upsetting you.
Keratosis pilaris usually gets better with age, sometimes disappearing completely in adulthood.
This page provides more information on keratosis pilaris and explains what you can do if you think you have this skin condition, or if you've just been diagnosed with it.
Where on the body it occurs
Keratosis pilaris most commonly affects the back of the upper arms, and sometimes the buttocks and front of the thighs. Less often, the forearms and upper back may be affected.
There are also rare variants of keratosis pilaris that can affect the eyebrows, face and scalp, or all over the body.
How it affects the skin
The patches of affected skin will be covered in tiny spiky bumps, which may be skin-coloured, red or brown. This spotting will give the appearance of 'chicken skin' or permanent goose pimples, and the skin will feel rough, like sandpaper.
In some people, the skin will itch and there may be slight pinkness around the bumps.
The condition is not contagious (will not spread from person to person).
Who is affected
Keratosis pilaris is very common, affecting up to one in three people in the UK. It is seen in people of all ages, but is especially common in:
- children and adolescents
- females
- those who already have eczema or a condition called ichthyosis (scaling of the skin)
- people of Celtic origin
The condition typically begins in childhood (although it can start in babies), and gets worse in adolescence, around puberty. Some people find that it improves after this and may even disappear in adulthood, although many adults still have keratosis pilaris in their 40s and 50s. It's uncommon in elderly people.
Flare-ups
The skin tends to improve in summer and get worse during winter months or dry conditions.
Keratosis pilaris is often associated with other dry skin conditions, such as eczema, which make the rash worse.
Causes
Keratosis pilaris runs in families and is inherited from your parents. The precise cause is unknown, but the skin rash occurs because:
- there is too much keratin, a protein found in the tough outer layer of skin, which causes thickening of the skin surface (hence the name 'keratosis')
- the hair follicles become blocked with plugs of hard skin, which feel rough
- the tiny plugs widen the pores, making the skin look spotty
Treating keratosis pilaris
There is no need to treat keratosis pilaris if it is not bothering you. Otherwise, the following measures may help to improve your rash:
- Use non-soap cleansers instead of soap, as soap may dry out the skin and make the condition worse.
- Moisturise your skin when it's dry. Ask your GP or pharmacist to recommend a suitable cream. However, moisturisers and emollients only help by reducing skin dryness and are not a magic cure for the rash. Emollients that contain urea and lactic acid are usually the most effective.
- Gently rub the skin with an exfoliating foam pad or pumice stone, to exfoliate the rough skin (but don't scrub too hard and rub off layers of skin).
- Take tepid showers rather than hot baths.
Also, ask your doctor about 'off label' treatments that may help. These are products that haven't been officially approved and licensed for the treatment of keratosis pilaris, but are used because they have helped previous patients. Examples are:
- creams containing retinol (which is derived from vitamin A)
- chemical peels
- microdermabrasion, which is a cosmetic exfoliation treatment sometimes offered in health spas
However, there's no strong evidence that the above treatments are effective in treating keratosis pilaris, and you may have to pay for some of these treatments privately.
It may not be possible to get rid of keratosis pilaris completely, but there's a good chance that your skin will improve with some of the above measures.
