Keratosis Pilaris (KP) – Causes and Management

Keratosis Pilaris -Red Bumpy Skin - Skin Federation

What is Keratosis pilaris?

Keratosis pilaris or KP for short, is a benign Skin condition that causes small, hard and painless bumps on the Skin around hair follicles. These rough-feeling bumps are actually plugs of dead Skin cells blocking the hair follicles.

KP varies in severity from a few small bumps to widespread involvement. It most commonly affects upper arms and thighs, buttocks, chest, back and the face. It can also appear on any other part of the body that has hair follicles.

The Latin term keratosis means ‘scaly Skin’ and pilaris means ‘hair’. It is commonly referred to as “chicken Skin” because it looks like goosebumps or the Skin of a plucked chicken. It feels rough like sandpaper.

It can occur at any age however, it usually starts in childhood and becomes more obvious during the teenage years and adulthood. About 50-80% of teenagers will develop this condition in their teens. Among adults, about 40% will have it at some point in adulthood. It is harmless, not infectious and not contagious meaning you can’t get it from other people and you can’t give it to anyone.

What does Keratosis pilaris look like?

KP usually appear as small, painless, scaly bumps that look like goosebumps. It usually causes very rough and dry Skin patches. They don’t hurt but may itch due to excess dryness and some bumps may have hair from the follicle inside them.

The bumps are usually the same colour as Skin but they may look red or white on light Skin and white, brown or black on darker Skin. They may not be discoloured at all or in some cases, the bumps can be quite red (keratosis pilaris rubra).

What causes Keratosis pilaris?

The exact cause of KP is still unclear however, in most cases Keratosis pilaris is a genetic condition that runs in families that causes abnormal keratinisation of the hair follicle. It is more common in individuals with a tendency towards eczema (atopic dermatitis).

There are 3 main KP symptoms listed below;

  1. Bumps on the surface caused by excess dead Skin cells blocking the hair follicles.
  2. Rough and dry Skin patches due to the abnormal keratinisation of the hair follicle.
  3. Redness due to the inflammation caused by blocked hair follicles.

What are the complications associated with Keratosis pilaris?

KP is a benign Skin condition and does not cause any harm to the body. However, it is a chronic condition, although some individuals can outgrow it overtime, for others it can stick around for the most of their lives.

The biggest complication is scarring due to picking at or trying to pop keratosis pilaris bumps.

Although KP is asymptomatic, the cosmetic appearance of KP can lead to psychosocial distress. It affects one’s self esteem and may affect their quality of life.

Affected individuals may choose treatments to improve the appearance of the Skin.

How to avoid further irritating the Skin affected by Keratosis pilaris?

  • Avoid scrubbing the Skin, vigorous scrubbing or removal of hair follicle plugs may further irritate the Skin and worsen the condition.
  • Be gentle to the Skin. Don’t scratch the bumps and avoid rubbing the Skin roughly.
  • Shaving or waxing the Skin affected by keratosis pilaris, can cause more bumps. Laser hair removal can remove the hair without causing flare-ups.
  • To prevent drying the Skin, take a short bath or shower and use warm water rather than hot water. Limit bathing to once a day as water washes away the body’s natural oils that help keep the Skin moist.
  • After washing or bathing, gently pat or blot the Skin with a towel so that some moisture remains.
  • Don’t wear tight clothing. Friction can further irritate the already irritated KP patches.
  • Use a mild cleanser, strong body cleansers can dry the Skin. Bar soaps are highly alkaline which can induce irritation and dryness due to the change of the Skin pH.
  • Avoid self-tanners, they make the bumps more obvious rather than hiding them.

How is Keratosis pilaris treated?

Unfortunately, KP can not be cured or prevented. Keratosis pilaris is harmless so no specific treatment is needed. However, self-help measures can improve how the affected Skin looks and can help manage the symptoms.

A gentle approach is of profound importance during the treatment. Further irritation caused by an ingredient or physical rubbing and scrubbing can dramatically worsen the flare-ups.

For an effective KP management, the 3 symptoms of this condition should be addressed;

1. Excess dead Skin cell build up can be regulated by the use of a keratolytic.

Keratolytics speed up desquamation which is the natural process of shedding dead Skin cells. They gently break the bonds that hold dead, dry and scaly Skin cells on the surface. The best keratolytics that are usually used for this Skin condition are:

  • Urea, synthetic grades are commonly used in topical treatments
  • Alpha Hydroxy Acids for example Lactic Acid
  • Beta Hydroxy Acids for example Salicylic Acid
  • Retinoids are also great keratolytics however, they can be irritating to some individuals.

2. Rough and dry Skin patches can be managed by regular use of a deep moisturiser.

Deep moisturising is key to keep the roughness at bay. Consider the below criteria to choose a suitable moisturiser;

  • Select a thick cream rather than a lotion. This will reduce Transepidermal water loss (TEWL) through creating a protective film on the Skin surface.
  • Pay attention to the ingredient list. Choose a non-comedogenic cream to avoid further flare-ups. Such cream will not clog the pores nor block the hair follicles.
  • Choose a cream with a combination of humectants and emollients for best results. While humectants hold onto water within Skin, emollients lock them in and reduce the rate of water evaporation from the surface. For example, Urea, Lactic Acid and Betaine are strong humectants. Shea Butter is a great choice when it comes to emollients. It is well known to assist cutaneous dryness, dermatitis, dermatoses, eczema, solar erythema and superficial burns

3. Redness, due to the inflammation caused by blocked hair follicles, can be managed by the use of an anti-inflammatory agent.

Colloidal oatmeal is one of the gold standard active ingredients within this group. It contains phenolic components such as Avenanthramides which have significant anti-inflammatory properties that help decrease itchiness and redness for an effective soothing action. Furthermore, hydrated granules of Colloidal oatmeal adhere to the surface of the Skin and provide a protective film. In June 2003, colloidal oatmeal gained the U.S. Food and Drug Administration (FDA) approval to be used as a Skin protectant.

Furthermore there are some additional considerations;

  • Topical products that combine keratolytics, humectants, emollients and anti-inflammatory ingredients can simplify the daily KP management routine.
  • In the beginning, depending on the severity of the condition, 2-3 times daily application may be required.
  • Once the condition is under control, because KP is not curable, there needs to be a maintenance plan. This often involves treating the Skin a few times a week.
  • In the alternating days, a non- comedogenic moisturiser without keratolytics may be used to keep dryness at bay.
  • The appearance of this condition is often more obvious in winter due to lower humidity levels and consequent drying of the Skin. Use of a humidifier when the air feels dry can help prevent dry Skin.

The bottom line is, although KP can not be cured or prevented, a consistent topical treatment routine can significantly improve how the affected Skin looks and can help manage the symptoms.

Urea Body Smoothing Cream

This Urea Body Smoothing Cream is a non-comedogenic and fast absorbing formula designed for dry, rough and bumpy Skin patches on the body.

  • Deeply Moisturises Dry Skin Patches
  • Smoothens Rough & Bumpy Skin
  • Softens Flaky & Scaly Skin
  • Relieves Itchiness & Redness