What is Keratosis Pilaris
By Cynthia Bailey MD.
What is keratosis pilaris? It's a common skin problem that I'm often asked about it in my dermatology practice. Approximately 40% of people have keratosis pilaris. I have it and my kids have it too. People sometimes call this bumpy skin problem "chicken skin" or just "KP".
The skin problem of “KP”, or “chicken skin bumps", is really called keratosis pilaris.
As the name implies, this term means spiny bumps of dead skin cell keratin plugs (keratosis) centered in the hair follicles (pilaris). Thus, dead skin cells cause these skin bumps that we love to hate. Your skin’s dead cell layer (made of a protein called keratin) builds up around the inside of the hair follicles and plug up the entire follicle opening. If your skin feels bumpy, rough and like sandpaper, KP is probably the cause.
Why do some people get keratosis pilaris (KP, chicken skin bumps)?
It is a genetic condition, meaning that it runs in families. If your family members are prone to dry skin, eczema, asthma or even seasonal allergies, then you may be more at risk for KP.
Keratosis pilaris is worse in childhood and the young adult years. It is also worse when your skin is really dry. The spiny rough bumps often improve with age. Though the skin condition is not curable, you can make it much better with the right skin care products and treatment.
What areas of your skin are affected by keratosis pilaris?
The areas of your skin most affected by KP are the back of the upper arms and the front of the thighs. The skin on your back, buttocks and cheeks can be affected too.
What does keratosis pilaris look like?
If you look closely at an area of KP, you will see that the little bumps are usually white and look like mini-pimples. The little white bumps feel rough and if you loosen one, you will see it is actually a hard and pointy little plug sticking out of a pore. The pore may have a fine hair or not, but it is still a hair follicle.
The rough plug of KP is made of dead cells that got stuck in the pore. The pore often has a little dusky redness around it which makes the bumps more noticeable when you look at your skin. Unfortunately, hair can also become trapped under the bumps causing a white head and making them look just like pimples.
It is important to know that people with KP are prone to dry skin and the KP gets rougher and worsens when the skin is dry. Dry climates and seasons like winter can make KP worse. If you are one of the lucky people prone to KP (as I am) you know that your skin is rougher and often drier than other people’s. We people with KP need to use skin creams and lotions to prevent any skin dryness where we get KP.
Dermatologist's tips for the best way to get rid of the skin bumps of keratosis pilaris.
Treatment involves keeping the skin hydrated to soften and help get rid of the rough bumps. We also want to break the little plugs apart. We do this by using skin cleansers, moisturizing creams and lotions that contain ingredients called keratolytics. Keratolytics are ingredients that loosen the 'glue' holding dead cells together. The soft, loosened cells in the plugs are then exfoliated with a rough cloth. Done regularly, the KP bumps will melt away.
Glycolic acid is an excellent keratolytic for KP. It is the best of the alpha-hydroxy acids for loosening the glue holding dead cells together. When used in a moisturizer, glycolic acid works wonders on keratosis pilaris. Other keratolytics that work against KP include lactic acid, salicylic acid, and benzoyl peroxide. Urea can also help to soften the plugs.
Use a Dr. Bailey Complete Skin Care™ Routine for the best results to treat your KP.
CLEANSE your KP prone skin using an exfoliating cloth or scrub, and massage the areas using an exfoliating cleanser made with keratolytics such as glycolic acid, salicylic acid or benzoyl peroxide. The most effective and popular cleanser is my Triple Action Exfoliating Cleanser™ used with a Salux Cloth in my Triple Action Ultra-Fast Body Smoothing Kit™.
CORRECT and HYDRATE by using a strong glycolic acid body lotion. You need a strong product to break up the KP bumps. Strong professional glycolic acid lotions may sting a little and they can smell strong too. This is one way you know you have a strong product that will work. Always apply moisturizer within 3 minutes after toweling skin dry. If your skin becomes irritated from the strong glycolic acid, alternate the glycolic acid lotion with a richly hydrating and gentle moisturizer such as my Natural Lotion to help keep the keratin plugs soft,
PROTECT KP bumps from the sun to keep the red spots from becoming brownish red spots that don't go away. Sun protective clothing or zinc oxide sunscreens are the most effective. My top choice sunscreen for KP is Sheer Strength Pure Physical Spray SPF 50+ Sunscreen because it gives ultra-light, transparent, broad-spectrum sun protection to help prevent brown marks.
Can you have smooth and soft skin if you have KP (keratosis pilaris, also called 'chicken skin')?
It is possible to have smooth skin if you are diligent with your anti-KP skin care.
Once your KP is under control you can alternate your glycolic acid moisturizer with a non-glycolic acid moisturizer, but be sure to moisturize almost every time you bathe to prevent the spiny bumps of KP from coming back. Protect KP skin from the sun to keep the red spots from becoming brownish-red.
My top choice product for keratosis pilaris is my Ultra-Fast Body Smoothing Triple Action Kit.
Liu, F., Yang, Y., Zheng, Y., Liang, Y., & Zeng, K. (2018). Mutation and expression of ABCA12 in keratosis pilaris and nevus comedonicus. Molecular Medicine Reports, 18, 3153-3158. https://doi.org/10.3892/mmr.2018.9342
Beltrani, Vincent S., The clinical spectrum of atopic dermatitis, Journal of Allergy and Clinical Immunology, Volume 104, Issue 3, S87 - S98