Keratosis Pilaris: The Little Red Bumps that Could

Could be making you miserable, that is.  According to Dr. Nili Alai, M.D. FAAD, keratosis pilaris affects up to 40% of the adult population and 50-80% of adolescents worldwide.  Often confused with small goosebumps or acne, keratosis pilaris occurs when a skin-based protein [keratin] forms hard plugs within hair follicles.  The result are skin-colored bumps about the size of a grain of sand, along with a fine, bumpy texture.  Some cases are accompanied by erythema, or redness, to the skin.

Keratosis pilaris is found most commonly on the back and outer sides of the upper arms (though the lower arms can also be affected).  It is also commonly found on the thighs, hands, and the tops of the legs, flanks, buttocks, and face, where it is commonly mistaken for acne (especially in adolescents).

One telltale sign of KP is that the condition traditionally gets worse in the winter.  Another clue is that patients with KP often have been previously diagnosed with atopic dermatitis or ichytosis, as noted in the British Journal of Dermatology.

Although it is widely believed that KP decreases with age, this is not necessarily the case; as noted in a 2006 study amongst 83 patients over the course of 20 years, KP improved with age in 35% of patients, remained unchanged in 43%, and worsened in 22%.


Various Types of Keratosis Pilaris

There are numerous types of KP.  Helpful pictures of each are available here, through GoogleHealth.

  • Keratosis pilaris rubra (red, inflamed bumps which can be on arms, head, legs)
  • Keratosis pilaris alba (rough, bumpy skin with no irritation)
  • Keratosis pilaris rubra faceii (reddish rash on the cheeks)

Neostrata 15

How to Treat Keratosis Pilaris

1.  First and foremost, visit a board-certified dermatologist, who will be able to properly diagnose the condition.  It is possible that keratosis pilaris may advance to a rare condition known as keratosis pilaris atrophicans in some genetically susceptible individuals, so it is important to be properly assessed by a physician.

2.  As recommended by your physician, use moisturizing lotions containing urea, lactic acid, glycolic acid, salicylic acid, tretinoin, or vitamin D.  Some over-the-counter options include:

  • AmLactin ($22.99, Amazon.com), which contains an unprecedented 12% lactic acid.  Molecules of lactic acid are larger than glycolic acid, so it does not penetrate the skin as easily.  However, lactic acid has not been associated with the same increase in UV sensitivity as glycolic acid, as mentioned in a 2000 study in the Journal of the American Academy of Dermatology.  As such, lactic acid is a better choice for the warm summer months, or if you live in a sunny climate year-round.
  • NeoStrata AHA 15 Lotion ($35.00, Amazon.com), which contains 15% glycolic acid.  The advantages to glycolic acid over lactic acid are that glycolic acid has a smaller molecular structure, allowing for it to penetrate the skin more easily, and that glycolic acid has anti-aging properties, advancing desquamation and thinning of the stratum corneum (the uppermost layer of the skin). By exfoliating the top layer of the skin, glycolic acid peels smooth the skin, quicken the rate of cell turnover (which is reduced by up to 7% every ten years), decrease small wrinkles and increase the fibroblast proliferation of collagen.  Again, however, given that glycolic acid sensitizes the skin to UV rays, it is highly recommended that Neostrata or any other treatment be used with sun protection, preferably in the form of UV protective clothing.
  • Glytone Keratosis Pilaris 3-Piece Kit ($53.35, Amazon.com).  Is it necessary to have a special cleanser for KP?  No.  But it is nice to have a specially-designed kit (well, for some of us, anyway!), and this one, replete with high concentrations of glycolic acid, is as good as any at delivering the AHA all over the skin.
  • LacHydrin Five ($11.33, Amazon.com), which contains 5% lactic acid.  The interesting thing about  LacHydrin Five is that it is touted for its buffering with ammonium hydroxide, a basic substance.  While this buffering makes the lotion more easily tolerated, it also increases the pH and hence alters the potency of lactic acid.  So I’m not sure I like this one as well, but I will say that it is a solid choice for those with easily irritated or sensitive skin types.

3.  Consider physician-administered pulsed tunable dye laser treatments, which were found in a 2000 study in the Journal of Cosmetic and Laser Therapy to improve the appearance of keratosis pilaris-associated bumps, though the skin was still found to have a rough texture thereafter.  For patient’s own opinions on laser treatments for KP, please visit the KP Online Community forum here.

4.  Call your physician for a follow-up if the condition does not improve after 1-2 weeks of continuous use of the recommended over-the-counter treatment(s).

The Bottom Line

Keratosis pilaris is a common skin condition, and no one should have to suffer from it.  If you think you may have KP, talk to your dermatologist immediately.  Your skin will thank you for it!

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7 thoughts on “Keratosis Pilaris: The Little Red Bumps that Could

  1. The Beauty Chick says:

    I unfortunately suffer from KP on my arms and I was once told by my dermatologist that nothing really helps get rid of it :-( I believe there is also a genetic component to the condition as well (unless it’s a fluke that my dad, sister, brother and I all have it!). Thanks for this post!

  2. Jeni says:

    I never had KP before, but I got it on my upper arms after using a body wash! There are a few different body washes that clogged my pores and caused it – it was exactly like this: Keratosis pilaris alba (rough, bumpy skin with no irritation). I now stay away from any body wash that says it’s super hydrating (like Olay Ribbons) because for some reason they cause KP for me. After not using them for a week, the problem resolved on its own!

  3. Digandie says:

    I know there’s really no cure for KP. Some treatments may just help to lessen the bumps but KP will just keep on coming back. That’s the most annoying part of it.

    More so, KP does not only occur during winter time.
    It can also happen during the hot dry summer non-humid season. When I was in Nevada, my KP got worse. :(

  4. Holli says:

    I found out that my KP is caused by an allergy/sensitivity to corn. It worsened when I developed Irritible bowel syndrome, implying a connection between diet and skin disorders. Many people on the Keritosispilaris.org site have found there to be a food connection and have, in fact ,cleared their KP entirely. Mine is a little more persistant due to the fact that corn is literally in EVERYTHING. However, it is 90% cleared up since I’ve been very careful to cook my own meals and eat out infrequently. Hope this helps someone.

  5. SkinDoc says:

    KP is sometimes very difficult to manage, especially during the winter months of the year. You have rightly dicussed the use of keratinolytics (AmLactin, LacHydrin, etc) for its treatment. Your readers may find it interesting to know that some dermatologists have used retinoid creams to successfully treat KP (Retin-A, Differin, etc). Retinoids do a great job at helping the follicles “reset” and expel the extra keratin that is trapped inside.

    You can go to: http://skinnyonskincare.com/2010/03/25/what-are-these-bumps-on-my-arms/ to learn more about KP, its causes and treatments.

  6. Beautiful Canvas says:

    I have Keratosis pilaris alba (rough, bumpy skin with no irritation) on my upper arms. I recently spent two weeks in the tropic. Did quite a bit of snorkeling. I discovered that by the second or third day of swimming in salt water, my arms where getting smoother. It must be the salt water because I am doing anything different. By the end of the trip, my arms were as smooth as baby bottom. Unfortunately without continuous swim in salt water, it’s starting to comes back :(

  7. t says:

    I had KP but no longer do. I started taking vitamin A (pls check with your doctor on dosage), as well cutting back on my sugar. Not just sugar from cookies or candy, etc, but also sugar you get from simple carbs (white bread, white pasta, etc.). Not exactly fun, I know…but now I can bear my upper arms with pride! You can get more vitamin A in your diet by consuming more carrots, cantaloupe, spinach, apricots, peaches and other brightly colored fruits and vegetables. The products mentioned above (all forms of chemical exfoliation) do help, but nothing worked as well as taking the vitamin A and less sugar. Good luck!

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