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What are the Best Treatments for Keratosis Pilaris (KP)?

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If you’ve ever seen a reddish rash on your cheeks, arms, or legs, and it’s not acne, chances are you may be suffering from Keratosis pilaris, or KP. Worldwide, over 50 percent of the population will suffer from KP at some point in their lifetime, with 50-80% of adolescents and 40% of adults being affected at some point in any given year (eMedicine, 2008).

How Do You Know if it is KP?

Ask yourself the following questions:
1.) Are the bumps itchy or sore? If no, then it may be KP. KP is seldom itchy or sore.
2.) Do the bumps feel like sandpaper when you touch them? If yes, then it may be KP. KP results in small bumps on the skin that are about the size of a grain of sand, and which also feel like sandpaper.
3.) Are the bumps slightly pink, or are they colorless? If slightly pink, then it may be KP.
4.) Do the bumps become more pronounced when exposed to a cold or dry environment? If yes, then it may be KP.
5.) Does it look like the picture above? If yes, then it may be KP. If not, it may be acne, eczema, or another condition. You should see a dermatologist.

And, of course, the best way to determine whether or not it is KP is to ask a physician.

What Causes KP?

If you carry the gene for KP, when your skin is exposed to cold or dry conditions (like winter!), your skin will produce excess keratin, a protein that is naturally found within the skin.

For a while, the excess keratin lays flat against the skin. But eventually, the excess keratin has nowhere else to go but to clog the pores. This is called hyperkeratinization.

Since pores contain a hair follicle, the excess keratin in the pore prevents the hair from growing optimally. (How would you like growing if you had a big blob of goo above your head all the time?!) The hair eventually becomes encased inside the keratin. So this is why many KP bumps contain an ingrown hair.

Can You Prevent KP?

KP is worsened with exposure to cold and dryness, both of which signal the skin to produce more “hydrating” proteins (and hence more keratin, which clogs the pores further).

Unfortunately, other than staying on a beach all the time (which prevents its own problems), if you are prone to getting KP, you will always get KP: it is a genetic condition.

Interestingly enough, KP is carried in an autosomal dominant fashion through the genes. Meaning (and we’re going back to high school biology here, so bear with me!), if both of your parents had it, you will have a 100% chance of having it. Or, if one of your parents had it, you will have a 50% chance of having it. (Makes you kind-of want to marry someone who doesn’t have KP too, doesn’t it?)

Luckily, even if the man or woman you love (or sperm/egg donor you choose) has KP, the condition is entirely harmless, aside from the cosmetic implications. So, all joking aside, of all the conditions that are autosomal dominant to have, this is amongst the best. (So stay partnered or on board with those fertility arrangements, folks).

What are the Best Treatments for KP?

The best treatments for KP are those that are designed to exfoliate the skin deeply. The ultimate treatment, believe it or not, is actually laser hair removal (eMedicine, 2014), which will remove the hair as well as the keratin “plug” that encapsulates it, as well as exfoliate the skin. It’s actually quite a beautiful one-two punch.

However, to care for KP at home, there are some very basic treatments you can use to unplug the follicle and increase cellular turnover, restoring your skin to normal. Keep in mind that this requires twice-daily care for 4-6 weeks, depending on the severity of your condition:

Step 1: DermaDoctor KP Duty Scrub ($49.00, Amazon.com)

I really like DermaDoctor KP Duty Scrub for those with keratosis pilaris. It contains three acidic ingredients that will slough your skin very well, including (in highest to lowest concentration) glycolic acid, lactic acid, and azelaic acid.

Glycolic acid exfoliates in a very specific way. Calcium ions often act as “glue” between skin cells. However, glycolic acid affects the calcium ions in skin cells, resulting in less “glue” and more separation (Medical Hypothesis, 1999). Regular use of glycolic acid can temporarily thin the skin (think: in terms of weeks), though heightened collagen production over time may more than compensate for this effect (in terms of months). So glycolic acid is an ingredient that may give you a thinner skin at first, but thicker skin over time. (Stay the course!)

Lactic acid is the next active on the ingredients list of DermaDoctor KP Duty Scrub, and I love it. Lactic acid is also my favorite alpha hydroxy acid because it is the smallest, which means it is positioned to get into deeper layers of the skin, resulting in greater exfoliation. Lactic acid also does not thin the skin in the way that glycolic acid does (Journal of the American Academy of Dermatology). 

Lastly, azelaic acid is typically found in acne and rosacea treatments. It has been found to have significant effects in treating acne (International Journal of Dermatology), because it effectively decreases the amount of debris in the pore. Considering that KP is caused by too much material in the pore, this is a win-win situation. 

DermaDoctor KP Duty Scrub also has a number of soothing ingredients, including green tea and white willow bark (the plant source of aspirin, believe it or not). What I love about this approach is that many of the treatments typically recommended for KP are harsh for the skin to exfoliate, seemingly forgetting that you are treating skin for KP mostly in the wintertime, when you really need moisture in the skin! So I love DermaDoctor KP Duty Scrub for containing these soothing ingredients.

Bottom line: if you want to get rid of KP, DermaDoctor KP Duty Scrub is probably your best bet for an over-the-counter treatment. 10/10. (High concentration of proven ingredients: 3/3. Unique formulation or new technology: 3/3. Value: 3/3. Sunscreen: N/A)

Step 2: CeraVe Renewing SA Lotion ($14.09, Amazon.com)

Granted, there is also a DermaDoctor KP Duty moisturizer designed for KP that work just fine for treating it. So why am I recommending CeraVe Renewing SA Lotion as step number two? Simple: While a DermaDoctor KP Duty moisturizer is great, it contains some of the actives as DermaDoctor KP Duty Scrub, namely glycolic acid. Whereas with CeraVe Renewing SA Lotion introduced as the second step, you can introduce the benefits of salicyclic acid in a very hydrating base that is unlikely to disrupt the skin.

One interesting thing about CeraVe Renewing SA Lotion, which I know many of my readers will write to me about, is the fact that CeraVe Renewing SA Lotion contains mineral oil. Gasp!, I know many of you are thinking, that’s atrocious! But here me out: Mineral oil has gotten a bad rap for two reasons. One, some really awful products back in the day carried non-cosmetic grade mineral oil, which carried all kinds of impurities. However, that is largely regulated.

Which brings me to point number two: Mineral oil gets a bad rap because of how it works. Your skin is constantly in flux. Think of skin cells like romantic partnerships: Some of your skin cells are going to be in a state of separating, some are just joining up, and some are currently linked. (Unfortunately, in this analogy, they all separate eventually, but that’s beside the point). Mineral oil works on the skin cells that are currently separating by filling the spaces between them. This leaves a really nice, smooth, hydrated surface where skin could before seem a little “rough.” This seems win-win, unless you apply a serum or moisturizer underneath a product with mineral oil. Then you have a problem because mineral oil is trapping the ingredients in the other product between the separating skin cells, and the other product may not be designed for that. The result? Breakouts!

So don’t combine your mineral oil-rich products with other leave-on treatments. Other than that, though, mineral oil containing products are great! Really!

Bottom Line

If you’re suffering from KP, realize that you’re not alone. This condition is one of the only autosomal dominant skin conditions out there, meaning 50-80% of the world’s population has had KP at some point in their lives. While the best treatment of all is laser hair removal, you can also get great results with DermaDoctor KP Duty Scrub and CeraVe Renewing SA Lotion.

What are your thoughts on KP? Got a special treatment? Let us know in Comments below!

Looking for the best skin care? FutureDerm is committed to having its customers find — and create — the best skin care for their individual skin type, concern, and based on your ingredient preferences. Learn more by visiting the FutureDerm shop! 

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