Dermatology Facts—Keratosis Pilaris

Keratosis pilaris is a rash that is usually found on the outer areas of the upper arms, thighs, and cheeks. It is characterized by skin-colored to slightly red, rough, distinct bumps. Keratosis pilaris is occasionally itchy, but otherwise it is only significant cosmetically. It is caused by a plug of dead skin cells that forms around a hair follicle. These "plugs" give the skin a sandpapery or "goose-flesh" feeling. Keratosis pilaris is usually worse during the winter months and is most commonly seen in children and young adults. Often the surrounding skin is dry.

Keratosis pilaris is a benign condition and treatment is usually only necessary for cosmetic reasons. Lubricants may help with the dryness, but do not tend to clear the bumps. Mild peeling agents are most effective in opening the plugged hair follicles by removing the excess skin. Each affected person may respond differently to therapies, but glycolic acid (such as alpha cream) and urea preparations (such as Carmol), lactic acid creams (such as Lac-Hydrin, AmLactin, or Lac-Hydrin V) and topical retinoids (such as Differin, Retin-A, Avita, or Tazorac) are the most commonly used therapies. Triceram, a new type of moisturizer with increased fats normally found in the skin, has been used with some success. Effective therapy must be continued on a regular basis or the keratosis pilaris recurs. The treatments do not work in all patients. For most children, treatment is unnecessary.