Keratosis pilaris tips from a dermatologist – Dr Dray

What is keratosis pilaris?

Keratosis pilaris is a common dry skin condition.  It appears as small, dry and rough bumps, often with some associated redness of the skin.  The rough bumps are the result of the accumulation of dry and dead skin cells within the hair follicle opening.

Who gets keratosis pilaris?

Keratosis pilaris affects up to half of normal children, and is more common in children with atopic dermatitis (aka eczema). Although most apparent during adolescence, it may occur at any age.

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What causes keratosis pilaris?

Keratosis pilaris is due to abnormal build up of dead skin cells in the upper part of the hair follicle opening.  Scale fills the follicle instead of exfoliating properly.  The tendency to develop keratosis pilaris is genetic.  Up to half of the children of a person with keratosis pilaris will be affected.  Keratosis pilaris-like lesions can arise as a side effect of targeted cancer therapies such as vemurafenib.

What does keratosis pilaris look like?

Keratosis pilaris often affects the outer aspect of both upper arms, as well as the thighs, buttocks and sides of the cheeks, and less often on the forearms and upper back. The scaly spots may appear skin colored, red, or brown.  Some people say these bumps look like “goosebumps,” while others often mistake the bumps for small pimples.  Keratosis pilaris tends to be more prominent at times of low humidity, such as in the winter months.

The rough-feeling bumps can appear skin-colored, red, and/or brown in color. They often feel rough and dry, like sandpaper.

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What is the treatment for keratosis pilaris?

It is important to understand that keratosis pilaris is a chronic skin condition.  While it can improve substantially and become less problematic over time, there is no cure and it can flare and/or return.  The following measures can be helpful to control keratosis pilaris:

• Select a non-soap cleanser like NutriBiotic Original Non-Soap Skin Cleanser, as soaps can worsen dryness and the appearance of keratosis pilaris.
• Lightly rubbing the affected area with a wash cloth while in the shower or bath can help to gently exfoliate the retained dead skin cells.
• Avoid harsh scrubs, as these can worsen dry skin and exacerbate keratosis pilaris.
• Apply a Lubriderm Daily Moisture Hydrating Unscented Body Lotion directly to wet skin, immediately after showering/bathing, and allow the skin to air dry.  This helps to decrease evaporative water loss from the skin. Evaporative water loss from the surface of wet skin ultimately leads to dry skin with worsening of keratosis pilaris.
• Select moisturizing creams/lotions that contain salicylic acid, urea, or alpha hydroxy acids.  A good option is CeraVe SA Lotion for Rough & Bumpy Skin with Vitamin D, Hyaluronic Acid, Lactic Acid & Salicylic Acid Lotion which is Fragrance Free & Allergy Tested.These ingredients are keratolytics, and help to dissolve and gently exfoliate some of the retained dead skin cells.  Creams and lotions with these ingredients are best applied to dry skin.
• A prescription Retinoid Cream or gel can be helpful.
• Pulse dye laser treatment or intense pulsed light therapy may help to temporarily improve redness.  However, these interventions do not improve the roughness of keratosis pilaris.
• Laser assisted hair removal.

What skin care products are helpful for keratosis pilaris?

PLAIN MOISTURIZING CREAMS (best applied to wet skin)
Cerave moisturizing cream http://amzn.to/2yXNyLI
Cetaphil moisturizing cream http://amzn.to/2icKzUW
Vanicream moisturizing skin cream http://amzn.to/2id2RFQ
Eucerin original healing cream https://iherb.co/jkcbenQ
Eucerin eczema relief cream https://iherb.co/3Pw1xruu

KERATOLYTIC BODY CREAMS AND LOTIONS (best applied to dry skin)
Cerave renewing salicylic acid cream http://amzn.to/2jygz9G
Cerave renewing salicylic acid lotion http://amzn.to/2zLNU77
Amlactin AHA restoring body lotion http://amzn.to/2ipSrmc
Eucerin intensive repair AHA body lotion http://amzn.to/2jyWFeL

NON-SOAP CLEANSERS
Cerave eczema soothing body wash http://amzn.to/2yzpBGa
Eucerin skin calming dry skin body wash oil http://amzn.to/2AHa08M
Cetaphil restoraderm eczema body wash http://amzn.to/2AG0rHt
Eau Thermale Avene Xeracalm cleansing oil http://amzn.to/2ibp7Qi

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References

Alai AN. “Keratosis pilaris clinical presentations.” Medscape. Last updated June 16, 2017.

Park J, Kim BJ, et. al. “A pilot study of Q-switched 1064-nm Nd:YAG laser treatment in the keratosis pilaris.” Ann Dermatol. Aug 2011; 23(3): 293–298.

Thomas M, Khopkar US. “Keratosis pilaris revisited: Is it more than just a follicular keratosis?” Int J Trichology. 2012 Oct;4(4):255-8.

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