Keratosis Pilaris

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Overview

Keratosis pilaris (KP) is a common inherited skin condition in which there is a buildup of skin protein (keratin) around hair follicles on the arms, thighs, buttocks and/or cheeks. This buildup of keratin causes a plug around hair follicles. It appears as red, white, or dry bumps around hair follicles on the body. KP can make you appear as if you have “goose bumps.”

Symptoms

Keratosis pilaris creates a sensation that your skin feels like bumpy sandpaper. This is a harmless condition and may be asymptomatic. Oftentimes, people find KP cosmetically annoying, and occasionally itchy. Sometimes the bumps are very red and raised. Otherwise they can be skin colored. Having dry skin can aggravate this condition. For some people the area affected by KP can look darker or lighter than surrounding skin.

Cause

Keratosis pilaris is an inherited condition associated with other skin disorders such as eczema. KP tends to start in childhood or teenage years, waxes and wanes over time, and for many resolves before the age of 30. In children, KP tends to occur on upper arms, thighs and/or cheeks. As kids get older, they can have KP lesions additionally on buttocks, lower arms and lower legs. For some people this condition can last into adulthood, sometimes lifelong. Keratosis pilaris is not contagious. It is not proven to be caused by nutritional deficiencies or dietary intake.

Treatment

Keratosis pilaris cannot be cured, but topical treatments can improve the look and severity. Topical products that contain keratolytics (agents that make skin cells turn over faster) or exfoliants (agents that help you shed skin cells) can be helpful. These agents speed up the turnover of skin cells, and can help shed the buildup of old skin cells. Some of these products can cause a burning sensation, so children may not tolerate these products. These products otherwise are generally very safe. Moisturizers can also be helpful and usually do not cause any burning or stinging. Corticosteroids can help calm some of the inflammation associated with keratosis pilaris, but chronic use is not ideal. Topical steroids can cause skin thinning and suppress cortisol production internally. Therefore, topical steroids should be used less frequently and in smaller surface areas, especially in young children.

OTC Treatment Options

Arms / Legs

Cleanse

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CeraVe SA Body Wash for Rough & Bumpy Skin

(salicylic acid, lactic acid & ceramides)

  • Neutrogena Body Clear Body Wash with Salicylic Acid

Treat

AmLactin Ultra Smoothing Intensely Hydrating Cream

(ammonium lactate)
  • Udderly Smooth Extra Care Cream with 20% Urea
  • CeraVe SA Lotion for Rough & Bumpy Skin (salicylic acid, lactic acid, ceramides)
  • Eucerin Roughness Relief Spot Lotion
  • Excipial Urea Hydrating Lotion (10% urea)
  • Glytone KP Kit
  • Aquanil 1% hydrocortisone lotion (for KP that has is more red or inflamed). For occasional use only.
  • Gold Bond Rough & Bumpy Skin

Instructions

Wash with CeraVe SA Body Wash for Rough & Bumpy Skin daily. After showering, apply Amlactin Alpha Hydroxy Therapy Ultra Smoothing Intensely Hydrating (or alternative) cream. A second application can be done later in the day.

Do not use these agents too frequently if it irritates your skin. Also, note that products like ammonium lactate (alpha-hydroxy acid) may increase your skin’s sensitivity to sun. Be sun smart: use sunscreen, wear protective clothing, and limit sun exposure while using this product and for a week afterward.

If you have sensitive skin, do these treatments two or three times weekly. Follow up with a moisturizers as needed, such as CeraVe Moisturizing Cream or Aveeno Eczema Cream.

OTC Tips

Note that shaving or waxing can aggravate keratosis pilaris. Self tanner may also aggravate KP in some people. For redness, occasional application of hydrocortisone 1% lotion can be helpful. Note that all of these treatments do not work overnight, and you may need to use these treatments for several weeks before you see improvement. You will need to continue to use these treatments for continued benefit.

Face

Cleanse

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CeraVe Renewing SA Cleanser

(salicylic acid & ceramides)
  • LaRoche Posay Effaclar Medicated Gel Facial Cleanser (salicylic acid)
  • CeraVe Hydrating Facial Cleanser
  • Cetaphil Gentle Skin Cleanser

Treat

AmLactin Alpha Hydroxy Therapy Rapid Relief Restoring Lotion

(ammonium lactate with ceramides)
  • Differin 0.1% gel (adapalene)
  • Glycolix Elite 15% Glycolic Acid Facial Cream
  • CeraVe Renewing SA Cream (salicylic acid and ceramides)
  • Aquanil 1% hydrocortisone lotion (for occasional use to combat redness)
  • CeraVe Moisturizing Cream
  • Aveeno Eczema Cream

Instructions

OTC Tips

Note that shaving or waxing can aggravate keratosis pilaris. Self tanner may also aggravate KP in some people. For redness occasional application of hydrocortisone 1% lotion can be helpful, but is not recommended for extended periods of time due to theoretical thinning of skin. These treatments do not work overnight, and you may need to use these treatments for several weeks before you see improvement. You will need to continue to use these treatments for continued benefit.

Children Under 6 Years Old

Cleanse

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Cetaphil Gentle Skin Cleanser

CeraVe Hydrating Facial Cleanser

Moisturize

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CeraVe Moisturizing Cream

  • Aveeno Eczema Cream
  • Aquanil 1% hydrocortisone lotion (for occasional use, to combat redness or inflammation). Note that this agent is a corticosteroid.

Instructions

AM & PM
Wash your face, arms and legs with a gentle cleanser, such as CeraVe Hydrating Facial Cleanser or Cetaphil Gentle Skin Cleanser. Apply CeraVe Moisturizing Cream at least once a day to face, arms or legs. Moisturizing well improves KP considerably.

OTC Tips

For redness occasional application of hydrocortisone 1% lotion can be helpful, but these agents must be used sparingly in children, who are more susceptible to its side effects.

These treatments do not work overnight, and you may need to use these treatments for several weeks before you see improvement. You will need to continue to use these treatments for continued benefit.

Following these regimens can improve the appearance of KP. Note that it will not cure the condition, but should make it much less noticeable.

If following these recommendations does not improve your condition, it may be helpful to see your dermatologist for stronger keratolytics that are prescription strength or other treatment options.

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