How to Treat Keratosis Pilaris

Also called “chicken skin,” Keratosis Pilaris (KP) is a common and harmless inflammatory disorder of the skin that affects about 40% of the world’s population. That number grows to 80% for adolescents and the condition is more common in women than in men.

Thankfully, KP isn’t hazardous to your health. However, the unsightly symptoms can cause discomfort and can be a drain on your self-esteem, especially if the disorder affects your face. KP is not a type of acne and is rarely associated with itching, burning, or pain. The visible effects of KP are purely cosmetic.

What is Keratosis Pilaris?

This inflammatory disorder is commonly recognized by lots of small, red or white bumps that make your skin feel sort of like sandpaper. The most common body parts affected are the outer sides of the arms followed by the thighs, hands, legs, sides, and sometimes buttocks. This disorder can also cause lesions or a red rash on the cheeks that is often mistaken for acne.

Did you know there are three types of KP? Each type looks slightly different and can appear on different parts of the body.

  • Type 1: KP Rubra
    • What it looks like: bumps are pimple-like, red, and inflamed
    • Where it appears: arms, legs, and head
  • Type 2: KP Alba
    • What it looks like: bumps are rough, small, and not irritated
  • Type 3: KP Rubra Faceii
    • What it looks like: a red rash or small bumps
    • Where it appears: face/cheeks

No matter which type you suffer from, KP bumps appear on your skin right at the base of your hair follicles. Unfortunately, symptoms will plague you year-round and may be worse in the winter months due to cold, dry air. Pregnant women with KP may notice worsening symptoms during their pregnancy and/or shortly after childbirth.

What causes Keratosis Pilaris?

keratosis-pilarisKeratin is the culprit in this crime. A small, cream-colored protein, keratin is naturally produced by the body. When the body produces far too much keratin, a person develops KP. Keratin traps hair follicles in their pores by creating a hard plug that caps off the follicle and prevents the hair from growing out through the skin. This process is called hyperkeratinization and can lead to ingrown hairs. Each KP bump contains a hair that is trying to get to the surface of your skin but can’t get through the hard lump of keratin.

 

keratosispilaris5The biggest factor that determines whether or not you will be born with KP is your family history. About 50% of KP cases are hereditary. In addition, there are certain conditions more prevalent in those suffering from KP, but scientists don’t know if they are related to or a factor in causing KP. If you suffer from asthma, eczema, and/or allergies you are much more likely to also suffer from KP.

Although we do know a lot about the process by which those small bumps form, we still don’t know why it happens and we don’t have a cure. KP remains somewhat of a mystery to scientists.

Treatment Options

First of all, don’t expect to ever be 100% symptom-free. That being said, the biggest thing you can do to alleviate symptoms is to unclog your hair follicles and reduce inflammation. The most common way to accomplish both of these tasks at once is to use a BHA exfoliant that lists salicylic acid as an active ingredient and also has a low pH.

2BHA is an acronym for beta hydroxy acid, an anti-inflammatory and antimicrobial agent that can penetrate deep into your pores, loosen the keratin plugs, and kill bacteria that may be contributing to inflammation. You may have heard about alpha hydroxy acid (AHA), which is usually paired with either lactic acid or glycolic acid. AHA is great for some skin conditions but is not recommended for KP treatment. Although it is a great exfoliant, AHA cannot penetrate deep enough to unclog your pores.

Another way to reduce the appearance of KP bumps is to take long, hot baths followed by exfoliation. The warm water opens up your pores and loosens the keratin plugs. When exfoliating, make sure not to scrub too hard, as that can just cause further irritation. It’s also important to avoid bar soaps and opt for gentle moisturizers and cleansers. The ingredients that help hold bars of soap together are known to cause clogged pores – which is the very last thing you need!

Keep in mind that because KP is not harmful, medical treatment is technically unnecessary. However, if the above advice doesn’t work and your symptoms are really bothering you, it might be time to visit a dermatologist. The most common prescriptions are topical creams that include ingredients like:

  • Urea
  • Lactic Acid
  • Glycolic Acid
  • Salicylic Acid
  • Treinoin
  • Vitamin D

Retinoids and steroid creams are also used to reduce redness and inflammation. Be patient. It often takes many months for KP symptoms to clear up. And be prepared to face returning symptoms if you stop treatment. If topical creams don’t work, you might want to consider laser therapy. There are many different versions out there, including:

  • Photopneumatic Therapy (PPX)
  • Intense Pulsed Light (IPL)
  • Pulsed Dye Laser
  • Long-Pulsed Alexandrite Laser
  • Nd:YAG laser

As these treatments all require considerable time and money, they might not be an option for everyone. Laser therapy has been known to work more effectively on KP sufferers with dark skin. Keep in mind that even though lasers aren’t considered “surgery,” there is still a risk of permanent damage.

Conclusion

Simply put, there is no “cure” for this skin condition. If you’re an adolescent, however, your symptoms will probably decrease considerably as you age. Most sufferers notice that symptoms have improved dramatically by the time they reach age 30. If you don’t want to wait that long, follow the above advice. If you’re over the age of 30 and experiencing moderate to severe symptoms, speak with a deramatolgist about your options. Click here for more tips on how to achieve the clearest skin possible.

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