Fight Sandpaper Skin: Keratosis Pilaris

Keratosis Pilaris (KP) is a common problem that results in rough texture at the back of the upper arms, thighs, buttocks, back and sometimes cheeks. It’s so common that almost every day at least one patient tells me they have “goose bumps” or “chicken skin” that they would like help treating. 40% of adults, and up to 80% of adolescents experience this. KP looks like rough, slightly red or skin colored bumps.

While KP is harmless and generally doesn’t itch or hurt, it can be quite annoying. It occurs when excess keratin, one of the major proteins in the skin, forms hard plugs within hair follicles. This plug then traps the hair in the follicle. KP runs in families and happens more when people have a tendency for dry skin or eczema. Sometimes it just happens. Because it’s associated with dryness, KP is usually worse in the winter or in dry climates, and improves in warm and humid climates.

KP can also be frustrating to treat and unfortunately there is no “cure”. It can take several months of diligent treatment to see an improvement. If you stop treating, KP generally comes back quickly. Fortunately, there are a lot of treatment options available. And, the good news is, for many people, symptoms improve with age.

The mainstay of treatment for KP includes frequent use of good moisturizers “keratolytics”. Keratolytics are products which help break apart the keratin plugs so that they gently exfoliate away. Some common exfoliating ingredients that can be found in creams to help KP include urea, alpha hydroxyl acids, such as glycolic and lactic acid, beta hydroxyl acids, such as salicylic acid, vitamin A creams (the retinols and retinoids), and topical vitamin D. Sometimes a mild cortisone may be needed to help with redness or itching. Exfoliation can also be aided by GENTLE scrubs, such as using a clarisonic, soft loofah, or towel in a circular motion with a non-soap moisturizing cleanser (to avoid drying the skin) or an exfoliating cleanser with glycolic or salicylic acid. Harsh scrubbing will only make things worse, so avoid the temptation.

There are many, many, many products on the market for KP. There is no one product that works for everyone. So, you may need to try one or two, or even a few before you find the right one or combination of products. Below are a couple easy to find over the counter options that I like. If the over the counter products don’t work, you may need an evaluation and prescription treatment.

Eucerin Smoothing Repair: This lotion contains contain a combination of ceramides, lipid molecules found in skin which are important in moisturizing the skin, gluco-glycerol, urea and lactic acid.

CeraVe SA Renewing lotion: This lotion contains the same ceramides as in CeraVe’s other creams, with the addition of vitamin D, salicylic acid, ammonium lactate and hyaluronic acid.

photo by: Gavin Craigie