Keratosis pilaris is a very common skin condition in which skin cells that normally flake off plug hair follicles (tiny pockets beneath the skin from which hair grows). The condition results in small bumps that are usually white, but sometimes red. It most often affects the upper arms, buttocks and thighs. The bumps resemble goose bumps or chicken skin and are the texture of coarse sandpaper. It is a benign (harmless) condition.

According to the American Academy of Dermatology, up to 40 percent of the population has keratosis pilaris, and it is much more common in children (particularly adolescents). Its cause is unknown, but it appears to be hereditary. The condition is often worse during the winter, clearing up during the summer.

Among treatments for keratosis pilaris are moisturizing lotions to prevent dry skin, topical retinoids that regulate skin growth and mild peeling agents that may unclog hair follicles.

Keratosis pilaris is a common skin disorder in which a protein found in the skin called keratin forms hard plugs within the hair follicles (tiny pockets beneath the skin from which hair grows).

In the normal development of skin, cells produce keratin, which forms the upper layers of the skin, nails and hair. The cells and keratin eventually move toward the outermost layer of the skin (called the stratum corneum) and then die and flake away.

In keratosis pilaris, the keratin does not flake off, but clogs the hair follicles and forms small bumps. The bumps usually resemble goose bumps or chicken skin and are the texture of coarse sandpaper. They can be found almost anywhere on the body (except the soles of the feet and palms), but are most common on the upper arm, buttocks and thighs. In some cases, bumps appear on the face. This is especially common in children. In extreme cases, the condition may also affect the chest and back. 

There are several different types of keratosis pilaris, including:

• Keratosis pilaris rubra. Characterized by red, inflamed bumps.
  
  
• Keratosis pilaris alba. Characterized by rough, bumpy skin with no irritation.
  
  
• Keratosis pilaris rubra faceii. Characterized by a reddish rash on the cheeks.

According to the American Academy of Dermatology, up to 40 percent of the population has keratosis pilaris. It can affect people of any age, but it is most common in children and found more often in girls. Because dry skin exacerbates the condition, it is usually worse during the winter and often clears up during the summer when humidity reduces the severity of dry skin. However, some patients flare-up with the summer heat. Women with the condition may also develop an increase in the severity of their symptoms during pregnancy or following childbirth.

Keratosis pilaris is a benign (harmless) condition. However, in some cases, patients may be distressed by the appearance of the skin.

The cause of keratosis pilaris is unknown, but it seems to be hereditary. It is also more common in overweight individuals and patients with atopic dermatitis, the type of eczema (chronic, itchy inflammation of the upper layers of the skin) caused by allergies.

Keratosis pilaris is sometimes confused with acne. The bumps usually do not itch or cause pain. Sometimes, a small, coiled hair can be seen beneath a bump.

Other signs and symptoms include:

• Skin with fine, bumpy texture
• Skin–colored bumps that are the size of a grain of sand
• Slight pinkness around some of the bumps

A physician can usually diagnose keratosis pilaris by visually inspecting the skin during a physical examination. Additional diagnostic tests are usually not required.

Because it is hereditary, there is no way to cure or prevent keratosis pilaris. However, it may lessen over time with age.

In some patients, the condition clears up on its own. When it does not, patients may choose to seek treatment for cosmetic reasons. There are several treatments aimed at softening the keratin deposits in the skin to improve its appearance. They include:

• Moisturizing lotions. Dry skin makes the condition worse, so applying moisturizer twice daily is important. Lotions that contain urea help the skin retain moisture and products that contain lactic acid or salicylic acid help to dissolve and exfoliate the keratin. Moisturizer should be applied immediately after bathing.
  
  
• Loofah sponges or brushes. Rubbing the affected areas after a long soak in a hot bath may help to unclog the plugged hair follicles.
  
  
• Topical retinoids. Class of chemical compounds that are chemically related to vitamin A. These drugs regulate skin growth but can be very irritating.
  
  
• Mild peeling agents (alpha hydroxy acids). When applied to the skin, they may open the plugged hair follicles.
  
  
• Antibiotics. In some cases, antibiotics (medications that kill or slow the growth of harmful microorganisms) may be prescribed if the bumps are very red.

Laser hair removal may also be recommended in some cases. In individuals with certain underlying conditions, such as eczema, keratosis pilaris often improves when the underlying disorder is addressed.

Even if the condition clears up with treatment, it is likely to recur. As a result, treatment must be continued regularly. A patient’s treatment for keratosis pilaris may continue for several years.

It is important to note that individuals with keratosis pilaris should avoid scratching the affected area. This can injure the bumps, leaving them open to infection.

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to keratosis pilaris:

1. Do my symptoms indicate keratosis pilaris?
   
   
2. Does keratosis pilaris pose a danger to my overall health?
   
   
3. What type of keratosis pilaris do I have?
   
   
4. What may have caused me to develop the condition?
   
   
5. Can I spread the condition to others?
   
   
6. What are my treatment options?
   
   
7. Am I likely to develop the condition again following treatment? If so, will it occur in the same areas and to the same degree?
   
   
8. I have heard dry skin makes the condition worse. What are some ways to prevent dry skin?
   
   
9. Am I more likely to develop the condition at certain times of year, or does it develop year-round?
   
   
10. Will my child inherit my keratosis pilaris?