Keratosis pilaris is a highly common genetic follicular condition manifested by the appearance of rough bumps on the skin and hence popularly known as "chicken skin" or "goose bumps".
Primarily, they appear on the back and outer sides of the upper arms, but can also appear on thighs and buttocks or any body part except on skin having a surface devoid of hair or pubescence (like the palms or soles of feet). On a global level, keratosis pilaris affects an estimated 40 to 50% of the adult population and approximately 50 to 80% of all teenagers. Varying in degree, keratosis pilaris can range from minimal to severe.
Keratosis pilaris tends to appear as excess keratin, a natural fibrous protein in the skin found usually in human hair, nails and callus, gathers around hair follicles (process known as hyperkeratinization).
Keratosis pilaris is unsightly, and it most often shows as a group of small hard bumps that are seldom sore or itchy. Though people with keratosis pilaris experience this condition year round, it's during the colder months when moisture levels in the air are lower that the problem can become exacerbated and the 'goose bumps' will appear and feel more pronounced in color and texture.
There are various different kinds of keratosis pilaris, including keratosis pilaris rubra (red, pronounced bumps), alba (rough, bumpy skin with no irritation), rubra faceii (reddish dots on the cheeks) and related disorders.
Keratosis pilaris alba is the more usual type and is characterized by tiny gray-white papules with a slight inflammatory component.
Keratosis pilaris rubra has an important inflammatory component, and thus sufferers present tiny red papules. This type is most conspicuous during the cold months.
Cells that have keratin are constantly being shed and replaced by new ones. The condition known as dandruff results when the scalp sheds such cells. Hormonal influence can appear because a high prevalence and intensity of keratosis pilaris is noted during puberty and in women suffering hyperandrogenism. In severe cases, the pores can become blocked and produce acne. The clogged pores appear like comedones of keratinized plugs surrounding the hair follicle.
Treatment of Keratosis Pilaris
Many sufferers find keratosis pilaris lesions cosmetically unappealing and therefore seek treatment. Occasionally, they can become secondarily infected because of scratchy tight-fitting clothing or abrasive self-therapy, in which case treatment of the infection is necessary. A significant inflammatory component may be present and can be relieved with topical steroid therapy. Treatment of the noninflamed papules can be difficult because they have proven resistant to most types of therapy.
Treatment options for keratosis pilaris concentrate on exfoliating or softening the dermis to reduce blocked pores. Treatment initially starts with adherence to nonpharmacologic measures and compliance with daily living functions that won't worsen the condition. An important first step is to use a mild cleansing agent with abrasive properties, often named scrub, but one that is not drying (for sensitive skin). The goal is to clean and open the pores of the dermis. Other measures to avoid excessive dryness include taking tepid, quick showers and using a humidifier, especially during the cold months when low humidity dries out the skin.