Articles

Keratosis pilaris is a very common inherited follicular condition characterized by the appearance of rough bumps on the skin and hence popularly referred to as "chicken skin" or "goose bumps".

Originally, they appear on the back and outer sides of the upper arms, but can also occur on thighs and buttocks or any body area 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 percent of the adult population and approximately 50 to 80 percent of all adolescents. Varying in degree, keratosis pilaris can range from slight to severe.

Keratosis pilaris tends to occur as excess keratin, a natural fibrous protein in the skin found normally in human hair, nails and callus, accumulates around hair follicles (process known as hyperkeratinization).

Keratosis pilaris is unattractive, and it most often appears as a proliferation of tiny hard bumps that are seldom sore or itchy. Though people with keratosis pilaris suffer this condition year round, it's during the colder periods when moisture levels in the air are lower that the problem can become worse and the 'goose bumps' will look and feel more pronounced in color and texture.

There are various different types of keratosis pilaris, including keratosis pilaris rubra (red, pronounced bumps), alba (asperous, bumpy skin with no irritation), rubra faceii (red dots on the cheeks) and related conditions.

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 a significant inflammatory component, and thus patients present tiny red papules. This variation 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 occur because a high frequency and intensity of keratosis pilaris is noted during adolescence and in women with 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 harsh tight-fitting clothing or abrasive self-therapy, in which case treatment of the infection is needed. 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 alternatives for keratosis pilaris concentrate on exfoliating or softening the dermis to minimize blocked pores. Treatment initially begins with adherence to nonpharmacologic measures and compliance with daily living actions that will not worsen the condition. An important first step is to apply a mild cleansing agent with abrasive characteristics, 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, brief showers and applying a humidifier, especially during the cold periods when low humidity dries out the skin.