Keratosis pilaris

We do not fully understand the cause of keratosis pilaris, but it appears to be associated with certain genes. Keratosis pilaris is harmless and is not infectious.

Is keratosis pilaris hereditary?

It is usually found in more than one member of a family. The way it is inherited varies from family to family, but it often fits into an 'autosomal dominant' pattern. This means that there will be a 1 in 2 chance that each child of an affected parent will inherit the condition.

Some people find keratosis pilaris unattractive. The skin feels rough, dry and appears as though it has permanent goose bumps. It can occasionally be itchy as well.

What does keratosis pilaris look like?

The groups of small bumps are most common on the backs of the upper arms and on the fronts of the thighs. Keratosis pilaris can also affect the buttocks, lower back and chest and, in less common forms, the face and eyebrows as well. Some redness may appear around the small bumps.

Image DermNetNZ.

There are no specific tests for keratosis pilaris. The doctor will be able to make a diagnosis based on the typical appearance. There are other conditions that can sometimes look similar to keratosis pilaris and a skin biopsy might help the diagnosis.

Can keratosis pilaris be cured?

No. However, it often (but not always) clears up during adult life.

Treatments don’t clear keratosis pilaris completely, but they can improve the condition temporarily. Emollients (moisturisers) can help soften the texture of the skin. Creams containing salicylic acid, lactic acid and/or urea can soften and flatten the bumps on the skin. These creams can be purchased over the counter or obtained on prescription from the doctor. The doctor may also sometimes prescribe topical retinoids (a group of medications related to vitamin A) which may reduce the redness and rough texture. Other treatments can also be used. However, they are not offered on the NHS (National Health Service) and HSC (Health and Social Care) as they can be expensive and are not shown to be very effective.  These include topical corticosteroids, photodynamic therapy, various lasers, chemical peels and dermabrasion. In many cases, it may be best to wait for the problem to improve on its own.

CAUTION:

This leaflet mentions 'emollients' (moisturisers). Emollients, creams, lotions and ointments contain oils. When emollient products get in contact with dressings, clothing, bed linen or hair, there is a danger that they could catch fire more easily. There is still a risk if the emollient products have dried. People using skincare or haircare products should be very careful near naked flames or lit cigarettes. Wash clothing daily and bedlinen frequently, if they are in contact with emollients. This may not remove the risk completely, even at high temperatures. Caution is still needed. More information may be obtained at https://www.gov.uk/guidance/safe-use-of-emollient-skin-creams-to-treat-dry-skin-conditions

General measures to reduce skin dryness may help:

• Use mild soaps or soap substitutes
• Apply emollients (moisturisers) frequently
• Have tepid rather than hot showers or baths
• The gentle use of an exfoliator may sometimes help