Doctor’s Note: Your Essential Guide to Keratosis Pilaris

As dermatologists, we know that keratosis pilaris (KP) can be really frustrating. This skin condition can last for many years, causing discomfort, itchiness, and making people feel self-conscious. While it’s hard to completely cure KP, there are many treatments that can help relieve symptoms and make your skin look better.

Doctor's Note

What is Keratosis Pilaris?

Keratosis pilaris (KP), also known as "chicken skin," is a common skin problem that causes small, rough bumps. These bumps often show up on the upper arms, thighs, cheeks, or buttocks. They happen when keratin, a protein in hair, builds up and clogs hair follicles. While KP doesn’t have a cure, it usually gets better by age 30. In the meantime, good skin care and treatments can help manage it.

Keratosis Pilaris Graphic

Keratosis Pilaris Pictures

Symptoms of keratosis pilaris (KP) include small bumps that can be flesh-colored, white, red, pink, brown, or black, often with some discoloration around them. These bumps usually show up on areas with hair follicles, like the upper arms, thighs, cheeks, or buttocks, but not on the palms or soles.

Rough, tiny bumps that look like goosebumps

Rough, tiny bumps that look like goosebumps

Dry, itchy, or irritated skin

Dry, itchy, or irritated skin

A sandpaper-like texture to the affected areas

A sandpaper-like texture to the affected areas

I often explain to my patients with keratosis pilaris (KP) that it is not exactly a “rash.” It’s just how their skin forms in certain areas, causing a bumpy texture. Although there are ways to reduce the appearance of the bumps, no medication or procedure can completely get rid of them. However, KP usually gets better on its own when patients reach their 30s.

What Causes Keratosis Pilaris?

Keratosis pilaris occurs when keratin, a protein in hair, builds up and clogs pores, blocking hair follicles. The exact reason for this buildup isn't clear. KP is more common in fair-skinned women, children, and teenagers who have:

  • Dry skin

  • Eczema

  • Hay fever

  • Seasonal allergies

  • Obesity

Hormonal changes during puberty and pregnancy can make keratosis pilaris worse. It usually starts in late childhood or the teen years and often gets better or goes away by age 30.

Dry skin - Eczema - Ichthyosis (extremely dry skin) - Hay fever

What Makes Keratosis Pilaris Worse?

Keratosis pilaris is a long-term skin condition that can come and go. Certain things can make it worse, such as:

  • Dry Skin: Low humidity and cold weather can make skin drier.

  • Hot Showers: Long, hot showers can remove natural oils from the skin.

  • Tight Clothing: Tight clothes can rub against the skin and cause irritation.

  • Harsh Soaps: Soaps with strong chemicals can dry out the skin.

  • Picking or Squeezing: Picking at the bumps can lead to irritation, swelling, or even scars.

What Makes KP Worse

What Makes Keratosis Pilaris Better?

Keratosis pilaris is a skin condition that can improve or worsen over time. Here are some ways to reduce symptoms:

  • Moisturizing: Use creams with urea or glycerin to soften the skin. Thicker creams work best and should be applied to damp skin after a shower.

  • Warm Baths: Short, warm baths can help unclog pores. Keep them brief to avoid drying out the skin.

  • Humidifiers: Use a humidifier to add moisture to the air and keep skin hydrated.

  • Avoid Tight Clothes: Loose clothing helps prevent friction and irritation.

  • Gentle Skincare: Use mild soaps and avoid scrubbing too hard or picking at the bumps.

  • Sun Protection: Limit sun exposure, especially if using exfoliating products.

  • Diet: Eat foods high in Omega-3s, like salmon, walnuts, and flaxseeds.

KP

How to Treat Keratosis Pilaris

Here are some ways to treat keratosis pilaris (KP), each targeting different parts of the hair follicle:

  1. Remove Dead Skin Cells: Use lactic, salicylic, or glycolic acid, or gently scrub with a loofah or washcloth.

  2. Reduce Inflammation: Apply a steroid cream, like hydrocortisone, to calm the skin.

  3. Prevent Clogged Pores: Retinol can help keep pores clear.

  4. Hair Removal: Laser treatments can reduce bumps by targeting hair.

Why does this matter? If one treatment doesn’t work, try another category! Different treatments target different parts of KP, so switching from exfoliating to a steroid cream, or from retinol to laser, can help you find the best fit.

For example, if lactic acid and glycolic acid (both Category #1) don’t work, try a topical steroid (Category #2) or retinol (Category #3) next. This approach makes sure you’re exploring all treatment options!

KP Graphic

Best Products for Keratosis Pilaris

Category 1: Remove Dead Skin Cells

Here are some of the best products for treating keratosis pilaris (KP). Look for lotions or creams with ingredients like lactic acid, urea, or salicylic acid. These help to smooth rough skin and remove dead cells. Products with moisturizing ingredients like ceramides or shea butter can also soothe and hydrate the skin. Popular choices include CeraVe SA Cream, AmLactin Daily Moisturizing Lotion, and Eucerin Roughness Relief Lotion. Using these regularly can help soften the bumps, but keep in mind that KP is a chronic condition, so continued treatment is key.

Amlactin for Keratosis Pilaris

These products contain lactic acid, which both exfoliates + moisturizes. Lactic acid is very gentle. Choose this if you have very sensitive skin.

Urea Cream for Keratosis Pilaris

Urea gently exfoliates deep in the pores, softening skin and adding moisture. It’s mild, so it’s less likely to irritate sensitive skin.

Salicylic Acid for Keratosis Pilaris

Exfoliates deep into the pore. Gentle. Should not irritate skin too much.

Glycolic Peel for Keratosis Pilaris

A stronger and more irritating acid. Choose this if the above options have not worked for your skin.

Keratosis Pilaris Body Wash

The most irritating + aggressive. For stubborn KP that does not respond to the above treatments.

Exfoliating Scrub for Keratosis Pilaris

The most irritating + aggressive. For stubborn KP that does not respond to the above treatments.

Amlactin for Keratosis Pilaris Before and After

Why do dermatologists always recommend Amlactin? Amlactin is a moisturizer that contains a bit of lactic acid, which gently exfoliates and moisturizes at the same time. This makes it ideal for sensitive skin needing exfoliation. Glycolic acid can be more irritating, so it’s less favored for KP. Amlactin provides both moisture and gentle exfoliation, which is why it’s often recommended. Here’s what it can do:

Amlactin for Keratosis Pilaris Before and After

Image: Kootiratrakarn, Tanawatt, Kampirapap, Kowit, Chunhasewee, Chakkrapong, Epidermal Permeability Barrier in the Treatment of Keratosis Pilaris, Dermatology Research and Practice, 2015, 205012, 5 pages, 2015.

Best Product to Decrease Redness

Category 2: Reduce Inflammation

Cortisone

In addition to removing dead skin cells, we can also use hydrocortisone to reduce inflammation. Hydrocortisone is a cream that helps calm down redness and irritation from KP. It can make the bumps look less noticeable. Use it as directed and only for short periods, because using it for too long can make your skin thinner. Be sure to apply a good moisturizer afterward to keep your skin hydrated and protected.

Tretinoin for Keratosis Pilaris

Category 3: Prevent Clogged Pores

Olay Regenerist Retinol 24 Night Moisturizer
Neutrogena Retinol Regenerating Cream

Along with removing dead skin cells, we can prevent clogged pores using retinol or tretinoin (a stronger, prescription retinol). Retinol, a type of vitamin A, speeds up skin cell turnover to help unclog hair follicles often blocked in KP. Using retinol regularly can reduce bumps, but start with a low strength and keep your skin moisturized. Remember to use sunscreen, as retinol can make your skin more sensitive to sunlight!

Laser Hair Removal Keratosis Pilaris

Category 4: Hair Removal

If the above methods don’t work, laser therapy is another option. Many laser treatments have been tried over the years for KP, and here is our top pick for treating it:

Laser Hair Removal Image: Above: Li M, Bai Y, Duan Z, Yuan R, Liu X, Liu Y, Liang X, Wu H, Zhuo F. Efficacy and Safety of Long-Pulsed 755-nm Alexandrite Laser for Keratosis Pilaris: A Split-Body Randomized Clinical Trial. Dermatol Ther (Heidelb). 2022 Aug;12(8):1897-1906. doi: 10.1007/s13555-022-00771-5. Epub 2022 Jul 15. PMID: 35838863; PMCID: PMC9357583.

KP Before and After

Laser hair removal can sometimes help with KP. It works best for dark hair and can improve skin texture by targeting the bumpy areas, making them less noticeable.

Keratosis Pilaris FAQs

How often to use AmLactin for keratosis pilaris?
AmLactin can be used daily or twice a day for keratosis pilaris to help exfoliate and moisturize the skin. Consistent use over several weeks is recommended for noticeable results.

Does keratosis pilaris look glittery?
Keratosis pilaris can sometimes appear slightly shiny or "glittery" due to dry, scaly skin reflecting light. Moisturizing can reduce this effect.

Does body scrub help with keratosis pilaris?
Body scrubs can help improve keratosis pilaris by exfoliating dead skin cells. Use gentle scrubs to avoid irritation, and follow with a moisturizer for best results.

Does laser hair removal help keratosis pilaris?
Laser hair removal can help reduce keratosis pilaris in some cases by minimizing hair growth and associated inflammation. However, it is not a guaranteed treatment and results may vary.