Keratosis Pilaris

1 What is keratosis pilaris?

Keratosis pilaris is one of the most common skin conditions. It is usually a harmless condition characterized by dryness, small bumps, and rough patches on the skin of upper arms, thighs, cheeks or buttocks, and makes the skin appear to have a sandpaper-like surface. The bumps or pustules are normally light in color. Generally, this condition doesn't cause any hazardous complications; however, complications may arise if it worsens.

It usually occurs when a protein called keratin, which protects the skin from parasites, germs, and infections, is present in higher concentrations. As mentioned, this does not cause harm, but it could in excess quantities. It is more likely to occur in patients who already suffer from dry skin or eczema.

This condition is most common in children and teenagers, and could get better with age. It commonly disappears as the patients grow older, and typically doesn't causes inflammation. However, it can be itchy. This condition worsens during the winter season, when there is less moisture content in the air. During this time of the year, a proper moisturizing routine is necessary for all skin types. 

Your dermatologist will immediately recognize this condition by looking at your skin. It is very easily distinguishable from other skin conditions. There is no cure or prevention for this condition, but that doesn't mean it isn't treatable; the patient can use moisturizers and prescribed creams to ease symptoms and for improving the appearance of the skin. 

2 Signs and symptoms of keratosis pilaris

Keratosis pilaris symptoms can vary from person to person and it depends on the age and condition. It doesn’t necessarily target one age group and the spots can also vary in size and shape. Keratosis pilaris can cause itchiness and irritation on the skin.

Keratosis pilaris usually affects children and infants because they are more vulnerable and prone to outside bacteria that can harm skin.

Symptoms can fluctuate over time. People with keratosis pilaris can experience a brief period of time where their symptoms will escalate rapidly and get worse, followed by times where keratosis pilaris completely disappears. Keratosis pilaris is an unpredictable condition for many people. As mentioned above, this condition isn’t dangerous, but it is distinguishable, so doctors can begin treatment immediately.

Keratosis pilaris symptoms in newborns

  • Patches of keratosis pilaris can be seen on the scalp, cheeks, and buttocks
  • It can spread throughout the body once it appears
  • It can lead to sleep deprivation from the scratching
  • Use creams as prescribed on the affected area(s)

Keratosis pilaris symptoms in children and teenagers

  • Spots appear behind the elbows or knees, or behind the neck
  • With older age, children have more control when it comes to itching, but it could still become infected
  • Patches are typically light in color but can also appear dark red

Keratosis pilaris symptoms in adults

  • Spots can appear on the arms, buttocks, face, and behind the elbows and knees
  • It can spread rapidly
  • Affected areas could appear inflamed 
  • The bumps are dry and rough

Although this condition can occur at any age, it is most common in younger children. It is considered a chronic condition that can have flare-ups and can worsen or get better.

It is benign and non-contagious. It generally improves in the summer months.

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3 Causes of keratosis pilaris

Keratosis pilaris can be caused by a number of factors, but the root cause is unknown. Keratosis pilaris can be inherited from the parents to the offspring, which makes it a hereditary condition in that case. Its appearance is caused by an acquired accumulation of keratin in the skin's hair follicles which may lead to follicle blockage.

To put it simply, keratosis pilaris appears to be connected with the overproduction of keratin, or hyperkeratinization, in the skin.

Patients who already have eczema or ichthyosis are more likely to develop this condition. Patients who undergo cancer therapy like vemurafenib may also develop keratosis pilaris as a side effect during treatment. Keratosis pilaris can sometimes disguise itself under an impression of another skin condition. Keratosis pilaris can exist under ichthyosis Vulgaris, dry skin seasonal inhalant allergies, rhinitis, asthma, eczema, and atopic dermatitis. The bumps of Keratosis pilaris can arise or get worse as the buildup of keratin escalates.

4 Making a diagnosis

The doctor diagnoses keratosis pilaris by physically examining the affected area. More often than not, doctors can tell if it is keratosis pilaris by observation alone. To identify Keratosis pilaris, a patient doesn’t have to go through any tests or thorough examination as it is easily distinguishable. Keratosis pilaris is usually self-diagnosable, but if symptoms are severe or if the skin appears infected, one may need to consult a physician or a skin specialist (dermatologist).

Untreated and/or infected keratosis pilaris spots can leave permanent scarring. Keratosis pilaris can be treated at home, but visiting a doctor and taking a specialist’s advice is always advisable. 

5 Treatment

There is no specific treatment method for keratosis pilaris.

It can be managed properly by following certain measures:

  • Lactic acid lotions can be used to reduce roughness and soften the clogged hair follicles
  • In order to reduce scaling, the patient can use Alpha hydroxy or glycolic acid lotions
  • Urea creams and Salicylic acid lotion can be used to moisturize and soften the skin
  • Use of corticosteroids helps in reducing itching
  • Topical use of retinoids also helps in preventing the hair follicles from getting clogged

If you want to treat keratosis pilaris at home, follow these tips. Remember that visiting a doctor can make a big difference and can also prevent potential infection.

  • Do not scratch or rub the affected area of skin. Never roughly itch the bump as it can leave marks, making it worse
  • Use mild warm water for bathing or showering rather than hot water. Hot water can escalate the inflammation sensation more
  • Try to stay away from water as much as you can
  • Always keep the affected area moisturized and apply moisturizer or the prescribed cream routinely or as instructed
  • Add moisture to the air where you live with the help of a humidifier
  • There are few treatments that you can use in order to eliminate Keratosis pilaris completely. The treatment measures mentioned above can help if used efficiently.

Topical exfoliants

These remove dead skin from the surface, removing all the bacteria or extra keratin that can cause keratosis pilaris. It is recommended not to use on children as their skin is sensitive.

Topical retinoids

This prevents hair follicles from being plugged, but it can also cause redness. Topical retinoids are strictly prohibited for pregnant women or for those who are planning to become pregnant.

6 Prevention

Anyone can get keratosis pilaris at any stage of life. Keratosis pilaris is usually considered to be a popular skin condition among children and adolescents. In terms of gender, females tend to get keratosis pilaris more often than males.

Children up to 10 years old are at a higher risk of getting keratosis pilaris. As they grow up, especially during puberty, keratosis pilaris may get worse but it is highly treatable. Keratosis pilaris is hereditary. 

7 Lifestyle and coping

Lifestyle modifications are necessary in order to cope with keratosis pilaris. Self-help measures would not prevent keratosis pilaris or treat it completely, but they may improve the appearance of the affected skin.

Some effective measures which should be followed are:

  • Avoid scratching or rubbing the bumps
  • Use warm water rather than hot water for bathing
  • Limit your time in the water
  • Use hydrating soaps
  • Use thick moisturizers to keep your skin moist
  • Add moisture to the air at your home with a humidifier
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