Keratosis pilaris

What is keratosis pilaris?

Keratosis pilaris is a harmless rash on your skin that looks like small red bumps or raised spots. The bumps are caused by extra keratin, a protein found in your skin, hair and nails.

How common is keratosis pilaris?

Keratosis pilaris is very common. It appears in more than half of teenagers and around 40% of adults. Keratosis pilaris can become more pronounced during and after puberty. The rash may disappear or become less noticeable with age, but it may also be longer term.

What causes keratosis pilaris?

Keratosis pilaris is caused by a build-up of keratin under the skin that forms hard, small bumps. The keratin can block hair follicles and sometimes trap hairs under the skin, causing inflammation and redness.

There’s no clear cause for keratosis pilaris, but it’s thought to be hereditary and may be linked to other skin problems like dry skin and atopic eczema.

You might be more prone to getting keratosis pilaris if you have:

• Any hereditary skin conditions

• Atopic eczema

• Dry skin

• Obesity

Keratosis pilaris is typically worse in the winter and improves in the summer.

What are the symptoms of keratosis pilaris?

Keratosis pilaris looks like tiny bumps or spots on the skin, which may feel rough like sandpaper. The rash might be skin-coloured, brown or pink. Some people might just have a few bumps, while others may have more. Keratosis pilaris often occurs on the upper arms and thighs, but it might also affect your face on your cheeks or forehead. Some people also get bumps on their back, chest or bottom.

Common symptoms of keratosis pilaris are:

• Bumps or spots on the skin

• Itching

• Some of the small bumps can have redness around them

• Dry skin

What else could the rash be?

There are several other skin reactions that look like keratosis pilaris. 

• Atopic dermatitis – a common skin condition that causes skin dryness and a red, itchy rash that can look like keratosis pilaris. 

• Folliculitis – inflammation of hair follicles that is usually caused by bacteria. This leads to red, itchy rashes.

• Milia – tiny white bumps under the skin made of keratin. in infants, they’re also called milk spots.

• Sometimes acne can also resemble keratosis pilaris.

How is keratosis pilaris treated?

Keratosis pilaris doesn’t usually need treatment. There’s no cure although it does tend to improve over adult life. There are medications that can help, like moisturisers containing urea, salicylic acid or lactic acid. If you're suffering from severe itchiness, topical steroids can be used to calm this down. 

If you’re worried about the way it looks, there are a few ways to make the rash less obvious, such as laser therapy and chemical peeling.

What can I do myself?

Moisturising your skin with emollient or moisturising lotions and creams can help. Ask a pharmacist for advice on which one might work for you. You can also try gentle exfoliation, but be careful not to scrub too hard as you might cause inflammation. Never scratch or pick at your skin. 

How to relieve keratosis pilaris:

• Keep your skin moisturised with lotions and creams

• Choose mild, unscented skin cleansers

• You can gently exfoliate your skin, but take care not to scrub too hard

• Dry your skin carefully by lightly patting it with a towel instead of rubbing

• Avoid having hot baths or showers

• Avoid picking at or scratching the bumps – this can cause irritation and inflammation

When should I speak to a doctor?

Speak to a doctor if you need help assessing your rash. Get medical help if your rash becomes irritated or inflamed. 

How can Livi help?

You can contact us at Livi for help with keratosis pilaris and other skin problems. A doctor will make an individual assessment, based on your symptoms and the results of a consultation. You may then be given a prescription or a referral for specialist care.

Remember that if it is your child that has the problem, then your child must be present at the consultation.