WHAT IS KERATOSIS PILARIS?
What is Keratosis Pilaris?
Keratosis Pilaris (KP) is a benign skin condition characterized by the appearance of tiny bumps on the skin that can appear as “chicken skin,” commonly found on the arms but can also be found in other parts of the body. It can affect people of all ages and races and is common in children and adolescents. It is non-contagious and harmless and is often considered a variant of normal skin.
What is the cause of Keratosis Pilaris?
The exact cause of KP is still poorly understood. It is thought to be caused by the abnormal build-up of keratin which fills the hair follicles and blocks the follicular openings, causing bumps on the skin. It is also postulated to have a genetic etiology, as it is strongly associated with certain skin conditions such as atopic dermatitis and ichthyosis Vulgaris.
The following factors contribute to the risk of having KP:
- Asthma, Atopic dermatitis, Ichthyosis vulgaris
- Family history of KP
- Being overweight or obese
- Hypothyroidism, Cushing syndrome, Insulin-dependent diabetes
- Down’s syndrome
Keratosis pilaris is also aggravated by changes in weather. Cold, dry weather and low humidity can exacerbate KP and cause the appearance of bumps in the skin.
Clinical features of Keratosis Pilaris
Lesions of KP appear as skin-colored, red, or brown keratotic, follicular papules or bumps most commonly found on the lateral cheeks, lateral sides of the arms, thighs, and buttocks. It can appear on any part of the body, except the palms and soles. The skin feels dry, and the lesions look like “chicken skin” or “goosebumps,” which may or may not be accompanied by pruritus/itch.
Biopsy of the lesions is usually not needed, but a dermoscopic exam can show hair shaft abnormalities with short hair shafts that are coiled or twisted, along with the presence of erythema and/or scaling.
Management of Keratosis Pilaris
Keratosis Pilaris lesions are chronic and benign, so treatment is not always necessary. However, it can be bothersome for some patients; therefore, treatment usually focuses on minimizing the symptoms such as the itch, dryness, and bumpy appearance.
Keratolytic agents can help loosen and soften dead skin cells, which can smoothen out the KP lesions. However, these agents may have potential side effects such as burning or stinging sensation, erythema, and irritation. Keratolytic agents include:
- Urea
- Lactic acid
- Glycolic acid
- Salicylic acid
- Retinoids (tretinoin, adapalene, retinol, etc.)
- Alpha hydroxyl acid
Topical corticosteroids may also be given to treat the bumps. This can help reduce the redness, itch, and irritation that may be seen with KP. For some cases, vascular lasers and pigment lasers can be used to improve the redness or hyperpigmentation associated with KP.
Some lifestyle modifications may be helpful to those who have KP. These include:
- Limiting bath time to 5-10 minutes.
- Use a mild cleanser.
- Applying moisturizer, especially after bath, traps the moisture and lessen the dryness of the skin.
- Use warm water when bathing.
- Gentle exfoliation, if needed.
- Using a humidifier indoors, to add moisture into the air
Prognosis
KP is a chronic disease; therefore, there is no known cure. Lesions may come and go, especially when triggered. If symptoms of KP are bothersome and if they affect your daily activities, it would be better to consult with a dermatologist to determine the appropriate treatment for your skin condition.
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References:
- Kang, S., & Leffell, D. J. (2019). Fitzpatrick’s Dermatology, 9e.
- Keratosis pilaris - Symptoms and causes - Mayo Clinic. (2021, January 30). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/keratosis-pilaris/symptoms-causes/syc-20351149
- Keratosis pilaris: Overview. (n.d.). American Academy of Dermatology. Retrieved June 13, 2022, from https://www.aad.org/public/diseases/a-z/keratosis-pilaris-overview
- Keratosis Pilaris: Symptoms, Causes, and Treatment — DermNet. (n.d.). DermNet NZ – All about the Skin | DermNet NZ. Retrieved June 13, 2022, from https://dermnetnz.org/topics/keratosis-pilaris
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