What Is Keratosis Pilaris: Causes, Symptoms, Treatments, and Prevention

The skin is the largest organ in the human body, protecting us from all kinds of environmental hazards. However, it is also highly visible and prone to a number of conditions that can be annoying or embarrassing, such as keratosis pilaris. So what is keratosis pilaris?

Keratosis pilaris is a mild skin condition that can affect anyone and is very common. Small bumps form in patches, causing a dry, scaly, and rough texture. Although the bumps are tiny, they are visible and often cause embarrassment. Many people who develop keratosis pilaris are concerned about their symptoms. However, the good news is that aside from cosmetic issues, the condition is not harmful.

Keratosis Pilaris Symptoms

The most telling sign of keratosis pilaris is developing small, raised bumps on the skin, which appear similar to goosebumps. Generally, these bumps are the same color as the skin but may also be darker. Some people have reddish or brown-black bumps, depending on their skin tone.

Most people who develop keratosis pilaris symptoms notice changes in patches of skin on the upper arms, thighs, buttocks, or cheeks. The skin in the affected areas might have a “sandpaper” feel or become dry and scaly. Keratosis pilaris bumps on the cheeks are more common in babies and young children.

Although the bumps can be an embarrassing cosmetic problem, patches of skin affected by keratosis pilaris typically do not hurt. The skin might feel dry or itchy, especially during dry weather, but the condition is not painful. Aside from being an annoyance, keratosis pilaris doesn’t usually affect daily life and normal activities.

Causes & Risk Factors

Keratin is a critical protein in our skin, hair, fingernails, and toenails. Keratosis pilaris is caused by keratin building up around the hair follicles in the skin. Excess keratin creates raised bumps and blocks the hair follicles. The condition is most common among people with light or fair skin but can occur in people of all skin tones.

People of any age can develop keratosis pilaris. However, it’s more common in people under the age of 30. Babies sometimes have excess keratin in their cheeks, causing bumps and redness that eventually go away.

Keratosis pilaris often gets worse during puberty and frequently affects teenagers. Because this coincides with other changes in the body, worsening keratosis pilaris during adolescence can affect confidence and self-esteem in young people.

There are several additional keratosis pilaris risk factors, including:

Family history
Eczema or atopic dermatitis
Asthma
Hypothyroidism (low thyroid hormone levels)
Being overweight
Down syndrome
Diabetes
Cushing’s syndrome (excessive “stress hormone” production)

How to Prevent Keratosis Pilaris

It’s unclear why some people develop keratosis pilaris, and others don’t. The cause of keratosis pilaris is keratin buildup, but the triggers are still not well-understood. Over half of all teens and about 4 in 10 adults will experience keratosis pilaris symptoms at some point in their lives.

Because it is such a mild skin concern, there are no specific prevention protocols—it’s a harmless condition that doesn’t cause any major health problems or discomfort. The bumps caused by keratin buildup can be unsightly, especially in highly visible areas like the cheeks. Teens and young adults with keratosis pilaris are often self-conscious about the appearance of their skin, which can cause emotional distress.

A consistent skincare routine can help calm the skin and improve its appearance, even if keratin does begin to build up. To keep skin in good condition, experts recommend:

Using gentle, fragrance-free cleansers and lukewarm water
Gentle exfoliation when needed
Moisturizing the skin with dermatologist-recommended creams and lotions, especially during dry weather
Using sun protection all year

These steps can help keep the skin healthy, soft, and supple. However, keratosis pilaris can still occur even with ongoing care.

Diagnosis

If you think you or your child might have keratosis pilaris, it might be worth speaking to your doctor or a dermatologist to rule out any other skin conditions and to get advice on caring for the skin. If you’re not sure whether the symptoms are in line with keratosis pilaris or another skin condition, getting a diagnosis can provide peace of mind.

Usually, your doctor will be able to make the diagnosis based on the history and physical exam. It’s not usually necessary to do any lab tests or biopsy to make the diagnosis.

Keratosis Pilaris Treatments

Medical treatment for keratosis pilaris is not necessary because it’s an asymptomatic benign condition. Most people find that the bumps disappear on their own over time. Supportive care at home can sometimes help improve the texture and appearance of the skin.

Moisturizing the skin frequently is a common method for reducing the dry, scaly texture associated with keratosis pilaris. A thicker cream moisturizer, applied several times a day, will help soften, hydrate, and improve the skin.

Other keratosis pilaris treatments include:

Eliminating perfumed skincare products
Gentle exfoliation with a keratolytic (also known as a chemical exfoliator)
Cooler baths and showers
Gentle drying using a patting motion instead of rubbing the skin
Avoiding scratching or picking at the skin
Increasing moisturization during dry weather

If these methods do not make a difference, your dermatologist may be able to offer other treatments, such as laser therapy and topical treatments.

Although it can be tempting to use harsh scrubs in an attempt to remove keratin buildup, this will only irritate the skin. The bumps caused by keratosis pilaris are more likely to become more red and more noticeable when the skin is irritated. Gentle care will help minimize the appearance of the bumps and sandpaper feel of the skin until the condition improves.

Next Steps

If you or your child are concerned about keratosis pilaris, rest assured that it’s regarded as a normal skin texture variation and is nothing to worry about. Over time, most people outgrow the condition.

Because keratosis pilaris sometimes occurs in people with other skin concerns, such as atopic dermatitis, it’s a good idea to look out for any changes in the skin that are not keratosis pilaris symptoms. If the skin becomes itchy and uncomfortable, it might be time to speak with a dermatologist.

Resource Links:

“Keratosis Pilaris” via Cleveland Clinic
“The Best Skincare Routine, According To A Dermatologist” via Forbes
“Keratosis Pilaris” via NHS
“Keratosis Pilaris: Self-Care” via American Academy of Dermatology
“Treatment of keratosis pilaris and its variants: a systematic review” via Journal of Dermatologival Treatment
“Keratosis Pilaris”via StatPearls