Keratosis Pilaris Treatment in Delhi, India

Keratosis pilaris has a typical skin appearance. The bumps that appear on the skin look like goosebumps. It may also resemble the skin of a plucked chicken and hence is also known as "chicken skin".

These bumps can appear on any skin surface where hair follicles exist. However, it is never seen in the feet or palms. It commonly involves the skin on the upper arms and thighs and may sometimes affect the forearms and lower part of the legs.

Other associated symptoms include:

• Slight pinkness or redness around bumps
• Bumps that appear in different colours based on the skin tone (red, pink, brown, flesh-coloured, white, or black)
• Itchy, irritable skin
• Dry skin
• Bumps that feel like sandpaper

Keratosis pilaris occurs due to the accumulation of keratin, a hair protein in the pores. The accumulated keratin blocks the opening of the growing hair follicles. As a result, small bumps begin to form over areas where hair should grow.

The exact reason for the build-up of keratin is unknown. However, the condition can be associated with other conditions, such as genetic disorders and atopic dermatitis. Some other reasons associated with this condition include:

• Hormonal changes sometimes cause flare-ups during pregnancy and puberty.
• Fair skin individuals are more susceptible.
• Genetics

Keratosis pilaris is diagnosed based on the patient's physical examination and medical history. Dermatologists often diagnose the condition just by looking at the skin. Some other supporting factors include:

• Age of the patient
• The appearance of the skin
• Affected areas

There are no formal tests needed to confirm the condition. However, sometimes an allergy test or a biopsy may be done to eliminate doubts about having other conditions.

Location of Keratosis Pilaris Bumps

Keratosis pilaris bumps often involve the upper arms and thighs. However, they can affect any skin areas, except the palms and feet, such as:

• Face - cheeks, neck or under the eyes
• Legs - thighs
• Butt
• Forearms
• Back
• Chest

Characteristics of Keratosis Pilaris

The bumps that appear in keratosis pilaris feel different to touch. These have the following characteristics:

• Painless: Keratosis pilaris bumps are painless. If the bumps hurt, it is another condition requiring further diagnosis.
• Itchy or dry: The bumps and the surrounding skin may feel dry or itchy.
• Rough: Running hands over the bumps may feel rough, like touching sandpaper.
• Discoloured: Depending on the natural colour of your skin, your bumps may appear skin-coloured, red, white, brown, dark brown or black.

Keratosis pilaris usually does not need any treatment. It heals on its own. However, if it bothers too much, various products are available to improve the appearance of the skin. If over-the-counter moisturisers and other self-care measures don't help, prescribed medicines may be beneficial.

• Creams to remove dead skin cells: Creams that contain lactic acid, salicylic acid, alpha hydroxy acid, or urea loosen and remove dead skin cells. In addition, they moisturise the skin and soften it. These may be prescription creams or over-the-counter varieties, depending on their strength. Sometimes, the acids in the creams may lead to stinging sensation, skin irritation or redness, and are thus not recommended for use by children.
• Creams that prevent plugged follicles: Creams derived from vitamin A, also commonly known as topical retinoids, help prevent clogging of the pores. However, these creams may cause dryness and irritate the skin. In pregnant or lactating women, topical retinoid therapy is not advisable.

Regular use of medicated creams improves the appearance of the skin and prevents itchiness and dryness, but the condition may relapse on stopping its use. Even with treatment, keratosis pilaris may remain for years. 

The dermatologist may also prescribe medicines that aid in removing dead skin cells. These medicines contain at least one of the following ingredients:

• Alpha hydroxy acid (AHA)
• A retinoid such as adapalene, tazarotene, tretinoin, retinol
• Salicylic acid
• Glycolic acid
• Lactic acid
• Urea

Dermatological treatments

If creams don't work, dermatologists may recommend the following treatment modalities:

• Microdermabrasion, an intense exfoliating therapy

• Retinol creams

• Chemical peels

Some experimental treatment modalities, such as photopneumatic therapy and vascular laser treatment, are also available.

The effectiveness of lasers

A laser or light treatment might help treat keratosis pilaris. One type of laser may be recommended for reducing redness and swelling, while another type may help improve the skin's texture and lower discolouration. Lasers also help clear the brown marks that may appear when the bumps are cleared. For best treatment outcomes with lasers, a combination of lasers and microdermabrasion sessions may be beneficial.

Home remedies

One can try some home remedies if allopathy does not help relieve symptoms. In some cases, trying home remedies in combination with medical treatment may improve the condition. Even though the condition cannot be cured, self-care treatments can minimise itching, redness, bumps and irritation. Some home remedies include:

• Take warm baths: Short and warm baths open and unclog the pores. However, do not overdo this since it can remove the body's natural oils for nourishment.

• Exfoliate: Regular exfoliation improves the appearance of the skin and helps unclog the pores. Dermatologists recommend using a loofah or pumice stone with gentle movements.

• Apply hydrating lotions: Lotions that contain alpha hydroxy acids, like lactic acids, provide hydration to the skin. As a result, more cells are produced, and fewer cells die. Skin becomes smoother, and with time, the skin condition improves. In addition, rose water can soothe inflammation of the skin.

• Avoid tight clothes: Wearing tight clothes causes friction between the clothes and the skin. The resulting friction irritates the skin and causes redness and itchy marks.

• Use humidifiers: Humidifiers increase the room's moisture in the air, which plays a role in maintaining the moisture in the skin. In addition, it prevents itchy flare-ups.

Be gentle to the skin: Avoiding harsh and skin-drying soaps is essential to improve skin with keratosis pilaris. It is important to remove dead skin using a washcloth or loofah. Avoid using rough and hard measures such as rough stones that can irritate the skin. Vigorous scrubbing or removal of hair follicle plugs should also be avoided. The skin should be gently patted with a towel after washing or bathing to leave some moisture on the skin's surface.

Keratosis pilaris commonly affects women, teenagers and children. In addition, it can be associated with the following conditions:

• Ichthyosis
• Hay fever
• Dry skin
• Eczema
• Obesity
• Late infancy or adolescence
• Hormonal changes during pregnancy and puberty
• Fair skin

Certain medical conditions associated with the disease are:

• Eczema
• Cushing's syndrome
• Diabetes
• Ichthyosis Vulgaris
• Asthma
• Hypothyroidism
• Down syndrome
• Obesity

Reviewed by Dr. Veenu Jindal, Attending Consultant, Dermatology on 20-Mar-2023.