Keratosis pilaris

Keratosis pilaris (KP) is a very common genetic follicular condition that is manifested by the appearance of rough bumps on the skin and hence colloquially referred to as "chicken skin". It most often appears on the back and outer sides of the upper arms (though the lower arms can also be affected), and can also occur on the thighs and tops of legs, flanks, buttocks or any body part except glabrous skin (like the palms or soles of feet). Less commonly, lesions appear on the face and may be mistaken for acne.

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Classification

Worldwide, KP affects an estimated 40 to 50% of the adult population and approximately 50%-80% of all adolescents ^[1]. It is more common in women than in men.^{[citation needed]} Varying in degree, cases of KP can range from minimal to severe^[2].

There are several different types of keratosis pilaris, including keratosis pilaris rubra (red, inflamed bumps), alba (rough, bumpy skin with no irritation), rubra faceii (reddish rash on the cheeks) and related disorders.

Many people with keratosis pilaris do not know they have it (if the condition is mild). While KP resembles goose bumps, it is characterized by the appearance of small rough bumps on the skin. As a result, it is often confused with acne.

Symptoms and signs

Keratosis pilaris occurs as excess keratin, a natural protein in the skin, accumulates within the hair follicles forming hard plugs (process known as hyperkeratinization). Bearing only cosmetic consequence, the condition most often appears as a proliferation of tiny hard bumps that are seldom sore or itchy. Though people with keratosis pilaris experience this condition year round, it’s during the colder months when moisture levels in the air are lower that the problem can become exacerbated and the “goose bumps” are apt to look and feel more pronounced in color and texture .

Many KP bumps contain an ingrown hair that has coiled. This is a result of the keratinized skin "capping off" the hair follicle, preventing the hair from exiting. Instead, the hair grows inside the follicle, often encapsulated, and can be removed, much like an ingrown hair, though removal can lead to scarring.

Treatment

There is currently no known cure for keratosis pilaris; however, there are effective treatments available which make its symptoms less apparent. The condition often improves with age and can even disappear completely in adulthood, though some will show signs of keratosis pilaris for life. Some treatments are largely symptomatic and may need repeating. Regardless, exfoliation, intensive moisturizing cremes, lac-hydrin, Retin A and medicated lotions containing alpha hydroxy acids or urea may be used to temporarily improve the appearance and texture of affected skin. Milk baths may provide some cosmetic improvement due to the lactic acid — a natural alpha hydroxy acid in milk. Sunlight may also be helpful but increases risk of skin cancer. Small amounts of vitamin A can be used orally but only with extreme caution due to potential for liver damage. Check with a dermatologist or family doctor before taking extra vitamin A due to the its potential toxic effects. A more safe and effective treatment is applying coconut oil to the affected area. Use the coconut oil when in the shower; this should help eliminate the bumps and may even prevent the return of them permanently.

Scratching and picking at KP bumps causes them to redden, and in many cases will cause bleeding. Excessive picking can lead to scarring. Wearing clothing that is looser around the affected areas can also help reduce the marks, as constant chafing from clothing (such as tight fitting jeans) is similar to repeatedly scratching the bumps.

Food allergies may also exacerbate the condition, causing hyper-keratosis pilaris, gluten and dairy being common culprits.^{[citation needed]}

Sun tanning is said by some sufferers to help alleviate symptoms, although the associated risks of tanning (including increased risk of skin cancer) may be more problematic in the long run than the keratosis pilaris. In truth, the sun will help by breaking down the skin but in end worsen the effects from drying out. The best solution is to use a cream or exfoliant that breaks down the thickness of the skin, while staying moisturized.

References

• HelpForKP.com - (Keratosis Pilaris Help) - Provides information on what keratosis pilaris is, treatment options, and discussion forum.

• Information on Keratosis Pilaris from the British Skin Foundation