Keratosis pilaris treatment: What are the options?

Keratosis pilaris affects an estimated 50% to 80% of adolescents and 40% of adults. Although this skin condition doesn’t cause harm or require treatment, many people who have it look for solutions to improve the texture and appearance of their skin.

Typically a painless condition, keratosis pilaris occurs when a protein called keratin builds up in the pores (tiny openings) of your skin. The job of pores is to release sweat to help cool you down and oils to lubricate and hydrate your skin. Pores also contain the follicles from which hairs emerge. When they become clogged with keratin, hard, rough bumps may form. In some cases, the bumps may look like goosebumps. On people with fair skin, the bumps may be white, pink, red or purplish-pink. People with dark skin usually develop brown or blackish-brown bumps. Normally, keratosis pilaris doesn’t cause physical discomfort.

Medical science has yet to uncover the exact cause of keratosis pilaris, but based on what we do know, you’re more likely to have the condition if you have:

• A relative with the condition
• Fair or light skin
• Other skin conditions, such as eczema
• Obesity
• Asthma
• Diabetes
• Hypothyroidism
• Down’s syndrome

Keratosis pilaris isn’t contagious, and it’s generally harmless, so treatment isn’t usually necessary. However, you can take steps to address this skin condition if you’re bothered by the presence of bumps.

Treatment for keratosis pilaris may include any of the following interventions:

Moisturizers

Dryness can worsen keratosis pilaris and lead to itching and discomfort. To soothe your skin, apply a creamy moisturizer that contains an occlusive, a type of ingredient that creates a seal over the skin to reduce how much moisture evaporates. Lanolin, glycerin and petroleum jelly are examples of occlusives commonly used in moisturizers.

Apply moisturizer after you shower or bathe, while your skin is still moist, and then reapply two or three more times during the day. Gently massage the moisturizer into the affected skin.

Exfoliation

Exfoliating is the process of lifting away dead skin cells. If you have keratosis pilaris, regular exfoliation may help soften the skin and loosen some of the keratin trapped in your pores.

There are two types of exfoliation: mechanical (physical) and chemical.

• Mechanical exfoliation is the process of removing dead skin with something that produces friction, such as a washcloth, loofah or body scrub. When using this type of exfoliator, apply a light touch to avoid injuring your skin.
• Chemical exfoliation dissolves dead skin cells with chemical ingredients, such as salicylic acid, alpha hydroxy acid or lactic acid. Many exfoliators that contain these ingredients are available over-the-counter. If they fail to produce results, your healthcare provider can prescribe a stronger exfoliator.
  

Retinoids

Increasing the rate at which your body sheds skin cells may also help diminish the appearance of keratosis pilaris. Topical treatments with retinoids, which are derived from vitamin A, help with the cellular turnover process, and they may remove some of the keratin buildup that causes bumps. As with chemical exfoliators, retinoids are available in over-the-counter and prescription strengths.

Corticosteroids

In some cases, healthcare providers may recommend topical corticosteroids to reduce redness and irritation that sometimes accompanies keratosis pilaris. These medications reduce inflammation by inhibiting certain immune system responses. They’re available in over-the-counter and prescription strengths.

Laser and light therapy

When keratosis pilaris doesn’t respond to other treatments, healthcare providers may recommend light or laser therapy treatments, which are performed on an outpatient basis. Depending on the type of laser used, this therapy may reduce swelling, diminish redness, improve skin texture and lessen discoloration.

Self-care

Taking good care of your skin is an important part of any keratosis pilaris treatment plan. Follow these tips to care for yourself during treatment:

• Limit your showers to 15 minutes or less and use lukewarm water rather than hot
• Consider using a humidifier in your bedroom to hydrate your skin while you sleep
• Choose gentle skin care products and avoid those that dry out skin
• Wear loose fitting clothing to protect the affected skin from friction
• Don’t pick or scratch the bumps
• Pat your skin dry after you bathe rather than rubbing

Treatment may assist in clearing up your skin over time. You may begin to see improvements within 4 to 6 weeks with most treatment plans, and symptoms should gradually continue to improve going forward. Some people need to try more than one treatment or combine treatments to see the results they desire.

Healthcare providers often recommend moisturizing, exfoliation and self-care as first-line treatments for keratosis pilaris. However, which treatments are right for you will depend on a variety of factors, such as the location and severity of the bumps, your age, what activities you engage in regularly and your overall health and medical history.

Your healthcare provider can develop a treatment plan based on your individual needs and provide you with personalized skin care tips for addressing keratosis pilaris.

Keratosis pilaris is harmless and doesn’t need to be treated unless it itches, becomes too dry or if you have cosmetic concerns. Your healthcare provider may prescribe retinoids or topical anti-inflammatories, or suggest phototherapy or laser treatments.

Updated June 2023.