Keratosis pilaris is a common skin condition which is usually characterized by small bumps on the back of the arms. It often occurs in people who have rough dry skin. The disorder results from a buildup of keratin, a protein, in the opening of the hair follicles in the skin. This makes the affected skin feel rough. Keratosis pilaris usually occurs on the arms, thighs and
cheeks. It's more common in children than in adults. The disorder may be associated with eczema (dermatitis).
In mild cases, small bumps, similar in appearance to "goose bumps," experienced when cold or frightened, are found on the posterior portion of the upper arms. The texture is that of very coarse sandpaper. Bumps may also appear on the buttocks and thighs. Less commonly, lesions on the face are found, often mistaken for acne. Individual lesions consist of a small, skin-colored papules which form within hair openings. The condition is generally worse in winter and often clears in the summer.
Keratosis pilaris is particularly common in teenagers on the upper arms. It may occur in babies where it tends to be most obvious on the cheeks. It may remain for years but generally gradually disappears usually before age 30. Keratosis pilaris is unsightly but completely harmless. It is usually worse during the winter months or other times of low humidity when skin dries out, and may worsen during pregnancy or after childbirth.
The specific causes of this disorder are unknown. Since this disorder runs in families, it is thought to be hereditary. Keratosis pilaris is not a serious disorder and is not contagious. The symptoms of keratosis pilaris are based on the development of small white papules the size of a grain of sand on the upper arms, thighs, and occasionally the buttocks and face. The papules occur around a hair follicle and are firm and white. They feel a little like coarse sandpaper, but they are not painful and there usually is no itching associated with them. They are easily removed and the material inside the papule usually contains a small, coiled hair.
Treatment of keratosis pilaris is not necessary, and unfortunately often has disappointing results. To treat keratosis pilaris patients can try several strategies to lessen the bumps. First, the patient can supplement the natural removal of dry skin and papules by using a loofah or another type of scrub showering or bathing. A variety of different over-the-counter (OTC) lotions, ointments, and creams can also be applied after showering while the skin is still moist and then several times a day to keep the area moist. Medicated lotions with urea, 15% alphahydroxy acids, or Retin A can also be prescribed by the dermatologist and applied one to two times daily. Systemic (oral) medications are not prescribed for keratosis pilaris. However if papules are opened and become infected, antibiotics may be necessary to treat the infection.