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Keratosis pilaris

Definition

Keratosis pilaris is a common skin condition in which a protein in the skin called keratin forms hard plugs within hair follicles.

Causes

Keratosis pilaris is harmless (benign). It seems to run in families. It is more common in people who have very dry skin, or who have atopic dermatitis (eczema).

The condition is generally worse in winter and often clears in the summer.

Symptoms

Symptoms may include:

  • Small bumps that look like "goose bumps" on the back of the upper arms and thighs
  • Bumps feel like very rough sandpaper
  • Skin-colored bumps are the size of a grain of sand
  • Slight pinkness may be seen around some bumps
  • Bumps may appear on the face and be mistaken for acne

Exams and Tests

The health care provider can usually diagnose this condition by looking at your skin. Tests are often not needed.

Treatment

Treatment may include:

  • Moisturizing lotions to soothe the skin and help it look better
  • Skin creams that contain urea, lactic acid, glycolic acid, salicylic acid, tretinoin, or vitamin D
  • Steroid creams to reduce redness

Improvement often takes months, and the bumps are likely to come back.

Outlook (Prognosis)

Keratosis pilaris may fade slowly with age.

When to Contact a Medical Professional

Contact your provider if the bumps are bothersome and do not get better with lotions you buy without a prescription.

Gallery

Keratosis pilaris on the cheek
Keratosis pilaris occurs most commonly during childhood and produces small, rough spots, called papules, that are typically the same color as the skin. They usually appear over the outer surface of the upper arms and thighs, but may also occur elsewhere on the body. Dry skin, especially during winter months, makes the condition worse. Keratosis pilaris tends to be inherited and may be associated with atopic dermatitis.

References

Bell MA, Grossberg AL. Keratosis pilaris and variants. In: Lebwohl MG, Heymann WR, Coulson I, Murell DF, eds. Treatment of Skin Disease. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 125.

Patterson JW. Diseases of cutaneous appendages. In: Patterson JW, ed. Weedon's Skin Pathology. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 16.

Last reviewed December 14, 2021 by Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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