Keratosis Pilaris – Everything You Ever Wanted to Know - Toronto Dermatology Centre
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Keratosis Pilaris – Everything You Ever Wanted to Know

Keratosis pilaris is a common skin condition that causes rough patches and small, acne-like bumps, usually on the outer arms, and less commonly on the shoulders, thighs, cheeks and buttocks. Keratosis pilaris bumps are either white or red, and don’t hurt or itch. Keratosis pilaris can be frustrating because it’s difficult to treat. However, keratosis pilaris isn’t serious and usually reduces as we age. In the meantime, various creams and self-care measures can improve the appearance of keratosis pilaris.

Keratosis pilaris can occur at any age, although it’s particularly common in children and becomes most noticeable around puberty. Signs and symptoms include:

  • Small white or red bumps, typically on the upper outer arms, legs, shoulders, buttocks or cheeks
  • Dry, rough and occasionally itchy skin in the areas with bumps
  • Worsening in winter, when humidity is low and skin tends to be drier
  • Keratosis pilaris may be limited to individual, sandpaper-like bumps resembling goose flesh. In some cases, the bumps may become inflamed and cause scarring, especially on the face.

Keratosis pilaris results from the build-up of keratin — a hard protein that protects your skin from harmful substances and infection. The keratin forms a scaly plug that blocks the opening of the hair follicle. Usually many plugs form, causing patches of rough, bumpy skin, often referred to as “chicken skin”.

Why keratin builds up is unknown. It may occur in families for genetic reasons or commonly in the presence of other skin conditions, such atopic dermatitis (genetic eczema). Keratosis pilaris also occurs in otherwise healthy people. Dry skin tends to worsen this condition.

Among the ways to treat keratosis pilaris, the most effective are:

Topical exfoliants:

Medicated creams containing alpha-hydroxy acid, lactic acid, salicylic acid or urea moisturize and soften dry skin while helping to loosen and remove dead skin cells. Depending on their strength, certain creams are available over-the-counter and others require a prescription. Your skin specialist can advise you on the best option for your skin. We like to recommend Alyria Resurfacing Body Cream, with 15% glycolic acid, but also contains hydrating moisturizers to exfoliate and soften the skin at the same time.

Topical retinoids:

Derived from vitamin A, retinoids work by promoting cell turnover and preventing the plugging of the hair follicle. Retinoids may be an effective treatment, but they can cause bothersome skin irritations, such as dryness, redness and peeling. Tretinoin (e.g. Retin-A) and tazarotene (Tazorac) are examples of topical retinoids by prescription. ZO Skin Health has a body cream with 0.05% pure, stable retinol that again, hydrates as it exfoliates and is less irritating than the prescription retinoids.

Laser therapy:

Certain types of keratosis pilaris involving severe redness and inflammation have been successfully treated with laser therapy. Laser treatment involves passing intense bursts of light into targeted areas of skin. This type of treatment may require repeat sessions over the course of a few months, depending on your response. The Profractional laser is able to break up the skin in the affected areas, thus eliminating the plugs; maintenance treatments with laser may be required.

Using a medication regularly may improve the appearance of your skin. But if you stop, the condition returns. And even with medical treatment, keratosis pilaris tends to persist for years. Fortunately people slowly outgrow this annoying skin condition, but it is good to know that there is treatment for its appearance in the meantime.

~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre


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