Have you ever noticed small, rough bumps on your skin? Maybe they show up on your upper arms and thighs or even on your cheeks or back. You may have a skin condition called keratosis pilaris (KP), which is pretty common.
Joshua Tournas, MD, a dermatologist with Banner Health, explained more about what keratosis pilaris is, what causes it, what the symptoms of keratosis pilaris look like, how you can manage it and when you should have it checked.
What is keratosis pilaris?
Keratosis pilaris is a common skin condition that causes small bumps on your skin. These bumps often look like goosebumps or "chicken skin."
They happen when your hair follicles get clogged with a protein called keratin. Your body uses keratin to protect your skin from things like infections or harmful substances. When keratin builds up in your pores, it forms small plugs, leading to the bumps that appear on your skin.
Keratosis pilaris is not an infection and it’s not caused by bacteria. It’s not contagious or cancerous. The bumps are usually painless but they can sometimes be itchy, red or irritating.
For most people, keratosis pilaris begins either before age 2 or during their teenage years. If you first get it when you’re a teen, it is likely to go away by your mid-20s.
Where does keratosis pilaris show up?
Keratosis pilaris tends to show up in areas with a lot of hair follicles, friction and irritation. You might spot it on your:
- Upper arms
- Thighs
- Lower legs and forearms, in more severe cases
- Back
- Chest
- Cheeks
The bumps can appear at any time of year but they may be more noticeable in colder months when your skin is drier.
What causes keratosis pilaris?
The main cause of keratosis pilaris is plugged hair follicles from keratin. It’s not always clear what causes this buildup but these are some of the reasons it might happen:
- Genetics: If one or both of your parents has keratosis pilaris, you’re more likely to get it too.
- Dry skin: Dry skin makes it harder for your body to shed dead skin cells, which can lead to the keratin plugs. Having a condition called ichthyosis vulgaris, which causes very dry skin, can make you more likely to get KP.
- Asthma or hay fever: People with these conditions are at higher risk.
- Atopic dermatitis (eczema): If you have atopic dermatitis, you may be dealing with dry, itchy, irritated skin which can cause keratin buildups.
- Hormonal changes: Puberty is a big time for hormonal changes which may trigger keratosis pilaris or make it worse.
- Age: The condition is more common in kids and teens. It often gets better as you grow older but some people may still have it as adults.
- Melanoma: Your risk is higher if you are taking vemurafenib (Zelboraf®), a targeted therapy medicine that treats late-stage melanoma.
What are the symptoms of keratosis pilaris?
Small bumps on your skin are the main symptom. These bumps can be the same color as your skin or they might be white or red on lighter skin. On darker skin, they may look brown or black.
The bumps can vary in size and can feel rough or dry. They might get itchy or irritated, especially if your skin is dry or if you rub or scratch the area. You might have a few bumps or an area that looks like a rash.
Keratosis pilaris is almost always harmless but it might make you self-conscious. Untreated, the bumps may last for years but they typically don’t get worse.
Is keratosis pilaris dangerous?
Keratosis pilaris doesn’t lead to any health problems or complications. For most people, it’s more of a cosmetic issue than a health issue.
“The KP that appears on the upper arms, thighs and chest in a lot of teens and some adults is closer to a normal variant of skin than something to be concerned about,” Dr. Tournas said. “Some people just have hair follicles that don’t turn over as well as others.”
That said, the bumps can sometimes get red, inflamed or infected. If that happens, it’s a good idea to reach out to your health care provider to see what you can do. Some people with severe or long-standing cases of keratosis pilaris may need professional treatment. Your health care provider may refer you to a dermatologist (a skin specialist).
How can you manage keratosis pilaris?
While there’s no cure for keratosis pilaris, that doesn’t mean you’re stuck with the bumps forever. With the right skincare routine, you can help your skin look and feel better. Here are some tips:
- Add moisture to the air: Dry air can make keratosis pilaris worse. Using a humidifier at home can help, especially in the winter when heat can dry the air.
- Use warm water instead of hot water: Hot water can strip natural oils from your skin, leaving it drier and more easily irritated. Stick with warm water when you shower or take a bath and don’t bathe more than once a day.
- Use a mild skin cleanser: Bar soaps can dry your skin.
- Exfoliate gently: Removing dead skin cells can help reduce the bumps and smooth your skin. Products with alpha hydroxy acid (AHA), retinoids or salicylic acid work well for gentle exfoliation. Just don’t overdo it — too much exfoliation can irritate your skin.
- Moisturize regularly: Apply thick moisturizers with ingredients like urea, glycerin or lactic acid after bathing and whenever your skin feels dry, at least two or three times a day. They can help keep your skin smooth, soft and hydrated.
- Choose loose clothing: Tight clothes can rub against your skin and irritate it. Go for loose, breathable fabrics like cotton instead.
“These steps are enough for most people to treat KP,” Dr. Tournas said.
When should you see a health care provider?
You don’t usually need to see a health care provider for keratosis pilaris. But if the bumps spread, get worse or become red and painful, it’s a good idea to talk to an expert. A health care provider can confirm that it’s keratosis pilaris and not another skin condition, like eczema, psoriasis or acne. They can also give you advice on how to care for your skin.
“If you have redness, signs of scarring, extensive bumps or facial involvement, especially around the eyebrows, it’s a good idea to get it checked by a board-certified dermatologist,” Dr. Tournas said. “There are some more aggressive KP variants, so an evaluation makes sense.” More aggressive cases may need to be treated with prescription medication.
The bottom line
Keratosis pilaris is a common skin condition that causes small bumps, usually on your upper arms and thighs. While it might not be serious, it can be annoying or make you feel self-conscious.
The good news? There are plenty of ways to manage it. Moisturizing, gentle exfoliation and avoiding warm water are all great steps that can help. Over time and with consistent care, your skin can look and feel better.
If you’re unsure about your skin or you feel like you have a skin condition that is getting worse, reach out to your primary care provider or an expert at Banner Health for advice and treatments that can help.
