A teenager with sandpaper-like bumps on the outer arms.

KERATOSIS PILARIS

Keratosis pilaris (KP) is a very common condition in which the hair follicles become clogged and variably inflamed. Some reports have shown an association with being overweight, leg skin dryness, and allergies/atopic dermatitis.

• Rough “sandpaper” most commonly on the outside of the upper arms is typical but KP may affect the cheeks, thighs, and/or back as well.
• Very common in young people.
• Entirely benign.

Treatment, Brief Overview

KP is entirely benign and need not be treated. Most young people grow out of it, but this can take years, even decades. No cure has been found, but the following OTC treatments may help. They are broken up into 3 main categories which can be used alone or in combination (see pictures below for examples.)

Caution. Some of these products may be too irritating for the face. For KP of the face, start with Differin gel and a moisturizer.

1. Retinoids like Differin attempt to unclog the pores and "normalize" the skin. Differin is applied once a day.
2. Moisturizers alone: Moisturizers try to relieve dry skin which can exacerbate KP. They may be applied once to many times per day. When using a moisturizer with Differin, apply the moisturizer after or at another time during the day.
3. Exfoliant/Keratolytic: Ingredients like ammonium lactate, urea, and salicylic acid all try to reduce the roughness of the skin. Exfoliants are usually applied once or twice a day. They usually already come with a moisturizer, so if you use one of these products, you may not need a separate moisturizer.

One common approach is to combine Differin with an exfoliant/keratolytic--one in the morning and one at night. If these products fail and your case is particularly bothersome, see a dermatologist.

Additional Pictures

Keratosis Pilaris. The upper, outer arms is the most common location of keratosis pilaris. The skin is typically rough like “sandpaper”. The cheeks, thighs, and back may be affected as well. There may be significant perifollicular redness, as shown here.

Keratosis Pilaris. The cheeks of a child or teenager is a common location.

Keratosis Pilaris, here on the thighs.

OTC Retinoid

Differin gel, the only OTC retinoid. Differin attempts to unclog the pores and "normalize" the skin.

Moisturizers Alone

e.g. Vaseline, CeraVe, Eucerin cream.

Moisturizers with Exfoliants/Keratolytics

AmLactin KP Bumps Be Gone - Moisturizing Cream with 15% Lactic Acid

CeraVe Moisturizing Cream with Salicylic Acid, Exfoliating Body Cream with Lactic & Hyaluronic Acid, Niacinamide, and Ceramides

GoldBond Rough and Bumpy skin containing Salicylic Acid and Lactic Acid

CeraVe Psoriasis Moisturizing Cream contains 2% salicylic acid to help relieve scaling, redness, and dry, flaky skin, lactic acid for gentle exfoliation, niacinamide to help calm skin, and three essential ceramides to help maintain the skin's barrier.

Eucerin® Roughness Relief products are enriched with Urea and emollients to smooth, moisturize, and exfoliate rough and bumpy skin.

Note: Neither Dr. White, nor RegionalDerm receive any funding from any product companies.

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