Is keratosis pilaris chronic?

Is keratosis pilaris chronic or acute?

Keratosis pilaris follows a chronic pattern, not an acute one that appears briefly and resolves. The bumps can become less noticeable and then return, especially when skin becomes dry. A winter flare does not mean the condition is new: keratosis pilaris is often worse in winter and better in summer.134

Does chronic mean permanent?

No. Keratosis pilaris usually starts in childhood and becomes more obvious during the teenage years and adulthood. It can fade slowly with age, and often clears during adult life, though not for everyone. There is no cure, but that does not mean the bumps must stay equally noticeable forever. Treatment can improve their appearance temporarily rather than permanently removing the tendency to develop them.245

Why do the bumps keep coming back?

Keratin, a protein found in skin, hair and nails, builds up and plugs hair follicles. The reason for that buildup is not fully understood, but keratosis pilaris tends to run in families. It is more common in people with very dry skin or eczema. Keratosis pilaris is harmless and is not infectious, so you cannot catch it or pass it on.145

Typical bumps feel rough and dry and sometimes itch. They commonly appear on the upper arms, fronts of the thighs and buttocks; children can also have them on their cheeks. Bumps can match your skin colour or appear white, red, pinkish purple or brownish black. Their colour and visibility can differ without changing the condition's long lasting pattern.6

How do you manage it long term?

Treatment is optional if the bumps do not bother you. Moisturizers help soften the skin, without needing a product name that sounds like a research department. If dryness, itch or appearance bothers you, use this sequence:23

1. 1Exfoliate gently with a washcloth. Avoid vigorous scrubbing, which can irritate skin and worsen keratosis pilaris.
2. 2Apply a chemical exfoliator, also called a keratolytic, to help remove excess dead skin. Options include lactic acid, glycolic acid, salicylic acid or urea. Follow the product's directions exactly rather than applying more or using it more often.
3. 3Apply moisturizer afterwards. Choose a thick oil free cream or ointment, and apply it to damp skin within five minutes of bathing. Moisturize whenever skin feels dry and at least two or three times daily.

Keep showers or baths short, no longer than 20 minutes, and use warm rather than hot water. Choose mild, unperfumed cleansing products. Avoid picking, scratching or rubbing the bumps. Shaving and waxing can cause more bumps, so reconsider those methods if they trigger flares.13

How long does improvement take?

Improvement often takes months, and bumps are likely to return if you stop treatment. Follow the daily home care plan until skin becomes clearer, while keeping exfoliator use within its label directions. After improvement, maintenance often involves treating the skin a few times a week rather than stopping completely.34

When should you get help?

Stop a chemical exfoliator for a few days if skin becomes too dry or irritated. Speak to a pharmacist if your skin becomes itchy or inflamed. See a clinician if bothersome bumps do not improve with nonprescription lotions, or if you are unsure what they are. A clinician can usually diagnose keratosis pilaris by examining the skin.134

A doctor can consider prescription treatments, including topical retinoids, medicines related to vitamin A. Lasers, chemical peels and dermabrasion can be expensive and have not been shown to be very effective, so an impressive treatment name is not a reason to give it a bathroom budget.2

Moisturizer residue on clothing and bedding increases fire risk, even after it dries. Keep affected fabrics away from naked flames and lit cigarettes; washing does not completely remove the risk.2