Is keratosis pilaris treatable?

Do you need to treat it?

Keratosis pilaris, often shortened to KP, is harmless and not contagious. Treatment is optional if the appearance and symptoms do not bother you. The tiny, rough bumps commonly appear on the upper arms, thighs, cheeks, back or buttocks. KP is common in children and teenagers and can worsen during puberty. If you are unsure what is causing a child's bumps, get a diagnosis rather than assuming they are KP: several childhood rashes look alike.2

The bumps form when keratin, a substance found in skin, hair and nails, builds up and blocks hair follicles. The reason for that buildup is not fully understood, but KP tends to run in families. Skin can feel itchy, with symptoms often worse in winter and better in summer.3

How do you treat keratosis pilaris at home?

1. 1Wash with a mild, unperfumed cleanser and cool or lukewarm water. Avoid hot baths and showers, and keep showers brief because hot water and long showers strip away natural oils.
2. 2Apply a creamy moisturizer after every bath or shower, within five minutes while skin is still damp. Gently massage it into affected areas at least two or three times a day. Urea and lactic acid are common ingredients in moisturizers used for KP.
3. 3If you need more help with texture, use gentle exfoliation to remove dead surface skin. A washcloth or exfoliating mitt is an option, but avoid harsh scrubs, picking and scratching.
4. 4Use exfoliating medicine only in the amount and at the frequency your dermatologist recommends. Stop it for a few days if your skin becomes dry or irritated.

Which ingredients are worth looking for?

Ceramide moisturizers help skin retain moisture and reduce roughness. Urea helps dissolve the keratin buildup, while ammonium lactate also helps break down the buildup behind bumps and redness. Salicylic acid may loosen keratin plugs, but can irritate sensitive skin. One suitable moisturizer is a sensible place to start, rather than turning the bathroom shelf into a selection committee.45

Lactic acid both moisturizes and exfoliates, and is one of the gentler alpha hydroxy acids, making it an option for sensitive skin. More exfoliation is not automatically better: excessive acid use can irritate skin and strip away structures that retain water and healthy fats. If you use facial acids for bumps on your cheeks, wear SPF 30 or higher sunscreen on your face every day.5

A humidifier can help in dry indoor air. Softer, looser clothing also reduces friction that can make bumps look redder and feel rougher.4

How long does treatment take?

Expect gradual improvement over weeks or months. If you have followed a treatment plan for four to six weeks without improvement, tell your dermatologist. Some people need to try several treatments before finding one that helps.14

Maintenance can mean using an exfoliating medicine twice a week instead of daily, or switching to a nonprescription moisturizer. A simpler maintenance routine can be enough, so the bathroom shelf need not remain a full time project. KP sometimes clears naturally, but that can take years and cannot be predicted.1

When should you get help?

Ask a pharmacist if home care is not helping or skin becomes itchy or inflamed. See a healthcare professional for new pain, pus, swelling or other skin changes during treatment. A dermatologist can assess persistent bumps and discuss prescription exfoliants, including retinoids.136

Laser treatment is sometimes used when moisturizers and medicines have not helped, targeting redness or texture. Benefits are not permanent, and effectiveness remains uncertain. Steroid creams and lasers are not usually available for KP on the NHS, and private treatment can be expensive.134