Keratosis pilaris treatment

What causes keratosis pilaris?

Keratosis pilaris, or KP, develops when keratin, a substance found in skin, hair and nails, builds up and blocks hair follicles. Nobody knows exactly why the buildup happens. KP runs in families, and genetics play a role. A gene called FLG is linked to both dry, scaly skin and KP. Research into the genes active in affected skin is still developing; more specific treatments remain a research goal rather than an available cure.23

Typical KP produces small, rough, usually painless bumps on the upper arms, thighs or buttocks. The bumps can match your skin colour, look red on white skin, or look darker on brown or black skin. Some patches itch. KP is not infectious, and it often looks worse in winter and better in summer.2

What cream can treat keratosis pilaris?

For dry, itchy KP, a creamy moisturizer containing urea or lactic acid is a common starting point. Ceramides are another option for roughness, especially alongside eczema. If sensitive skin makes exfoliating treatments difficult to tolerate, discuss the choice with a pharmacist rather than automatically choosing an acid. The percentages above describe clinical treatment options, not a reason to start with the strongest formula.124

What can you use for keratosis pilaris?

1. 1Wash with mild, unperfumed soap or bathing products. Keep showers brief and use cool or lukewarm water rather than hot water.
2. 2If you use a washcloth or exfoliating mitt, use it gently. Harsh scrubs can make KP worse. Do not scratch, pick or rub the bumps.
3. 3Apply moisturizer within 5 minutes of every bath or shower while your skin is still damp. Gently massage moisturizer into affected areas at least 2 or 3 times daily.
4. 4For a prescribed exfoliating medicine, use only the amount and frequency your dermatologist recommends. If the medicine makes your skin dry or irritated, stop using it for a few days.
5. 5Reduce friction around affected areas with softer, looser clothing. In a dry environment, a humidifier can help add moisture to the air.

Moisturizer and exfoliating medicine have different instructions: the moisturizer schedule is not a schedule for applying acids or retinoids. Some exfoliating medicines already contain a moisturizer. A pharmacist can help choose a cream or lotion, and a dermatologist can set the application frequency when treatment needs adjusting.1

How long does treatment take?

Expect gradual improvement over weeks or months, not immediate clearance. If you have followed your treatment plan for 4 to 6 weeks without improvement, tell your dermatologist. Some people need to try several treatments or adjust their moisturizer and application frequency before finding a useful balance between smoother skin and irritation.14

Symptoms can return when treatment stops. A maintenance routine can be as simple as a moisturizing cream, which is less elaborate than the word 'maintenance' suggests. A dermatologist can also reduce medicine to twice weekly instead of daily. KP sometimes improves through adulthood, but natural clearing can take years and cannot be predicted for an individual.13

How is keratosis pilaris treated in kids?

Confirmed KP is harmless and does not require treatment in children. Tiny, dry, rough bumps can appear on the upper arms, thighs, cheeks, back or buttocks. KP is common in children and teenagers and can worsen during puberty. Teenagers who dislike its appearance can discuss treatment with a dermatologist.6

For a child with confirmed KP, moisturizing and mild bathing products are practical care options. Avoid acid creams in young children because they can burn and sting. Do not assume a child's new rash is KP simply because it has bumps: several childhood rashes look alike. A pediatrician or dermatologist can identify the cause before you choose treatment.56

When should you get medical help?

Speak to a pharmacist if home care is not helping, KP is bothering you, or the skin becomes itchy or inflamed. They can advise on creams and whether you need a doctor. A dermatologist diagnoses KP by examining the skin and can tailor treatment to dryness, bumps, redness or discoloration.12

Beyond moisturizers, clinical options include retinoids, azelaic acid and topical tacrolimus. A corticosteroid, a medicine applied to reduce inflammation, is sometimes used to soften bumps and reduce redness. These are options to discuss with a clinician rather than additions that every KP routine needs; response to treatment is variable.15

Laser or light treatment is an option for persistent KP, including noticeable facial redness or roughness. Different lasers target different concerns, and results are not permanent. In the UK, laser treatment and steroid creams for KP are not usually available on the NHS because effectiveness has not been proven; private treatment can be expensive. Discuss the specific change you want and the likely cost before booking.24