What does keratosis pilaris look like?

What should you look for?

• Small bumps in groups. Individual bumps are about 1 to 2 mm across, rather than large lumps.
• A rough texture. The skin can look as though it has permanent goosebumps and feel noticeably dry.
• Variable colour. Some people have only a few bumps matching their skin; others have more noticeable patches resembling pimples or a rash.
• Colour around the bumps. There can be a pink or red area around individual bumps, not just a change in the bump itself.
• Usually no pain. Occasional itching can happen, so painless does not necessarily mean completely symptom free.

On white skin, the bumps can appear red or pinkish purple. On brown or black skin, they can look darker brown or brownish black. Redness is not required: bumps that match the surrounding skin can still be keratosis pilaris.15

Where do the bumps appear?

The backs and outer parts of the upper arms and the fronts of the thighs are typical places. Children commonly develop bumps on their cheeks too; teens and adults commonly have them on their buttocks. Keratosis pilaris can also affect the back, chest, forearms and lower legs. It does not appear on the palms or soles.125

The bumps often become more obvious in winter or a dry climate and improve in summer. Keratosis pilaris usually starts in childhood and can become more noticeable during the teenage years, including puberty, although people of any age can have it.1346

What makes the bumps?

Keratin, a protein in skin, forms small plugs inside hair follicles, the openings where hairs grow. Those plugs produce the bumpy texture. The exact reason keratin builds up is not fully understood, but keratosis pilaris tends to run in families. It is harmless and not infectious, so you cannot catch it from someone or spread it to another person.345

Can you tell just by looking?

A doctor can usually identify keratosis pilaris by examining the skin, without tests. At home, appearance is a clue rather than a diagnosis. Facial bumps can be mistaken for acne, and eczema or folliculitis, inflammation of hair follicles, can look similar. Bumps filled with pus, or very itchy bumps that leak fluid and crust, need assessment rather than an assumption that they are keratosis pilaris.356

What can you do about the texture?

Moisturizers can soften the texture of the skin, which is a more useful job description than most cream names manage.2

• Apply moisturizer frequently, and use mild, unperfumed washing products.
• Choose cool or lukewarm baths and showers rather than hot water.
• Keep any exfoliation gentle. Harsh scrubs can make the condition worse, and scratching or picking should be avoided.
• Ask a pharmacist about creams containing urea, lactic acid or salicylic acid to help soften and flatten the bumps.

Treatment can improve the appearance without clearing every bump, a distinction that rarely gets the largest font on a skincare box. Improvement often takes months, and bumps can return after treatment stops. Keratosis pilaris can last for years, although it sometimes fades with age.234

If the bumps bother you and do not improve with lotions bought without a prescription, contact a doctor. A pharmacist can also help if the skin becomes itchy or inflamed. For a child whose rash you cannot identify, a pediatrician or dermatologist can check the cause.346