Keratosis pilaris

Keratosis pilaris is a very common and completely benign skin condition. It is characterised by the appearance of small rough bumps that give the skin an appearance popularly known as "chicken skin" or "goose bumps".

These small bumps appear because keratin, a natural skin protein, accumulates at the opening of the hair follicle and forms a small plug.

The condition usually begins during childhood or adolescence and can persist into adulthood. Many people improve spontaneously over the years.

Keratosis pilaris is not contagious, is not an infection and poses no health risk.

This is one of the most common questions in consultation. The answer is that it does not appear because of poor hygiene or because the skin is dirty.

It is produced by an alteration in the way the skin eliminates keratin. This protein accumulates around the hair follicles forming small plugs.

Several factors favour its appearance:

• Genetic predisposition.
• Dry skin.
• Atopic dermatitis.
• Cold, dry climates.

Why do some people have it and others not?

Because there is an individual and familial predisposition. It is common to find several members of the same family with this condition.

Why does it worsen in winter?

During the cold months the skin loses more water and dries out more easily, which favours the accumulation of keratin and makes the bumps more visible.

Keratosis pilaris produces:

• Small rough bumps.
• A rough feel to the skin.
• Redness around some follicles.
• Dry skin.

The most common areas are:

• The outer surface of the arms.
• The thighs.
• The buttocks.
• The cheeks, especially in children.

It does not usually cause pain. Some people experience mild itching when the skin is very dry. The condition usually remains stable for years and improves progressively with age. It is not contagious.

The diagnosis is clinical.

The doctor usually recognises the condition simply by observing and examining the skin.

Complementary tests, blood tests or biopsies are usually not necessary.

One of the most frequent questions is: is there a treatment? Yes, although it is important to know that there is no treatment that eliminates it definitively. The aim is to improve the appearance and texture of the skin.

The most commonly used treatments include:

• Moisturising creams.
• Urea creams.
• Lactic acid.
• Salicylic acid.
• Glycolic acid.
• Topical retinoids in some selected cases.

When there is a lot of redness, the doctor may recommend other specific treatments.

Why should treatment be maintained?

Because keratosis pilaris tends to reappear when care is interrupted. The aim is to control the condition, not to cure it definitively.

Daily care is the most important part of treatment. It is recommended to:

• Apply moisturiser every day.
• Use products with urea or mild acids if they have been recommended.
• Shower with lukewarm water.
• Avoid harsh soaps.
• Not scratch or try to pick off the bumps.
• Exfoliate the skin gently only if the doctor advises it.
• Maintain good skin hydration throughout the year.

Consistency is usually more important than using many different products.

Keratosis pilaris is not usually a medical emergency. However, it is advisable to consult if:

• The lesions change significantly in appearance.
• Pain, pus or signs of infection appear.
• There is intense itching.
• The diagnosis is unclear.
• The appearance of the skin causes significant concern.

• Myth: Chicken skin appears because I don't shower enough. Fact: No. It has no relation to hygiene.
• Myth: It is a contagious disease. Fact: It cannot be passed on to other people.
• Myth: It will disappear if I exfoliate every day. Fact: Excessive exfoliation can irritate the skin and worsen the problem.
• Myth: It is an allergy. Fact: No. It is an alteration of the skin's keratinisation.
• Myth: There is no treatment. Fact: There are treatments that clearly improve the appearance and texture of the skin, although they require consistency.

• Keratosis pilaris is a very common benign condition.
• It is not related to poor hygiene.
• It is not contagious.
• It is caused by an accumulation of keratin in the hair follicles.
• Daily moisturising is the most important treatment.
• There are creams that notably improve the texture of the skin.
• It usually worsens during winter.
• In many people it improves spontaneously with age.