Keratosis pilaris, also called chicken skin, is a harmless condition and does not usually require treatment. Its appearance can be a cosmetic issue for some people.
It cannot be cured; however, there are several treatment options that may improve its appearance. In addition, in some people, it may improve or disappear on its own with age.
Overview
Keratosis pilaris can lead to rough bumps on the arms, legs, face, buttocks, and other areas of the body. They usually do not hurt or itch.
The color of the bumps may vary with the skin tone of a person. They can be skin-colored, red, purple, brown, or black in color.
Keratosis pilaris is often seen in children and teenagers. It is also commonly seen in people with a family history of keratosis pilaris, a history of atopic dermatitis or allergies, obesity, or diabetes.
It is thought to occur due to the buildup of keratin in the hair follicles. The bumpy appearance and rough texture can be bothersome for some people.
Treatment options
There are several treatment options for keratosis pilaris. These include topical creams, lotions, serums, or cleansers which can be obtained over the counter. In addition, your doctor may prescribe medicated creams for keratosis pilaris.
A few procedures like laser treatment may also improve the appearance of chicken skin.
Topicals
Below are the ingredients to look for when buying creams or lotions for keratosis pilaris.
1. Urea
Urea is a humectant and can hydrate and moisturize the skin. It is also part of the natural moisturizing factors of our skin and can enhance our skin barrier.
In addition, it is keratolytic and can dissolve the glue which holds the skin cells together. This can slough away dead skin cells and improve the appearance of bumps.
Urea can be found in several lotions and creams.
2. Alpha and beta hydroxy acids
Alpha and beta hydroxy acids can exfoliate the surface of the skin reducing the appearance of bumps. Beta hydroxy acids, in addition to the surface, can exfoliate inside the pore.
- Alpha hydroxy acids include glycolic acid and lactic acid.
- Beta hydroxy acids include salicylic acid
There are several products on the market – toners, serums, cleansers, and creams based on hydroxy acids.
3. Retinoids
Retinoids are Vitamin A derivatives that can increase cell turnover and reduce the build of dead skin cells on the surface. This can improve the appearance of keratosis pilaris bumps.
Retinoids include prescription-strength retinoids like tretinoin or tazarotene and over-the-counter retinoids like retinol, retinaldehyde, or adapalene 1%.
One small study evaluated 0.01% tazarotene in 20 patients with keratosis pilaris. Tazarotene was used every evening. The bumps started improving in 2 weeks and resolved in 4 to 8 weeks. Over-the-counter retinoids may not work this fast but one can achieve great results if retinoids are used consistently.
Note: Some of the above-mentioned ingredients like exfoliants and retinoids should not be used by pregnant women.
4. Topical steroids
In a few cases, your doctor may prescribe a topical steroid to calm down inflammation if keratosis pilaris is irritated.
Laser
The laser works by emitting short pulses of light which can target a structure in the skin like a vessel or pigment. There are different types of lasers. Some lasers can help with the redness associated with keratosis pilaris while some lasers can target the hair follicle.
An ablative laser like a fractional CO2 laser can remove the outer layers of skin which can improve the appearance of keratosis pilaris bumps.
Your doctor will decide which laser will benefit you depending on the main concern and your skin tone.
The lasers that have been studied for treating keratosis pilaris include:
- Pulsed dye laser
- Diode laser
- Q switched Nd:YAG laser
- Alexandrite laser
- Fractional CO2 laser
Microdermabrasion
Microdermabrasion involves the use of small crystals to remove the top dead layers of skin. This can improve the bumpy texture of keratosis pilaris. The best results are achieved when it is used with other treatments like lasers.
Be careful when using at-home microdermabrasion kits. Follow all the instructions on the packaging.
Chemical peels
Chemical peels involve the use of high concentrations of acids to remove outer dead layers of skin. This can give a smooth appearance. The type of peel will depend on the individual’s skin condition and skin tone.
Home remedies
One can use the following measures for treating keratosis pilaris at home, in addition to above mentioned topicals.
1. Lukewarm water to take a bath
Hot water can remove natural oils from our skin. This makes our skin more prone to dryness and irritation. So, use lukewarm water to take a bath and also keep the bath time short.
2. Gentle cleansers
Harsh cleansers can cause damage to the skin barrier leading to dryness. So, always use pH–balanced cleanser or a cleanser with a slightly acidic pH (~5.5)
3. Moisturize to hydrate
The rough texture of keratosis pilaris can be improved by moisturizing the skin. Look for ingredients like glycerin, hyaluronic acid, and shea butter.
Many moisturizers meant for keratosis pilaris are strong and based on alpha-hydroxy acids. If you use such a moisturizer, keep a check on your skin so that it is not getting irritated. You can use a treatment moisturizer once or twice daily and a simple moisturizer for any additional applications.
4. Exfoliate regularly
Regular exfoliation can reduce the chances of buildup of dead skin cells. This can improve the bumps and rough surface caused by keratosis pilaris. If you prefer using a scrub, use one with nonabrasive particles or beads and avoid scrubbing too aggressively.
Harsh scrubbing can lead to skin inflammation and irritation which can worsen keratosis pilaris.
5. Avoid scratching
Keep your fingernails trimmed and avoid scratching the area. It can lead to redness and hyperpigmentation.
6. Wear comfortable clothes
Friction from tight and rough clothes can irritate keratosis pilaris. So, wear loose, breathable and soft clothes.
7. Avoid hair removal
Waxing and shaving in the areas affected by keratosis pilaris can worsen it. If possible, get a laser treatment for hair removal.
8. Use a humidifier
A dry environment can lead to dry and itchy skin and can worsen the appearance of keratosis pilaris.
Use a humidifier to add moisture to your surroundings.
9. Eat a healthy diet
There is not much solid evidence to link diet and keratosis pilaris. However, eating a healthy diet is good for your skin health. Omega-3 fatty acids in your diet can make your skin more supple.
What to expect from the treatment?
There is no proven treatment that will get rid of keratosis pilaris. Keratosis pilaris is a chronic skin condition and once you stop treating your skin, the bumps may appear the same.
So, to maintain the improvement, you have to keep treating the area. In addition, every individual will get different results from treatment. Some individuals see a drastic improvement with topicals or other treatments while some don’t see much of a difference.
Does it go away?
One cannot cure keratosis pilaris, but in many individuals, it improves or disappears completely by the age of 20-30s.
An older study from 1994, evaluated a questionnaire sent to patients with keratosis pilaris. A total of 49 patients were included in the evaluation. With age, keratosis pilaris improved in 35% of patients, remained the same in 43%, and became worse in 22% of the patients.
Once you start treatment for keratosis pilaris, you may start to see improvement in 4 weeks. In 3-4 months, you may see a significant improvement in the rough and bumpy texture of keratosis pilaris or chicken skin.
When to see a doctor
Keratosis pilaris usually does not require treatment. However, one should see a doctor if the appearance of the bumps bothers your self-confidence or affects you in any other way.
In addition, some skin conditions like folliculitis can mimic keratosis pilaris. So, if you are not sure what is causing the bumps on your skin, it’s best to see a doctor for proper diagnosis and treatment.
Key points
Keratosis pilaris treatment includes the use of gentle skin care, topicals like exfoliants and retinoids, in-office procedures, and self-care measures at home. The rough bumps caused by keratosis pilaris cannot be cured but their appearance can be improved.
The improvement lasts as long as the affected area is treated. Even without treatment, keratosis pilaris may go away on its own by the age of 30.
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References
- Maghfour J, Ly S, Haidari W, Taylor SL, Feldman SR. Treatment of keratosis pilaris and its variants: a systematic review. J Dermatolog Treat. 2022 May;33(3):1231-1242. doi: 10.1080/09546634.2020.1818678. Epub 2020 Sep 14. PMID: 32886029.
- Ibrahim O, Khan M, Bolotin D, Dubina M, Nodzenski M, Disphanurat W, Kakar R, Yoo S, Whiting D, West DP, Poon E, Veledar E, Alam M. Treatment of keratosis pilaris with 810-nm diode laser: a randomized clinical trial. JAMA Dermatol. 2015 Feb;151(2):187-91. doi: 10.1001/jamadermatol.2014.2211. PMID: 25372313.
- Maitriwong P, Tangkijngamvong N, Asawanonda P. Innovative 1064-nm Nd:YAG Laser Significantly Improves Keratosis Pilaris, A Randomized, Double-Blind, Sham-Irradiation-Controlled Trial. Lasers Surg Med. 2020 Jul;52(6):509-514. doi: 10.1002/lsm.23184. Epub 2019 Nov 11. PMID: 31713266.
- Andreas W. Gerbig, MD. Treating keratosis pilaris. VOLUME 47, ISSUE 3, P457, SEPTEMBER 01, 2002 JAAD.
- Kootiratrakarn T, Kampirapap K, Chunhasewee C. Epidermal permeability barrier in the treatment of keratosis pilaris. Dermatol Res Pract. 2015;2015:205012. doi: 10.1155/2015/205012. Epub 2015 Feb 24. PMID: 25802513; PMCID: PMC4354723.
- Poskitt L, Wilkinson JD. Natural history of keratosis pilaris. Br J Dermatol. 1994 Jun;130(6):711-3. doi: 10.1111/j.1365-2133.1994.tb03406.x. PMID: 8011494.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.