Keratosis pilaris, also referred to as chicken skin, is a common skin condition that causes rough bumps on the skin. These are harmless but can be hard to manage.
Keratosis pilaris may get worse in winter, dry weather, or with hormonal changes. While there is no way to completely get rid of these rough bumps, there are several ways to improve the appearance of chicken skin.
In addition, in many cases, keratosis pilaris bumps disappear or improve with age.
Why is it called chicken skin?
Chicken skin is another name often used for keratosis pilaris because the bumps caused by keratosis pilaris make the skin look like the plucked skin of a chicken.
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Symptoms
Chicken skin or keratosis pilaris usually presents with rough bumps which can look just like goosebumps. They usually appear in children and teenagers. The color of these bumps can vary depending on the skin tone.
They can appear as pink or red spots in lighter skin tones and skin-colored, purple, brown, or black spots in darker skin tones.
The bumps can appear anywhere on the body where there are hair follicles (so you won’t see them on palms or soles). There can be few bumps or there can be many bumps making it look like a rash.
The commonly affected areas are:
- Upper arms
- Thighs
- Buttocks
- Face especially cheeks (Spots can be mistaken for acne)
- Neck
- In some cases, they can involve the lower legs, forearms, or trunk.
The other associated symptoms may be:
- Sandpaper feeling.
- Dryness.
- Redness if they are irritated.
- Worsening in winter months and during pregnancy.
Types (variants)
The classic type of keratosis pilaris is not irritated and is usually not itchy. However, there are a few variants of keratosis pilaris. The features of these variants may overlap.
Some of the types of keratosis pilaris include:
- Keratosis pilaris rubra: This variant can lead to rough bumps which are inflamed and the skin surrounding them is red. It can be seen on the arms, face, or trunk.
- Keratosis pilaris rubra faciei: It appears as bumps with redness on the cheeks and neck. It may look like a red bumpy rash on the cheeks.
- Erythromelanosis follicularis faciei et colli: This variant is characterized by rough bumps, redness, and hyperpigmentation. It is usually seen at the age of 20s and involves the cheeks and sides of the neck.
- Keratosis pilaris atrophicans: This variant is commonly seen in children and usually involves the skin of the cheeks and lateral eyebrows. It can lead to atrophy, scarring, and patches of hair loss in the affected areas.
Causes
Keratosis pilaris occurs due to the plugging of hair follicles with excess keratin which feel like rough spots. Keratin is a protein that is part of our skin, hair, and nails.
Why it occurs in some people is still not completely clear. There may be a role of genetics.
There are some theories as to how it occurs:
- One theory is abnormal keratinization of the cells lining the hair follicle. This results in excess buildup of keratin leading to rough bumps.
- Another theory is the presence of coiled hairs which can damage the epithelium lining the hair follicles. This can lead to inflammation and keratin buildup.
Who is at risk of getting it?
Keratosis pilaris is often seen in children, teens, and women. It is also common in those with:
- Family history of keratosis pilaris.
- Atopic dermatitis.
- Ichthyosis vulgaris.
- Allergies like asthma or hay fever.
- Obesity.
- Diabetes.
- Down syndrome.
Is it contagious?
Keratosis pilaris is not contagious. It does not have an infectious etiology. One cannot get keratosis pilaris by touching nor can one spread it to others.
Diagnosis
Keratosis pilaris can often be diagnosed by a doctor after a physical examination. They will look at the skin lesions and may ask you for details like when you first noticed them, other involved areas, or any associated symptoms.
Additional testing is usually not required.
Treatment
Treatment of keratosis pilaris may improve the appearance of the affected areas. However, there is no proven method that can completely get rid of it. Once the treatment is stopped, they may become apparent again.
The treatment options include procedures done in the doctor’s office, prescription medications, and at-home treatment.
Note: Some of the below-mentioned procedures and topical treatments are not suitable for pregnant and breastfeeding women. Talk to your doctor before using any topicals meant to treat keratosis pilaris if you’re trying to get pregnant, currently pregnant, or breastfeeding.
1. Urea
Urea is keratolytic which can dissolve the glue between the skin cells and help in getting rid of the layers of dead skin cells. These can flatten the bumps and improve the appearance.
Urea is also a humectant so it can hydrate your skin as well.
2. Alpha and beta hydroxy acids
These acids can exfoliate the top layers of skin giving it a smooth appearance. These include:
- Alpha hydroxy acids like glycolic acid and lactic acid.
- Beta hydroxy acids like salicylic acid.
You can get these skincare ingredients in many topical forms – cleansers, serums, or moisturizers.
3. Retinoids
Retinoids are vitamin-A derivatives that can normalize cell turnover. This can help in getting rid of layers of dead skin cells and give a smooth appearance to the skin.
You can get retinoids like retinol, retinaldehyde, and adapalene (1%) over the counter. Prescription-strength retinoids like tazarotene and tretinoin may be more effective.
However, retinoids, in general, can be very irritating and cause dryness. So, start using retinoids slowly in your skincare routine and make sure to moisturize the skin.
4. Steroids
Your doctor may prescribe a short course of topical steroids to calm down the inflammation and reduce redness.
5. Lasers
There are multiple studies that have looked into lasers for treating keratosis pilaris. They have shown promising results. The best outcome can be achieved by a combination of different treatments.
Some of these lasers include – Pulsed dye laser, Diode laser, Q switched Nd: YAG laser, Alexandrite laser, and fractional CO2 laser.
6. Microdermabrasion
This is a procedure that involves buffing the top layer of skin. This can give a smooth appearance to the skin.
7. Chemical peels
Chemical peels involve the use of high concentrations of acids which can exfoliate the top layers of skin. This can improve the appearance of chicken skin.
Common peeling agents are glycolic acid, salicylic acid, and lactic acid.
Home remedies
Following home remedies can help in managing your symptoms.
1. Take a warm bath
Hot water can deprive your skin of natural oils making it dry. This can worsen keratosis pilaris. Instead, opt for lukewarm water baths and keep the bath time short.
2. Use gentle skin care products
Use skincare products that are meant for sensitive skin. This prevents chances of irritation from fragrance or essential oils which can worsen keratosis pilaris. Use a pH-balanced cleanser to avoid dryness.
3. Moisturizer
Moisturizing the skin alone can make a difference in the rough texture of keratosis pilaris. Moisturize your skin just after bathing while it’s still damp.
Look for moisturizers with urea or lactic acid, which can not only hydrate the skin but can also get rid of dead skin cells.
4. Regular exfoliation
Exfoliating your skin regularly can reduce the chance of buildup of dead skin cells. A few times a week or daily (as per your skin’s tolerance) use a skin care product with exfoliants like glycolic acid, salicylic acid, or lactic acid.
You can use a serum, moisturizer, body wash, or cleanser based on these exfoliants.
If you prefer to use scrubs, make sure to pick one with non-abrasive particles. Harsh scrubbing can lead to inflammation and can worsen keratosis pilaris.
5. Tight clothes
Friction from tight or rough clothes can worsen keratosis pilaris. So, opt for breathable loose clothes.
6. Humidifier
If you live in a very dry environment, a humidifier can be beneficial and can add moisture to the air.
7. Sun protection
Always protect your skin from the sun by using sun-protective clothing and broad-spectrum sunscreen.
Prevention
Keratosis pilaris cannot be prevented, however, using the above-mentioned treatments and home remedies can improve its appearance.
Key points
Keratosis pilaris, also called chicken skin, can lead to rough bumps on arms, legs, face, and buttocks. There is no treatment that can cure it, but with age, it may improve or disappear completely.
Gentle skincare, moisturizers, exfoliants, and retinoids are some of the treatments one can use at home. Procedures like laser, dermabrasion, or chemical peels can also improve the appearance of keratosis pilaris.
Related post: Petechiae vs keratosis pilaris
References
- Wang JF, Orlow SJ. Keratosis Pilaris and its Subtypes: Associations, New Molecular and Pharmacologic Etiologies, and Therapeutic Options. Am J Clin Dermatol. 2018 Oct;19(5):733-757. doi: 10.1007/s40257-018-0368-3. PMID: 30043128.
- Marqueling AL, Gilliam AE, Prendiville J, et al. Keratosis Pilaris Rubra: A Common but Underrecognized Condition. Arch Dermatol. 2006;142(12):1611–1616. doi:10.1001/archderm.142.12.1611.
- Pennycook KB, McCready TA. Keratosis Pilaris. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- 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.
- Thomas M, Khopkar US. Keratosis pilaris revisited: is it more than just a follicular keratosis? Int J Trichology. 2012 Oct;4(4):255-8. doi: 10.4103/0974-7753.111215. PMID: 23766609; PMCID: PMC3681106.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.