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What Are Those Bumps on My Arms? A Rough Guide to KP

The name "Keratosis pilaris" sounds serious. The first time I heard it, I assumed it had something to do with skin cancer, because no one uses a term that technical to describe a harmless rash. But that’s essentially what this condition (commonly known as KP) is: a frustrating but benign rash with the nickname “chicken skin” (because of its characteristic bumps). Many who have this common ailment misdiagnose it as acne or something else, so the first step in seeking relief from KP is understanding it.
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Half of Us Have KP and Don’t Know It
Karen Smith, who manages a Web site for sufferers of KP, writes that the condition affects approximately 40 to 50 percent of the adult population and 50 to 80 percent of adolescents, with varying severity. Most people with KP, according to Smith, don’t know they have it, usually because they don’t know about their condition and therefore mistake their symptoms for something else, like acne. That’s a real problem, because the treatments for acne and KP are completely opposite. 


Unsightly, but Harmless
There are two main types and manifestations of KP. Keratosis pilaris alba appears as rough, dry, bumpy skin without irritation. Keratosis pilaris rubra presents as red, inflamed bumps that may look like acne pustules. Other variants of the condition are less common. The former (and more common) presentation resembles goose bumps, which is how it got the “chicken skin” moniker. According to the Mayo Clinic staff, these small, painless, skin-colored bumps appear primarily on the upper arms, legs, or buttocks, but they can also occur on the face and closely resemble acne. The difference is that KP bumps are generally dry, rough patches of skin that may itch. 


KP is frustrating because it affects the skin’s appearance and has no cure, but it doesn’t have any long-term health implications, either. And whereas some skin conditions, like rosacea, worsen over time, especially without treatment, KP may actually resolve itself on its own. For most people, it follows a cycle of improving during the humid summer months and flaring up during the winter.


Moist Skin Is Happy Skin
People who believe their KP is acne and use harsh, drying treatments are only exacerbating the problem. KP skin needs moisture! According to the Mayo Clinic staff, the condition arises when keratin—a hard protein that protects skin from infection—builds up and forms a scaly plug that blocks the openings of hair follicles, causing patches of sandpapery skin. Doctors don’t know exactly why this happens in some people and not others, except that genetics may have something to do with it. 


There may not be a cure for KP, but there are plenty of treatment options to keep your skin looking its best. Because dry skin worsens keratin buildup, the best remedy for KP is to keep skin moist. Here’s how:


  • Cleanse skin gently. You may want to scrub out the keratin plugs or slough off dry skin, but you’ll only aggravate your condition by doing so. Just use a mild cleanser and pat or blot skin dry with a towel afterward. Also, limit bathing to fewer than fifteen minutes in warm water; hot water and long showers strip important oils from your skin.
  • Moisturize. While your skin is still damp from bathing, apply a thick lotion or cream to seal in moisture and prevent keratin buildup.
  • Humidify. Depending on where you live, the air inside your home is probably pretty dry. Use a portable humidifier in your home and office to add moisture. Remember to clean it regularly, as these machines become a trap for bacteria and fungi. 
  • If these home-care measures aren’t doing enough to improve the appearance of your skin, see your dermatologist. He or she will be able to diagnose your problem and offer you further treatment options:
  • Ammonium lactate (Lac-Hydrin) is available in a prescription cream or lotion. It softens skin and reduces keratin buildup.
  • Urea (Carmol, Keralac) is an effective moisturizer for dry, rough skin and also helps to loosen dead skin cells that contribute to plugs. However, there are side effects with urea, including redness, stinging, and skin irritation.
  • Topical corticosteroids are anti-inflammatory drugs that help decrease cell turnover by suppressing the immune system. Doctors usually prescribe corticosteroids for short-term treatment and temporary relief, not for long-term use.
  • Topical retinoids, derived from vitamin A, work by promoting cell turnover and preventing the plugging of the hair follicle. They include Tretinoin (Retin-A Micro, Avita) and tazarotene (Tazorac). They may work well for some people, but retinoids could be too harsh and drying for others and can cause severe irritation, redness, and peeling. 


Cheat the Chicken Skin
It’s important to know whether your skin problem is KP or something else, because your diagnosis determines your treatment. While you may actually have acne, you could also be among the many people with this common disorder and require different measures to heal your skin. The good news is that if you do have KP, the condition is harmless and can be managed with the appropriate treatment methods.

Updated April 8, 2011

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