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Keratosis pilaris (KP, also follicular keratosis) is a very common genetic follicular condition that is manifested by the appearance of rough bumps on the skin and hence colloquially referred to as "chicken skin". It most often appears on the back and outer sides of the upper arms (though the lower arms can also be affected), and can also occur on the thighs and tops of legs, flanks, buttocks or any body part except glabrous skin (like the palms or soles of feet). Less commonly, lesions appear on the face and may be mistaken for acne.

Classification

Worldwide, KP affects an estimated 40 to 50% of the adult population and approximately 50%-80% of all adolescents. It is more common in women than in men. Varying in degree, cases of KP can range from minimal to severe.

There are several different types of keratosis pilaris, including: keratosis pilaris rubra (red, inflamed bumps), alba (rough, bumpy skin with no irritation), rubra faceii (reddish rash on the cheeks) and related disorders.

Many people with keratosis pilaris do not know they have it. While KP resembles goose bumps, it is characterized by the appearance of small rough bumps on the skin. As a result, it is often confused with acne. Squeezing them may cause bleeding and eventually scarring.

Causes

Symptoms

Keratosis pilaris occurs when the human body produces excess keratin, a natural protein in the skin. The excess keratin, which is cream color, surrounds and entraps the hair follicles in the pore. This causes the formation of hard plugs (process known as hyperkeratinization). Bearing only cosmetic consequence, the condition most often appears as a proliferation of tiny hard bumps that are seldom sore or itchy. Though people with keratosis pilaris experience this condition year round, it’s during the colder months when moisture levels in the air are lower that the problem can become exacerbated and the “goose bumps” are apt to look and feel more pronounced in color and texture.

Many KP bumps contain an ingrown hair that has coiled. This is a result of the keratinized skin "capping off" the hair follicle, preventing the hair from exiting. Instead, the hair grows inside the follicle, often encapsulated, and can be removed, much like an ingrown hair, though removal can lead to scarring.

Treatment

There is currently no known cure for keratosis pilaris, however, there are effective treatments available which make its symptoms less apparent. The condition often improves with age and can even disappear completely in adulthood, though some will show signs of keratosis pilaris for life. Some treatments are largely symptomatic and may need repeating. Regardless, exfoliation, intensive moisturizing cremes, lac-hydrin, topical retinoids such as Retin A and medicated lotions containing alpha hydroxy acids or urea may be used to temporarily improve the appearance and texture of affected skin.

Depending upon the severity of keratosis pilaris in a patient, some who have the disorder may be prescribed Triamcinolone Acetonide cream. The cream is a synthetic corticosteroid and is highly effective in reducing the amount of keratin in pores. It often dramatically reduces the visibility of the red, inflamed bumps and leaves patients with xeroderma feeling as if their dry skin has been quenched. Triamcinolone is typically applied after bathing once every one to two days.

Also, beta hydroxy acids can help improve the appearance and texture of the afflicted skin. Milk baths may provide some cosmetic improvement due to the lactic acid—a natural alpha hydroxy acid in milk.^{[citation needed]} Sunlight may also be helpful but increases risk of skin cancer. Coconut oil may also be helpful if applied to afflicted areas while in the shower.^{[citation needed]} Scratching and picking at KP bumps causes them to redden, and in many cases will cause bleeding. Excessive picking can lead to scarring. Wearing clothing that is looser around the affected areas can also help reduce the marks, as constant chafing from clothing (such as tight fitting jeans) is similar to repeatedly scratching the bumps.

References

External links

The American Osteopathic College of Dermatology - Article on keratosis pilaris
Keratosis Pilaris : The Chicken Skin Condition : Help for KP - Information on keratosis pilaris
Information on Keratosis Pilaris from the British Skin Foundation