| KERATOSIS
PILARIS |
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 WHAT IS KERATOSIS PILARIS?
Keratosis pilaris is a condition that causes
small, rough bumps to appear around the hairs. This mainly occurs on the outside of the upper arms. It looks a bit like goose bumps. Keratosis pilaris is very common, especially in children and young people. If you look closely, you will see that approximately 50-80% of children and adolescents and approximately 40% of adults have these bumps to a greater or lesser extent. It often runs in the family, as it is hereditary. Because it is so common, it cannot really be called an abnormality; some people have it and others do not. It is a harmless condition that usually causes no symptoms. Some people find it cosmetically disturbing.
WHAT DOES KERATOSIS PILARIS LOOK LIKE?
A bump has formed on all areas where a hair emerges. The skin is also slightly thickened in these areas and feels rough to the touch.
Keratosis is the medical term for a thickened stratum corneum (the top layer of skin) and
pilaris means 'around the hairs'. It looks a bit like goose bumps, and keratosis pilaris is sometimes simply referred to as goose bumps or
chicken skin. Keratosis pilaris mainly occurs on the outside of the upper arms and legs, and sometimes also on the face, buttocks, or torso. It can be very mild and barely visible, but it can also be extensive.
It usually causes no symptoms. Sometimes there is some inflammation, visible as redness. In darker skin, this mild inflammation can cause pigmentation spots. Itching and scratching can cause scabs, wounds, and scars.
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HOW DOES KERATOSIS PILARIS DEVELOP?
Hair grows from a hair follicle. The inside of this hair follicle is also lined with skin cells, which divide and eventually shed as skin flakes. In keratosis pilaris, the skin flakes block the hair follicle's drainage duct, causing a small bump to form. Sometimes the hairs cannot grow out because a plug of flakes blocks the opening. It can also become inflamed. It is not known exactly why this happens. It seems to be genetically determined, i.e., the predisposition to keratosis pilaris is hereditary; often the parents also have it, or had it as children.
WHO GETS KERATOSIS PILARIS?
Keratosis pilaris is very common, affecting about half of the population, so anyone can get it. It mainly occurs in people with
dry skin and atopy (a predisposition to allergic reactions to various things) or atopic eczema. It occurs in all races, in both men and women. It is better in summer than in winter. With age, the condition disappears in
some patients.
Keratosis pilaris sometimes occurs together with other abnormalities. There is a rare condition called
ulerythema ophriogenes.
Patients with this disorder have noticeably red cheeks, with small bumps on them, red bumps on the forehead, in and between the eyebrows, loss of eyebrow hair, especially on the outside, and keratosis pilaris on the upper arms.
HOW IS THE DIAGNOSIS MADE?
The diagnosis is made based on the clinical picture, on how it looks. The picture is so clear, especially when it is on the upper arms, that no additional tests are necessary.
HOW IS KERATOSIS PILARIS TREATED?
Usually, no treatment is necessary. If necessary, care products intended for dry or rough skin can be used. There are many products available for people with dry skin (see products for
dry skin). For rough-feeling skin, which is usually skin with a thickened stratum corneum (the top layer), there are products available that dissolve the stratum corneum slightly. This group of products is called keratolytics. They contain substances that soften the stratum corneum, such as urea, salicylic acid, lactic acid, tretinoin (vitamin A), adapalene, or alpha hydroxy acid (AHA).
Ointments, fatty creams, or lotions for dry skin
See under products for
dry skin.
Products containing urea
Urea 5 or 10% in eucerin cum aqua, urea 5 or 10% in lanette cream, urea 10% in vaseline, urea 5 or 10% in cetomacrogol cream, urea 5 or 10% in vaseline cetomacrogol cream, urea 5 or 10% in vaseline lanette cream,
urea 5%, lactic acid 5% in vaseline lanette cream.
Products containing salicylic acid
Salicylic acid ointment 2%,
salicylic acid 5 or 10% cream, salicylic acid 5 or
10% in vaseline.
Products containing alpha hydroxy acids (AHA)
Cosmetics, for example Louis Widmer AHA concept 10% cream.
Other products
Tretinoin cream 0.05%,
adapalene gel.
The skin can also be treated with gentle exfoliation. Exfoliation involves removing dead skin cells from the skin with light abrasive movements. Special scrubs are available in the form of a cream with exfoliating particles mixed in. Some people make their own scrub solution from olive oil and coarse sea salt. Another effective and much simpler option is to buy a exfoliating glove
(scrub glove) for use in the shower.
A skin therapist can also perform treatments such as skin cleansing, scrubs, and peels, which are treatments with chemicals that dissolve the stratum corneum, such as glycolic acid peels.
WHAT IS THE PROGNOSIS?
Keratosis pilaris often improves with age. It is better in summer than in winter. Keratosis pilaris usually causes few complaints. Treating dry skin is often sufficient.
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