An Overview of Keratosis Pilaris

A child getting moisturizer applied to her cheeks.

Cultura RM Exclusive / GretaMarie/ Getty Images

In This Article
Table of Contents

Keratosis pilaris is a common bumpy rash that most often appears on the upper arms, thighs, cheeks, and buttocks. The rash can occur at any age, but it is most common during adolescence, affecting 50-80% of boys and girls during their teen years. It tends to run in families, but a specific gene that causes keratosis pilaris hasn't been discovered.

Keratosis pilaris is a cosmetic condition, meaning it is harmless and does not need to be treated unless you choose to do so.

Symptoms

Keratosis pilaris is an incredibly common skin condition. It causes tiny, hard bumps similar to goosebumps. In mild cases, you may only know the bumps are there by running your hand over the affected skin. In other people, the rash is more noticeable and the skin is quite rough.

Keratosis pilaris rash may be skin-colored, or it may be red, purple, or brown, depending on your complexion. The bumps themselves may be white.

The rash can appear anywhere on the body except the palms of your hands and the soles of your feet, but it most often occurs on the:

  • Upper arms
  • Thighs
  • Buttocks
  • Cheeks

Keratosis pilaris doesn't hurt and typically doesn't itch. If itching does occur, it's usually mild.

In babies and young children, the rash is most often seen on the cheeks and backs of the arms. For teens and adults, the backs of the arms and the buttocks are the areas most likely to be affected.

Causes

Keratosis pilaris is caused by a buildup of keratin in the pores. Keratin is a protein that makes up your skin, hair, and nails.

In some people, for reasons that aren't certain, keratin collects within the pore creating a plug. This plug swells out of the pore, causing irritation and often trapping hair inside. The pressure and inflammation cause the pore opening to contract and the sebaceous gland to shrink. All of these factors create the bumpiness you feel across the surface of the skin with keratosis pilaris.

Some experts, however, believe that keratosis pilaris may not be a keratinization disorder at all. One study published in 2012 in the International Journal of Trichology suggests that the condition is actually caused by circular hair shafts that damage the follicle wall and trigger inflammation.

Results of a 2015 study found abnormal or atrophied sebaceous glands may be the initial triggering factor, leading to abnormal shedding of keratinized cells and atypical hair growth.

Whatever the exact cause, keratosis pilaris is more common in those with:

  • Xerosis (dry skin)
  • Atopic dermatitis
  • Ichthyosis
  • Obesity
  • A family history of keratosis pilaris

Although a specific gene hasn't been identified, keratosis pilaris does seem to run in families. If one of your parents had the condition, you are much more likely to develop it yourself. It is also more common in those with fair skin.

Keratosis pilaris occurs more often in women than in men. It is also more common at certain ages. It's frequently seen in babies and toddlers, and it may recede somewhat during childhood, re-emerging during puberty. For most people, keratosis pilaris resolves itself by age 30.

Keratosis pilaris is not contagious.

Diagnosis

Keratosis pilaris is diagnosed clinically—that is, based on the typical features of the rash. If there is any question about the diagnosis, a doctor might perform a skin biopsy to be sure, but these rarely need to be done.

Other conditions that look similar to keratosis pilaris include:

You should always have an unidentified rash checked out by a physician in order to get a proper diagnosis. This is especially true of rashes in babies and young children.

Treatment

Because keratosis pilaris is a cosmetic issue, there is no medical reason to treat it. Its appearance, however, may be bothersome to some. There are no treatments that cure keratosis pilaris. However, there are medications and other measures you can take to make it less noticeable.

Treating keratosis pilaris can help keep it from getting worse, though it doesn't progress in all cases. Your doctor can help you decide how best to manage your case.

Over-the-Counter Treatments

Many cases of keratosis pilaris can be managed and improved with over-the-counter (OTC) products.

  • Moisturizers: Because the rash gets worse with dry skin, following the eczema skincare guidelines can help improve skin hydration. Apply moisturizing creams twice daily, especially after showering. Moisturizers that contain urea or ceramides are especially helpful.
  • Exfoliating products: Gentle exfoliation helps loosen keratin plugs and smooth the skin. Creams and body washes that contain alpha-hydroxy acids such as lactic acid or salicylic acid are especially helpful.

Prescriptions

If over-the-counter products aren't improving keratosis pilaris, there are prescription medications that can. These are often stronger forms of lactic acid, salicylic acid, and urea. Examples of these medications include:

  • Lac-Hydrin
  • Vanamide
  • Keralac

Topical retinoids are another treatment option. These help speed up cell turnover and smooth the skin. They are variably effective, though, and can be too irritating for some people.

Topical steroids may be prescribed if the rash is very irritated. These are used for just a short time until the irritation improves. Only use these medications on the face if advised to do so by a physician.

Never assume that medications prescribed to treat your keratosis pilaris are appropriate for your child. Speak to a pediatrician for a recommendation.

Coping

Although keratosis pilaris is not a serious skin condition, it can cause embarrassment or self-consciousness for those who have it. This may keep some from feeling comfortable wearing sleeveless tops, shorts, or bathing suits. In severe cases, people may even avoid physical contact with others.

If this sounds like you, it may help to remember that you are far from the only person with this condition. It's incredibly common.

If you feel like keratosis pilaris is impacting how you feel about yourself, let your doctor know. They may opt to treat your rash more aggressively to, ideally, get better and faster results.

Also, talk to trusted people in your life. Sometimes just airing your feelings helps put things in perspective.

A Word From Verywell

Keratosis pilaris is simply a cosmetic condition, so there's really no reason to treat it unless you choose to. On the bright side, keratosis pilaris usually starts improving on its own in the late teen years. While there is no cure, OTC products and (in certain cases) prescription medications can improve the look and feel of the skin.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pennycook K, McCready T. Keratosis Pilaris. StatPearls Publishing. Updated September 13, 2019.

  2. Keratosis Pilaris - Skin Disorders - MSD Manual Consumer Version. MSD Manual Consumer Version. Updated March 2018.

  3. Keratosis Pilaris - Causes and Treatment | familydoctor.org. familydoctor.org. Updated July 11, 2018.

  4. Lipsky M, King M. Blueprints Family Medicine. 3rd ed.; 2011:130.

  5. Keratosis Pilaris Management and Treatment | Cleveland Clinic. Cleveland Clinic. Updated March 29, 2018.

Additional Reading