This weekend, I was spending time with some of my favorite women when one approached me to ask about bumps that she had on her arms. Before she could even finish describing it, I knew exactly what she was asking about: keratosis pilaris, also known simply as “KP.”
It is a condition that has plagued me as long as I can remember, and is frequently asked about on every Internet skin forum.
While it may resemble an acne bump at first glance, upon closer examination you know it isn’t, but then… what is it?
It’s befuddling, embarrassing, and can be a source of shame for many people. I’ve had many women tell me they only wear long sleeves or three-quarter sleeves to avoid embarrassing questions, and indeed, I never thought much of my KP until my teens, when an ex-boyfriend asked me one day what all the red bumps on the back of my arms were. After that, I banished all of the sleeveless options in my closet and hid in long sleeves and sweatshirts.
Thankfully, KP is an incredibly common, harmless skin condition that is fairly simple to treat.
Keratosis Pilaris (KP) is a common, frequently inherited disorder of follicular hyperkeratosis (build-up of dead skin), where dead skin cells – known as keratinocytes – form hard plugs within the hair follicle and do not shed properly. It is typically referred to as “goose bumps” that never quite go away, appearing as hard bumps. It is most commonly found on the arms (particularly the back of the arms) and thighs, but can appear on the butt and face as well, where it is frequently mistaken as acne (if you believe you have KP on your face, please visit a medical professional to confirm).
One thing about keratosis pilaris that makes it more distinguishable from other conditions is that it is a symmetrical condition, meaning if it appears on one arm, it will appear on the other.
The bumps are very rough, frequently appearing to be the normal tone of the skin with a small halo of red.
It is most common in children, affecting up to 50%, but is also frequently seen in adolescents and adults, where it only begins improving in the elderly years. People who have drier skin, eczema or atopic dermatitis, seasonal allergies, and asthma seem to be the most frequent sufferers of KP, but it can also appear in people undergoing chemotherapy.
It worsens in the winter or in lower humidity environments where the skin is most prone to water loss (known as TEWL, or trans-epidermal water loss). It can flare up at any time though, and has no cure, but thankfully can be managed at home with ease.
As I said before, KP is most prevalent in people with drier skin types. As such, it is very important to look for soap-free cleansers that will not strip the precious lipids from the surface of the skin, drying out the skin cells, and creating a build up of dead skin.
This means avoiding bar soaps (frequently very drying due to their high pH value and ability to strip away lipids indiscriminately) and even liquid soaps. Soaps containing SLS (sodium lauryl sulfate) and even it’s gentler cousin, SLES (sodium laureth sulfate) are frequently far too drying for the parched skin of KP and should be avoided.
Some people find value in gently scrubbing their KP with a washcloth or sponge to loosen the dead skin cells to help them shed, though aggressive scrubbing should be avoided if your skin is sensitive, as aggressive scrubbing can cause inflammation and actually make the KP worse.
Moisturizing the body, particularly the areas affected by KP, is incredibly important with KP. When moisturizing, be sure to put moisturizer on straight out of a shower, before drying off. This will lock the moisture from the shower into your skin, and slow down TEWL.
Sufferers of KP should also look for products that are keratolytic (meaning they can break down the “glue” that holds skin cells together, allowing them to shed), such as glycolic acid, salicylic acid, and urea. For some, tretinoin and adapalene (Differin) may also prove helpful.
If your KP is particularly aggressive, try moisturizing twice a day – with a thick, creamy moisturizer in the day, and a keratolytic moisturizer at night.
Managing KP on the Face
As I mentioned before, KP can appear on the face, though I’ve only been able to find examples of facial KP in children, so I apologize for the lack of photos of facial KP on adults.
Regardless, many of the same rules apply, with some differences to account for the sensitive nature of the facial skin.
Look for creamy cleansers that will not strip the skin of essential moisture, or consider using a wash with salicylic acid (SA, also known as BHA). Feel free to use this cleanser around the areas most affected, massaging it in with your hands. Rise with lukewarm water and pat dry. From there, apply your moisturizer. I prefer moisturizers with low percentages of urea, but you may do better with a glycolic or lactic acid (AHA).
Avoid taking very hot showers or baths if possible, and reduce your showers to once a day at max. Water, especially hot water, can still be very stripping to dry skin. If you’re in a drier climate or running the heater, use a humidifier in your bedroom at night to keep humidity levels higher, which will reduce the rate at which skin dries out.
Shaving the hair, waxing, and epilating can all aggravate the condition, so if your KP is particularly resistant to at-home treatments, consider laser hair removal.
If your skin begins to feel raw, irritated, or tender after using products containing AHAs or BHAs, back down on frequency. Body skin is pretty resilient to these ingredients in my experience, but it is still possibly to over-do it. Stick with moisturizing twice a day, once with the creamy moisturizer and once with the keratolytic moisturizer. Adjust as needed, swapping out the AM creamy moisturizer with a keratolytic moisturizer if you need more oomph.
One last note: if you have tattoos, keratolytic ingredients such as glycolic acid are perfectly fine and safe to use over your tattoos. They do not penetrate deep enough to disrupt the ink, and in fact may brighten your tattoos by sloughing off the dead skin in the stratum corneum that dulls their color.
As I mentioned, KP is all about dry skin and moisture, so look for products that can boost the moisture content in the skin. I’ll be breaking down my recommendations into creamy cleansers and keratolytic cleansers as well as creamy moisturizers and keratolytic moisturizers.
Most people do not see resolution of their KP until they add a keratolytic product to their routine and remove their drying cleanser, so I recommend starting there.
CeraVe Hydrating Body Wash (Body)
Water, Cocamidopropyl Betaine, White Petrolatum, Lauric Acid, Sodium Cocoyl Glycinate, Glycerin, Glycine Soja (Soybean) Oil, Urea, Stearic Acid, Sodium Cocoyl Isethionate, Sodium Hydroxypropyl Starch Phosphate, Sodium Lauroamphoacetate, Sodium Methyl Cocoyl Taurate, Sodium Chloride, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Phenoxyethanol, Guar Hydroxypropyltrimonium Chloride, Sodium Hydroxide, Sodium PCA, Ophiopogon Japonicus Root Extract, Tetrasodium EDTA, Ethylhexylglycerin, Sodium Lauroyl Lactylate, Phytosphingosine, Cholesterol, Carbomer, Xanthan Gum.
CeraVe Hydrating Cleanser (Face)
Ingredients: Purified Water, Glycerin, Behentrimonium Methosulfate and Cetearyl Alcohol, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Cholesterol, Polyoxyl 40 Stearate, Glyceryl Monostearate, Stearyl Alcohol, Polysorbate 20, Potassium Phosphate, Dipotassium Phosphate, Sodium Lauroyl Lactylate, Cetyl Alcohol, Disodium EDTA, Phytosphingosine, Methylparaben, Propylparaben, Carbomer, Xanthan Gum.
La Roche-Posay Toleriane Hydrating Gentle Face Cleanser (Face)
Ingredients: Aqua/Water/Eau (La Roche-Posay Prebiotic Thermal Water), Glycerin, Pentaerythrityl Tetraethylhexanoate, Propylene Glycol, Ammonium Polyacryloyldimethyl Taurate, Polysorbate 60, Ceramide NP, Niacinamide, Sodium Chloride, Coco-Betaine, Disodium EDTA, Caprylyl Glycol, Panthenol, T-Butyl Alcohol, Tocopherol.
Neutrogena Ultra Gentle Hydrating Cleanser – Creamy Formula (Face)
Ingredients: Water, Glycerin, Cetearyl Alcohol, Polyglyceryl-10 Laurate, Ethylhexylglycerin, Cetearyl Glucoside, Caprylyl Glycol, Carbomer, Sodium Hydroxide, Phenoxyethanol.
CeraVe Salicylic Acid Body Wash to Cleanse and Exfoliate Rough and Bumpy Skin (Body)
Purified Water, Cocamidopropyl Hydroxysultaine, Glycerin, Sodium Lauroyl Sarcosinate, Niacinamide, Gluconolactone, Sodium Methyl Cocoyl Taurate, PEG-150 Pentaerythrityl Tetrastearate, Salicylic Acid, Sodium Benzoate, Zea Mays (Corn) Oil, Disodium EDTA, Sodium Lauroyl Lactylate, Ceramide 3, Cholecalciferol, Ceramide 6-II, Phytosphingosine, Cholesterol, Sodium Hyaluronate, Xanthan Gum, Carbomer, Ceramide 1.
CeraVe Renewing Gentle SA Cleanser for Rough and Bumpy Skin with Salicylic Acid (Face)
Purified Water, Cocamidopropyl Hydroxysultaine, Glycerin, Sodium Lauroyl Sarcosinate, Niacinamide, Gluconolactone, Sodium Methylcocoyl Taurate, PEG-150 Pentaerythrityl Tetrastearate, Salicylic Acid, Ceramide 6 II, Ceramide 3, Ceramide 1, Hyaluronic Acid, Cholesterol, Sodium Benzoate, Zea Mays (Corn) Oil, Disodium EDTA, Sodium Lauroyl Lactylate, Cholecalciferol, Phytosphingosine, Xanthan Gum, Carbomer, Sodium Hydroxide.
CeraVe Moisturizing Cream (Body)
Ingredients: Purified Water, Glycerin, Ceteareth-20 and Cetearyl Alcohol, Caprylic/Capric Triglyceride, Behentrimonium Methosulfate and Cetearyl Alcohol, Cetyl Alcohol, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Cholesterol, Petrolatum, Dimethicone, Potassium Phosphate, Dipotassium Phosphate, Sodium Lauroyl Lactylate, Disodium EDTA, Phenoxyethanol, Methylparaben, Propylparaben, Phytosphingosine, Carbomer, Xanthan Gum.
CeraVe Baby Moisturizing Cream (Body)
Ingredients: Water, Glycerin, Cetearyl Alcohol, Caprylic/Capric Triglycerides, Cetyl Alcohol, Ceteareth-20, Petrolatum, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Cholesterol, Phenoxyethanol, Behentrimonium Methosulphate, Potassium Phosphate, Dipotassium Phosphate, Ethylhexylglycerin, Sodium Lauroyl Lactylate, Disodium EDTA, Phytosphingosine, Carbomer, Xanthan Gum, Sodium Hydroxide.
CeraVe Renewing SA Lotion 8 oz Salicylic Acid Body Moisturizer for Rough and Bumpy Skin (Body)
Purified Water, Glycerin, Mineral Oil, Ammonium Lactate, Salicylic Acid, Trolamine, Glyceryl Stearate SE, Behentrimonium Methosulfate and Cetearyl Alcohol, PEG-100 Stearate, Cetyl Alcohol, Cholecalciferol (Vitamin D3 in Corn Oil), Ceramide 3, Ceramide 6-II, Ceramide 1, Cholesterol, Phytosphingosine, Dimethicone 260, Methylparaben, Disodium EDTA, Propylparaben, Hyaluronic Acid, Sodium Lauroyl Lactylate, Carbomer, Xanthan Gum.
CeraVe SA Cream for Rough and Bumpy Skin (Face)
Purified Water, Glycerin, Ceteareth-20 And Cetearyl Alcohol, Caprylic/Capric Triglyceride, Behentrimonium Methosulfate And Cetearyl Alcohol, Cetyl Alcohol, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Cholesterol, Petrolatum, Dimethicone, Potassium Phosphate, Dipotassium Phosphate, Sodium Lauroyl Lactylate, Disodium EDTA, Phenoxyethanol, Methylparaben, Propylparaben, Phytosphingosine, Carbomer, Xanthan Gum.
CeraVe Psoriasis Moisturizing Cream (Body)
Active Ingredient: Salicylic acid 2% Inactive Ingredients: water, urea, glyceryl stearate SE, cetearyl alcohol, butyrospermum parkii (shea) butter, glycerin, cetyl alcohol, niacinamide, laureth-9, limnanthes alba (meadowfoam) seed oil, PEG-100 stearate, gossypium herbaceum (cotton) seed oil, behentrimonium methosulfate, 1,2-hexanediol, C12-13 alkyl lactate, dimethicone, tasmannia lanceolata fruit/leaf extract, ceramide 3, ceramide 6-II, ceramide 1, phytosphingosine, cholesterol, tocopherol, hydroxyacetophenone, hydrogenated olive oil, glyceryl stearate, disodium EDTA, sodium lauroyl lactylate, xanthan gum, carbomer, sodium hyaluronate, sodium hydroxide.
Eucerin Intensive Repair (Body, warning: feels very thick, like spreading glue)
Water, Mineral Oil, PEG-7 Hydrogenated Castor Oil, Isohexadecane, Sodium Lactate, Urea, Glycerin, Isopropyl Palmitate, Panthenol, Microcrystalline Wax, Magnesium Sulfate, Lanolin Alcohol, Bisabolol, Methylchloroisothiazolinone, Methylisothiazolinone.
Eurcerin Advanced Repair Lotion
Water, Glycerin, Urea, Cetearyl Alcohol, Glyceryl Glucoside, Cyclomethicone, Sodium Lactate, Butyrospermum Parkii (Shea) Butter, Caprylic/Capric Triglyceride, Methylpropanediol, Octyldodecanol, Dicaprylyl Ether, Tapioca Starch, Glyceryl Stearate SE, Hydrogenated Coco-Glycerides, Arginine HCl, Sodium PCA, Dimethiconol, Lactic Acid, Chondrus Crispus (Carrageenan), Carnitine, Ceramide 3, Mannitol, Serine, Sucrose, Citrulline, Glycogen, Histidine HCl, Alanine, Threonine, Glutamic Acid, Lysine HCl, Sodium Chloride, Sodium Cetearyl Sulfate, 1,2-Hexanediol, Phenoxyethanol.
AMLACTIN Alpha-Hydroxy Ceramide Therapy Restoring Lotion (Body)
Water, Ammonium Lactate, Butylene Glycol, Glycerin, Potassium Lactate, Sodium Lactate, Mineral Oil, Petrolatum, Steareth-21, Dimethicone, Glyceryl Stearate SE, Steareth-2, Stearyl Alcohol, Xanthan Gum, Tocopheryl Acetate, Methylparaben, Disodium EDTA, Propylparaben, Sodium Lauroyl Lactylate, Ceramide NP, Ceramide AP, Phytosphingosine, Cholesterol, Carbomer, Ceramide EOP.
AMLACTIN 12% Moisturizing Lotion (My Body Routine Product)
Water, Ammonium Lactate, Mineral Oil, Propylene Glycol, Glycerin, PEG-100 Stearate, Glyceryl Stearate, Magnesium Aluminum Silicate, Laureth-4, Peg 40 Stearate, Cetyl Alcohol, Methylparaben, Propylparaben and Methylcellulose.
For additional facial recommendations check out my recommended products for rosacea.