Keratosis refers to a build-up of skin
Pilaris refers to the hair portion of the skin
Which equals a build-up of skin in your hair follicles
Do you feel like the queen of bumpy skin?
Maybe you have read every Reddit thread on keratosis pilaris?
Or perhaps you’ve tried every DIY recipe under the sun?
Yet, no matter what you do, those bumps still persist.
Keratosis pilaris is a common skin concern with no universally accepted treatment.
However, unclogging hair follicles and reducing inflammation can make a significant difference.
So join us as we decode this treatment together.
Helping you to transform your skin from rough and bumpy to smooth and glowy.
What Causes Keratosis Pillaris?
There are several theories on why some people are more susceptible to keratosis pilaris (KP) than others.
Keratosis pilaris occurs due to a build-up of keratinised dead skin cells within hair follicles that block the follicle’s opening.
This condition is linked to skin conditions like dry skin, eczema, ichthyosis, and various health concerns such as asthma, hay fever, hypothyroidism, Cushing’s syndrome, diabetes, down syndrome, and obesity.
Low humidity in dry air can also make conditions worse.
Nutritional deficiencies, particularly vitamins A and C and essential fatty acids can also contribute to skin changes typical of keratosis pilaris.
It is common in children and adolescents, and it peaks during puberty and is often resolved by adulthood.
Genetic factors lead to the accumulation of skin cells, resulting in the rough bumps characteristic of keratosis pilaris.
If you want to gain a deeper understanding of this tricky condition, our expert guide on keratosis pillaris has you covered.
What Does Keratosis Pilaris Look Like
Before correctly treating this condition, it’s essential to understand what it looks like on your skin.
Small Bumps: At a glance, they appear as rough, raised dots on ypur skin, which can resemble goosebumps. They’re commonly found on the upper arms, thighs, cheeks, buttocks, and sometimes even under the eyes.
Plugged Hair Follicles: If you were to examine keratosis pillaris under a microscope, it would show that keratin, a skin protein, forms small plugs is blocking your hair follicles, and it is these plugs that cause the raised bumps on your skin.
Rough Texture: Your affected skin may feel rough to the touch due to the accumulation of these keratin plugs.
Redness and Irritation: In some cases, you may experience mild inflammation around the affected hair follicles, which causes redness and potential irritation.
Understanding how keratosis pilaris appears on your skin is essential for effectively identifying and treating the condition.
How to Treat Keratosis Pilaris?
Now that you better understand how it shows up in your skin, it’s time to learn how to treat this tricky.
We always recommend a three-pronged approach to our clients:
- Treat the inflammation: Because there is a direct correlation between eczema and keratosis pilaris, there may be inflammation in your skin. So, treating the inflammation is important to keep your pH balanced and skin barrier function intact.
- Keep your skin moisturised and hydrated. Gentle moisturising is also key; we recommend using a moisturiser with essential skin-identical ingredients like ceramides and lipids naturally found in your skin; these will replenish what is missing and keep your skin soft, supple and bump-free.
- Break down the Keratin: The build-up of keratin blocks the follicle, causing the tiny bumps. So, ideally, you need to focus on breaking down this keratin with keratolytic ingredients. These include urea and gentle alpha hydroxy acids. There is one exception here; however, avoid using alpha hydroxy acids on your skin if irritated, as this will inflame your skin further.
- Avoid keratosis pilaris popping: This can cause post-inflammatory pigmentation (PIH) and potentially scar your skin.
4 Ingredients to Treat Keratosis Pilaris
#1: Urea for keratosis pilaris
Urea is an important multitasking ingredient that offers a rare combination of exfoliation and moisturisation, providing a unique and effective skincare solution for keratosis pillaris.
At concentrations exceeding 10%, it acts as a natural exfoliator, breaking down the keratin bonds between skin cells and gently exfoliating the top layer of your skin.
This dual action allows deep moisture to penetrate the lower layers of your skin, encouraging cell turnover whilst gently shedding dead skin cells.
Urea also has powerful humectant properties, drawing moisture into the deeper layers of your skin.
#2: Alpha hydroxy acids
Lactic acid is an alpha hydroxy acid that boasts powerful moisturising properties, hydrating and smoothing your skin. It’s a gentle treatment option for addressing keratosis pilaris, especially on delicate areas of your skin like your face and around the eyes.
If you have stubborn keratosis pilaris in your body, then glycolic acid is a good option. This study  found that chemical peels containing 70% glycolic acid, when applied to participants’ skin for 5 to 7 minutes, significantly reduced the appearance of their keratosis pilaris.
#3: Salicylic acid
Salicylic acid acts as another important natural exfoliant that effectively penetrates the hair follicle, breaking down the build-up of keratin.
In a 12-week trial by Kootiratrakarn et al. (2), lactic acid at 10% and salicylic acid at 5% in cream significantly improved skin moisturisation and reduced bumps at weeks 4, 8, and 12.
Use Salicylic and Urea in Combination
Novick presents a protocol in a referenced paper (3) to address keratosis pilaris by utilising a blend of keratolytic agents. The approach involved gently massaging a combination of 2% salicylic acid and 20% urea cream onto the skin for five seconds in the initial treatment week.
The application time was gradually increased to help the skin adapt and avoid excessive dryness, and it was found that the participant’s keratosis pilaris significantly improved over time.
#4: Topical retinoids
Retinoids are essential ingredients that promote skin cell turnover and will smooth the top layer of your skin whilst also breaking down keratin around the hair follicle.
In a study  Involving 33 patients, a topical retinoid at a concentration of 0.05% was applied nightly, resulting in the patients experiencing smoother skin within two weeks, with a resolution of keratosis pilaris occurring after four to eight weeks.
However, despite their multitasking properties, retinoids can lead to skin irritation and flakiness if not followed by proper moisturisation, especially if you are prone to sensitivity or eczema.
To conclude. The naked truth
Understanding the multifaceted nature of keratosis pilaris will hopefully help you see why a comprehensive approach is required when treating this tricky condition.
A three-pronged approach is the best option:
- That addresses the inflammation
- Preserves your skin’s moisture
- Targets the build-up of keratin within the hair follicles.
Maintaining a balanced pH and ensuring your skin barrier’s integrity is extremely important to alleviate inflammation.
Also, gentle moisturisation, particularly with products containing ceramides, will help keep your skin soft, supple, and less prone to bumps.
Breaking down the build-up of keratin is a crucial aspect of managing this condition, and urea, with its dual exfoliating and moisturising properties, stands out as a powerful treatment option, aiding in shedding dead skin cells and encouraging cell turnover.
Alongside urea, using alpha hydroxy acids such as lactic acid and glycolic acid, when introduced gradually, can significantly improve your skin’s moisturisation and texture.
Furthermore, topical retinoids are important, which will help boost cell turnover and smoothen your skin’s surface.
However, it is essential to note that retinoids require careful application and moisturisation to prevent irritation, especially if you are prone to sensitivity or eczema.
Emphasising a gentler, holistic approach will safeguard your skin’s protective barrier while effectively managing this skin condition.
Transforming your skin from rough and bumpy to a smoother, healthier state.
1. Epidermal permeability barrier in the treatment of keratosis pilaris
2. Continuing Education Activity around Keratosis pillaris.
3. Practical management of widespread, atypical keratosis pillaris
4. Tazarotene 0.05% cream for the treatment of keratosis pilaris.