Keratosis Pilaris

What is Keratosis Pilaris (KP)?

KP is a chronic condition of dry, rough skin on the upper arms. The skin feels like sandpaper with many tiny bumps.

The bumpy skin can also occur on the outer thighs and the buttocks. The skin remains a normal color. KP does not cause any pain. Sometimes it can be itchy. Most children with KP also have dry skin. KP affects 30% of children and adults.

What is the cause?

KP is a genetic disorder that causes plugs of dead skin cells to build up in the hair follicles. It’s made worse by too much bathing and soap. Soap removes the skin’s natural protective oils. Once they are gone, the skin can’t hold moisture. Dry climates make it worse, as does winter weather and forced air heating.

With treatment, the skin should feel softer within 1 week. However, the bumps will never go away. Most people with KP have it all their life

How can I take care of my child?

  • Soap and Bathing

    Young children with KP should avoid all soaps. Soaps take the natural protective oils out of the skin. Bubble bath does the most damage. For young children, the skin can be cleansed with warm water alone. Keep bathing to 10 minutes or less.

    Most young children only need to bathe twice a week. Teenagers can get by with using soap only for the armpits, genitals, and feet. Also, use a mild soap such as Dove. Never use any soap on the areas with KP. This is very important.

  • Moisturizing Cream

    Buy a large bottle of moisturizing cream. Avoid creams with fragrances. Put the cream on the KP areas 2 times per day.

    After warm water baths or showers, trap the moisture in the skin by putting on the cream quickly. Apply the cream within 3 minutes of completing the bath. During the winter, apply the cream on all every day to prevent dry skin.

  • Steroid Cream

    Usually KP is not itchy unless you scrub it with soap. For very itchy spots, use 1% hydrocortisone cream. No prescription is needed. Use up to 2 times per day as needed until the itching is better. Eventually, the moisturizing cream will be all that you need for treating KP.

  • Prescription Creams

    There are some peeling agents that make KP look somewhat better. But they are expensive and only give improvement while they are being used. When you stop, the bumpiness will come back. There is no cream that can cure KP

  • Humidifier

    If your winters are dry, protect your child’s skin from the constant drying effect. Do this by running a room humidifier full time.

What can be done to prevent keratosis pilaris?

Most importantly, don’t use soaps or bubble bath. Bubble bath is very hard on the the skin. Also limit the use of swimming pools or hot tubs because pool chemicals are very drying. Finally, in the wintertime, run a humidifier to protect the skin from dryness

When should I call my child’s health care provider?

  • After 2 weeks of treatment, the KP is not better.
  • Your child becomes worse.
  • You have other concerns or questions.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2015.1 published by RelayHealth.
Last modified: 2013-05-30
Last reviewed: 2014-06-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 Barton D. Schmitt, MD. All rights reserved.

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