Have lumps and bumps turned your skin to sandpaper? Does it look like chicken skin?  It could be Keratosis Pilaris. Dr Haran Sivapalan explains what it is and what can be done about it.

Have you ever peered closely at the skin covering an uncooked chicken drumstick or thigh piece? It looks as if it’s covered with goosebumps, almost the opposite of the surface of a golf ball. Well, for about 1 in 3 people in the UK, areas of the skin take on a similar “chicken skin” appearance. These people are said to have keratosis pilaris – a relatively harmless condition that results in rough, bumpy skin (hence the informal moniker “chicken skin’).

The term ‘keratosis’ means there is an excessive amount of keratin, the tough structural protein found in the outermost ‘horny’ layer of the skin (stratum corneum), while ‘pilaris’ refers to hairs. In keratosis pilaris, too much keratin accumulates in the hair follicles. The follicles become blocked with keratin plugs, which form small bumps about 1-2mm in diameter and look like permanent goosebumps. The bumps are usually red, white or skin-coloured and typically affect the back of the upper arms, the front of the thighs. Less frequently, keratosis pilaris can affect the back and chest. There are also rare variants of the condition that may affect the eyebrows, face or whole body.

Running your fingers over areas of keratosis pilaris feels rough, similar to sandpaper. In some cases, the skin may be itchy. Does this mean the condition causes lasting damage to the skin? In a word, no. Although the appearance of ‘chicken skin’ can understandably be discomforting to some people, keratosis pilaris does not cause physical damage to the body. It’s not contagious and often goes away with time. In fact, it’s quite rare for elderly people to have the condition.

Typically, keratosis pilaris starts in childhood and gets worse in adolescence. Statistics show that it also tends to more commonly affect women, people of Celtic origin and people with dry skin conditions such as eczema or ichthyosis,  a skin condition that looks a little like fish scales.    Fortunately for a lot of people, symptoms of keratosis pilaris often improve in adulthood. For reasons that are yet unknown, the condition also seems to get better in the summer months. This may be due to increased sweating keeping the skin moist.

Things that help

If symptoms don’t get better on their own, there are various beneficial things you can do, both on your own and with the help of a doctor. People with keratosis pilaris are more at risk of dry skin, so keeping your skin well moisturised is important.

Frequent application of emollients can help. More effective are creams, particularly those containing salicylic acid, lactic acid or urea. Your GP can prescribe you a cream or emollient or you can choose from the many options available over the counter.

Opting for non-soap cleansers over soaps can also help keep the skin from dry out. Similarly, a lukewarm shower is less likely to cause skin dryness than a hot baths.

To reduce the roughness of ‘chicken skin’, some people find that using an exfoliator such as a pumice stone can help, and there also some over-the-counter creams that can have an exfoliating effect. Ask your pharmacist.

Additionally there are other medical treatments available (but not on the NHS), including: topical retinoids, chemical peels, microdermabrasion and laser therapy. Unfortunately, none have these has been demonstrated to be effective at treating and curing keratosis pilaris, but they may improve the visual appearance – temporarily at least.