Definition

• A chronic condition of dry, rough skin on the upper arms
• Called Keratosis Pilaris (KP)

Health Information

Symptoms

• Rough and tiny bumps on the upper outer arms. (100% of patients)
• Also occurs on the outer thighs (60%) and buttocks (30%)
• Roughness may be described as sandpapery.
• The same on both sides of the body
• Skin is normal colored.
• It rarely causes any itching.

Causes

• Dead skin cells plug the hair follicles
• KP does run in families (genetic). May occur in half of the sibs.
• 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. Reason: low humidity inside.
• Can occur as early as 2 years.

Prevention of Recurrent KP

• Don’t use soaps or bubble bath.
• You may want to limit use of swimming pools or hot tubs. Reason: Pool chemicals are very drying.
• Run a humidifier in the winter if the air is dry.

Care Advice

1. Overview:
   • Keratosis Pilaris (KP) is a common condition. It occurs in up to 30% of adults.
   • KP is not contagious to others.
   • It is harmless and can be treated at home.
   • Moisturizers are the key.
   • Here is some care advice that should help.
2. 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.
3. Moisturizing Cream:
   • Buy a large bottle of unscented moisturizing cream. Avoid those 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. Do this by putting on the cream quickly. Use the cream within 3 minutes of completing the bath.
   • During the winter, apply the cream to all the skin. Do this every day to prevent dry skin.
4. 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.
5. 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.
   • There is no cream that can cure KP.
6. 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.
7. What to Expect:
   • With treatment, the skin should feel softer within 1 week.
   • KP however will never completely go away.

Call Your Doctor If

• After 2 weeks of treatment, KP is not better
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

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