Keratosis Pilaris – The Ultimate Guide

Keratosis Pilaris (KP), also known as chicken skin is a common skin condition that causes small rough, dry bumps to appear on the skin. They may look white, red, pinkish-purple on fair skin, or brownish-black on dark skin.

This is an incurable disease but you can treat it with OTC products and reduce its appearance.

Where does Keratosis Pilaris occur?

Keratosis pilaris commonly occur on the face, outer arms, outer legs, buttocks, shoulders, chest, and cheeks. It is less likely to see KP on the trunk than it is to see KP on the outer limbs.

It isn’t contagious and doesn’t usually cause discomfort or itching.

The reason why keratosis pilaris appear in those areas is because there is no sebum production there.

How is Keratosis Pilaris caused?

Keratosis pilaris is caused by dead skin cells plugging hair follicles. This can lead to dryness, erythema, and scaling around the follicle opening.

Genetics, hormonal imbalances, puberty, pregnancy, and PCOS are some other causes.

What are the symptoms of Keratosis Pilaris?

The most common symptom of keratosis pilaris is its appearance. The bumps on the skin resemble goosebumps or the skin of a plucked chicken.

Other symptoms associated with it include:

  • Redness
  • Slight discoloration around the bumps
  • Dry, irritable, and sensitive skin
  • Bumps that feel like sandpaper
  • If you find it only on the outer arms, outer legs, buttocks, shoulders, chest, or cheeks

Who can get Keratosis Pilaris?

Keratosis pilaris first appears in early childhood and progresses during the second decade of life. The condition often improves over time (by age 30).

Keratosis pilaris is associated with many other conditions, including atopic dermatitis, obesity, diabetes mellitus, ichthyosis vulgaris, and malnutrition.

What skincare ingredients can be used for Keratosis Pilaris?

  • AHAs: like glycolic acid and lactic acid are the main ingredients that help to reduce the appearance of KP. They help remove dead skin cells, remove ingrown hairs, even skin tone, and reduce hyperpigmentation.
  • BHAs: like salicylic acid should also help. It is great at penetrating the skin and breaking down the keratin plugs built up, but if left on for too long can actually further irritate and compromise the skin barrier in those with KP. You can use a salicylic acid body wash because it does not sit on the skin. Just don’t use salicylic acid in lotions or anything that absorbs into the skin for long durations. Now that doesn’t mean you shouldn’t use salicylic acid, you can try it and see if it keeps irritating your skin and further exacerbating KP.
  • Urea: is the 4th ingredient in this list. It is moisturizing, exfoliating, and keratolytic.
  • Oils: like jojoba oil, rosehip oil, argan oil, grapeseed oil, and squalane oil can work. You can add them to your moisturizers.
  • Glycerin: this is an ingredient we recommend and is very underrated. It is a humectant suitable for dry skin conditions like eczema and psoriasis.
  • Retinoids: like retinol, tretinoin, adapalene, and Tazorac can help. We don’t recommend using isotretinoin (accutane) because it can dry out your skin and exacerbate KP. There are also people who said that accutane caused KP for them.

What are some things to keep in mind before starting treatment?

  • Treatment for the face and body: the skin on the face and body is different. The skin on the face is very sensitive and you will need to use products with ingredients that are in low concentrations. For the body, you can use products with ingredients that are in high concentrations.
  • Over-exfoliation: do not over-exfoliate as it can worsen or exacerbate KP.
  • Sunscreen: as you use AHAs everyday, your skin will become sensitive so you need to use sunscreen.
  • Shower: never take hot showers or shower more than once a day.
  • Climate: changes in climate can also affect your KP. Colder climates can aggravate your KP whereas hotter climates can reduce your KP.
  • Regulate your hormones: if you have hormonal issues or triggers, try to fix them as they can affect KP a lot.
  • Exercise, eat healthy, sleep well, and reduce your stress levels: doing these 4 things will help reduce the severity of keratosis pilaris, and improve your skin and lifestyle.
  • Wear loose clothes: loose fitting clothing around the arms/legs or where you have KP will avoid unnecessary irritation and flair-ups.

How to treat Keratosis Pilaris?

For face and body:

Note: concentrations for face (5%-10% or below) and body (10%-15% or below).

  • Cleansers for face and body: for the face, you can go for normal cleansers or a 2% salicylic acid face wash. For the body, a 2% salicylic acid body should be perfect.
  • Toners: containing active ingredients like glycolic acid or lactic acid can be used on the face and body.
  • Chemical Exfoliation: find a chemical exfoliating moisturizer you can use everyday and not irritate your skin. For the face, urea is perfect and for the body, AHAs are perfect.
  • Physical exfoliation: you can use shower gloves or exfoliating mitts. Try not to over-exfoliate, you just need to run the gloves gently over your skin once or twice.  
  • Using normal moisturizers: after using a chemical exfoliating moisturizer, you can use a normal moisturizer for the rest of the day.
  • Adding a mixture of carrier oils to your routine: like jojoba oil, rosehip oil, argan oil, grapeseed oil, and squalane oil can help supplement the skin’s sebum/lipids. You can also use coconut oil but can be comedogenic.
  • Sun exposure: try to get sun exposure to see if your keratosis pilaris improves or worsens. You could also move to a more humid place and test it out. Wear SPF.
  • In-office chemical peels: high strength in-office chemical peels can help. A TCA peel is the strongest one.
  • Lasers: using lasers and laser hair removal treatments can also improve KP but can be very expensive.
  • Shaving and waxing: can also help reduce the appearance of keratosis pilaris.
  • Hair removal creams: people have had success with hair removal creams like Nair and Veet and is something you can try out.

Other treatments that have worked for KP sufferers:

  • Trying out different diets might help but diet is related to KP.
  • Switch from hard water to soft water using a water filter.
  • Epsom salt baths and dead sea salts are some other treatments.
  • Switching to sulfate, paraben, and alcohol-free products.

What is the best skincare routine for Keratosis Pilaris?

For face:

Morning routine:

  1. Use a normal cleanser or a 2% salicylic acid face wash
  2. Apply toner with glycolic acid or lactic acid
  3. Apply a moisturizer with exfoliating ingredients, and
  4. Then finish it off with sunscreen.

Night routine:

  1. Use a normal cleanser
  2. Apply retinol
  3. Apply a moisturizer with exfoliating ingredients, and
  4. Then finish it off with a mixture of jojoba oil and squalane oil.

Note: the morning routine might irritate the skin, it also depends on the concentrations. You can use chemical exfoliators once or twice a week.

For body:

  1. Shower and perform physical exfoliation by scrubbing your KP with light pressure using exfoliating mitts or shower gloves. You can use a body wash (2% salicylic acid) that works to break up the keratin within your follicular channel. BHA penetrates the skin more effectively than AHAs can do alone.
  2. Immediately after the shower, apply your AHA lotion.
  3. After that, you can apply niacinamide or azelaic acid to help with hyperpigmentation.
  4. Finally, apply a mixture of oils to your skin (we recommend jojoba oil and squalane oil). You can also mix it with your moisturizer.

For the rest of the day, you can apply a normal moisturizer. You want to apply AHA lotion 2x a day and oils 3x or 2x a day.

How to Shave with Keratosis Pilaris?

  • Before shaving: use a gentle body scrub and exfoliate with mitts or cloths (Italy or Salux cloths) to remove dead skin cells. This helps to get a closer shave.
  • Shaving process: apply shaving gel or shaving cream and use a double edge safety razor or an electric razor to shave in the direction of the hair growth. This keeps your skin smooth and gives a closer shave.
  • After shaving: apply a lightweight moisturizer or oil to prevent ingrown hairs and roughness. After a few hours or the next day, use a chemical exfoliating lotion (with AHA/BHA/Urea) for the skin.

How to Wax with Keratosis Pilaris?

  • Before waxing: use a gentle body scrub and exfoliate with mitts or cloths (Italy or Salux cloths) to remove dead skin cells. Also, make sure your skin is oil and lotion-free.
  • Waxing process: apply cornstarch, baby powder, or makeup powder so the wax only sticks to the hair, not your skin. Also when waxing, make sure you’re following the natural path your hair grows in just like shaving.
  • After waxing: apply a lightweight moisturizer or oil to prevent ingrown hairs and roughness. The next day, use a chemical exfoliating lotion (with AHA/BHA/Urea) for the skin.

How to remove ingrown hairs with Keratosis Pilaris?

For ingrown hairs, exfoliation is the only option. One product we can recommend is Skin Doctors – Ingrow Go. This is a strong exfoliant that deals with ingrown hair and can dry and peel the skin. You’re supposed to use this everyday (morning and night) for about 1-2 weeks till the ingrown hairs are completely gone. But, since we are dealing with keratosis pilaris you can use it once or twice a week depending on your skin sensitivity. If you have sensitive skin, rinse off within 15 minutes.

As your skin starts to peel, use a gentle body scrub and a washcloth to get rid of the dead skin (physical exfoliation is better). Then, for hair that’s still trapped use a exfoliating brush.

After this process, your skin will be super dry. So use a moisturizer to keep the skin moist so that hair can easily grow up through the follicle instead of becoming trapped.

Also, use a chemical exfoliating lotion once or twice a week. This also helps to prevent ingrown hairs and keep your skin smooth.

Note: if you feel Ingrow Go is too strong, you can skip it and continue with the other steps (gentle physical exfoliation, moisturizer, and then chemical exfoliating lotion).

How to deal with Skin Picking and Keratosis Pilaris?

  • Keep your nails short and that should help a little bit.
  • Find the right moisturizer.
  • Chemical exfoliation can help a lot with ingrown hair and overall skin texture.
  • Wear long sleeves.
  • You can slather your hands in oils so you can’t get a good grip on the inflamed bumps.
  • You can use hydrocolloid patches to prevent picking on the bumps.
  • Visit a psychologist to talk about your problem.

How to deal with Keratosis Pilaris in Children?

Unfortunately, there is nothing you can do to treat keratosis pilaris in children as their skin can be sensitive at a very young age and regular exfoliation might further worsen keratosis pilaris.

What you can do for the time being is teach them to use a moisturizer regularly. Physical exfoliation can also help as it will be gentle on the skin. You could try using exfoliating creams or lotion but it is better to consult a doctor about this.

How to deal with Redness in Keratosis Pilaris?

Niacinamide, azelaic acid, and the most basic treatments for KP (exfoliation, moisture, sunscreen) can help to reduce redness. 

Hero Cosmetic’s Rescue Balm is one product you can use to reduce redness.

How to treat hyperpigmentation with Keratosis Pilaris?

Regular chemical exfoliation, moisturizing, and applying sunscreen can help to treat hyperpigmentation with Keratosis Pilaris.