Keratosis pilaris is a highly common genetic follicular disorder manifested by the appearance of rough bumps on the skin and hence popularly referred to as "chicken skin" or "goose bumps".

Originally, they appear on the back and outer sides of the upper arms, but can also appear on thighs and buttocks or any body part except glabrous skin (like the palms or soles of feet). On a global level, keratosis pilaris afflicts an estimated 40 to 50% of the adult population and approximately 50 to 80% of all adolescents. Varying in degree, keratosis pilaris can range from slight to severe.

Keratosis pilaris tends to appear as excessive keratin, a biological fibrous protein in the skin found usually in human hair, nails and callus, accumulates around hair follicles (process known as hyperkeratinization).

Keratosis pilaris is unsightly, and it most often shows as a group of tiny hard bumps that are seldom sore or itchy. Though people with keratosis pilaris suffer this condition year round, it's during the colder periods when moisture levels in the air are lower that the condition can become worse and the 'goose bumps' will look and feel more marked in color and texture.

There are several different kinds of keratosis pilaris, including keratosis pilaris rubra (red, inflamed bumps), alba (rough, bumpy skin with no irritation), rubra faceii (reddish rash on the cheeks) and related conditions.

Keratosis pilaris alba is the more common variant and is characterized by small gray-white papules with a negligible inflammatory component.

Keratosis pilaris rubra has a significant inflammatory component, and thus sufferers present small red papules. This variation is most perceptible during the winter months.

Cells that contain keratin are constantly being shed and replaced by new ones. The condition known as dandruff results when the scalp sheds such cells. Hormonal influence can appear because a high prevalence and intensity of keratosis pilaris is observed during puberty and in women suffering hyperandrogenism. In severe cases, the pores can become clogged and produce acne. The clogged pores resemble comedones of keratinized plugs surrounding the hair follicle.

Treatment of Keratosis Pilaris

Many people find keratosis pilaris lesions visually unsightly and therefore seek treatment. Sometimes, they can become secondarily infected because of harsh tight-fitting clothing or abrasive self-actions, in which case treatment of the infection is needed. A significant inflammatory component may be present and can be relieved with topical steroid therapy. Treatment of the noninflamed papules can be hard because they have proven resistant to most types of therapy.

Treatment alternatives for keratosis pilaris focus on exfoliating or softening the dermis to minimize clogged pores. Treatment initially begins with adherence to nonpharmacologic actions and compliance with daily living functions that will not worsen the condition. An important first step is to apply a mild cleansing agent with abrasive properties, often named scrub, but one that is not drying (for sensitive skin). The goal is to clean and open the pores of the dermis. Other measures to avoid excessive dryness include taking tepid, brief showers and applying a humidifier, especially during the winter periods when low humidity dries out the skin.