A number of patients, especially young girls, are concerned about tiny bumps on their upper arms or on their thighs. Typically the skin lesions that they are complaining about are little, flesh-colored to slightly red bumps (almost like goose bumps) that give the skin a sandpaper-like texture. They are usually noticed on the outer upper areas of the arms and also may occur on the upper part of the thighs and occasionally on the cheeks. This “rash” is called keratosis pilaris and is an inherited skin condition that occurs in up to about 40 percent of the population.
In other words it is very common and is most commonly noticed in children and young adults. It may also occur in infants and is often of concern to the mother, but does not bother the your-baby in the least.
In this condition there is an over production of keratin from the skin that then plugs the hair follicle. The tiny bumps that then form on the skin each represent a plug of dead skin cells that form at the site of the entrapped hair follicle. The “bumps” seem to be most bothersome to teens as the bumps may sometimes be red and irritated and therefore more noticeable. The teenage girl population often picks at these, which only makes them more noticeable and a cycle erupts.
There has not been a definitive way to “cure” the skin problem. Most people are not bothered by the rash other than for cosmetic purposes, which is of huge importance to my adolescent girl population (funny how teen boys seem to be unaware of the rash) and will do anything to try and lessen the bumps.
Moisturizers are the mainstay of treatment and those that contain urea or lactic acid seem to be preferred and should be used liberally and frequently. Medications that cause mild peeling are also helpful in opening the plugged hair follicles and remove excess skin. These are typically retinoids, like “Retin- A”, or adapalene, “Differin” which are also often used to treat acne, and are by prescription.
At times using a topical steroid cream with a retinoid may also improve keratosis pilaris. Different patients respond differently and it may take several products to help control keratosis pilaris. Unfortunately, therapy must be continued on a regular basis or the rash will re-occur.
The rash of keratosis pilaris usually does lessen with age, and many adults say that they hardly notice it any more! Like so many things in life.
That’s your daily dose, we’ll chat again tomorrow.
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