Keratosis pilaris is a very common inherited follicular condition manifested by the appearance of rough bumps on the skin and hence colloquially referred to as "chicken skin" or "goose bumps".

Originally, they pop-up 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). Worldwide, keratosis pilaris affects an estimated 40 to 50 percent of the adult population and approximately 50 to 80 percent 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 normally in human hair, nails and callus, gathers around hair follicles (process called hyperkeratinization).

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

There are various different types of keratosis pilaris, including keratosis pilaris rubra (red, inflamed bumps), alba (asperous, bumpy skin with no irritation), rubra faceii (reddish rash on the cheeks) and related disorders.

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

Keratosis pilaris rubra has an important inflammatory component, and thus sufferers present small red papules. This variation is most perceptible during the cold months.

Cells that have keratin are continually being shed and replaced by new ones. The condition called dandruff results when the scalp sheds such cells. Hormonal influence can appear because a high frequency and intensity of keratosis pilaris is noted during puberty and in women with hyperandrogenism. In severe cases, the pores can become blocked and cause acne. The clogged pores resemble comedones of keratinized plugs surrounding the hair follicle.

Treatment of Keratosis Pilaris

Many sufferers find keratosis pilaris lesions cosmetically unsightly and therefore seek treatment. Occasionally, they can become secondarily infected because of harsh tight-fitting clothing or abrasive self-therapy, in which case treatment of the infection is needed. An important inflammatory component may be present and can be alleviated with topical steroid therapy. Treatment of the noninflamed papules can be difficult because they have proven resistant to most modes of therapy.

Treatment options for keratosis pilaris focus on exfoliating or softening the dermis to minimize blocked pores. Treatment initially starts with adherence to nonpharmacologic actions and compliance with daily living actions that will not worsen the ailment. An important first step is to apply a mild cleansing agent with abrasive characteristics, often named scrub, but one that is not drying (for sensitive skin). The goal is to cleanse and open the pores of the dermis. Other measures to prevent excessive dryness include taking tepid, brief showers and using a humidifier, especially during the cold periods when low humidity dries out the skin.