Every time I catch a glimpse of my bare arms in the mirror or run a hand over my sore triceps in the gym, I have the same frustrated grimace. No matter how much lotion I use or how much I exfoliate, the skin is always, without fail, speckled with a field of tiny red bumps. It is not actually bothersome — not itchy or painful like eczema — so most of the time I forget the bumps are even there. But it is all the more frustrating when I do notice them.
These bumps have been decorating my upper arms as long as I can remember. Was it a rash? A plague of tiny pimples? An epidemic of miniscule moles? Only in the last few years have I finally learned what they are: a common skin condition called keratosis pilaris (KP).
What is Keratosis Pilaris?
Sometimes colloquially referred to as “chicken skin” (since the tiny red bumps resemble the skin of a plucked chicken), KP is a common skin condition that causes rough, bumpy patches typically on the upper arms, thighs, butt or even sometimes on the face. It is totally harmless, but it can be annoying.
So, what exactly is going on to produce the ever-present rash-like effect? “Keratosis pilaris is a genetic condition where the hair follicles produce a cone of keratin,” explains Lily Talakoub, M.D., a board-certified dermatologist at the McClean Dermatology and Skincare Center in Virginia. Essentially, the cone is like a tiny plug of dead skin cells jamming up the hair follicle, often causing it to appear mildly red and inflamed and feel slightly rough or prickly to the touch. (KP bumps can also appear flesh colored, white, pinkish purple or brownish black, according to the American Academy of Dermatology (AAD).
The bottom line: There is no miracle cure for keratosis pilaris
I wondered if it might be stress-related, since stress can do a number on your skin, but Talakoub says, that’s not the case with KP — no amount of meditating or avoiding inflammatory foods in your diet will help calm the mild inflammation. KP is genetic, meaning there is unfortunately nothing you can do to prevent it. Most people start to notice the bumps in childhood or once they hit their teens (thanks to the hormonal rollercoaster of puberty). That being said, “because it’s an indication of sensitive or dry skin, it will often be found in the same patients who have eczema,” says Shari Marchbein, M.D., a board-certified dermatologist in New York.
The bottom line: There is no miracle cure for keratosis pilaris, Talakoub says. But the good news is that it is a pretty mild condition — for some people it even goes away on its own (or gets noticeably better as you age), according to a Mayo Clinic study.
How to Smooth Things Over
A lot of people are not bothered by KP (truth be told, I notice mine less and less the older I get). But if you do want to do something about your “chicken skin” — and there is no shame in that — there are a few topical options that can help contain it, Talakoub says.
Step 1: Exfoliate
Since keratosis pilaris is caused by plugged hair follicles, exfoliating can help clear things up. Dry brushing, gentle scrubs and exfoliating body brushes like the Clarisonic, can all help smooth skin.
You can also go the chemical route. Skincare products containing alpha hydroxy acids, like lactic acid and salicylic acid can all help remove dead skin cells and soften your skin. Topical retinoids, which work by promoting cell turnover, can also help you minimize the issue by preventing hair follicles from becoming plugged.
The only hitch? These exfoliators can also be irritating if you have sensitive skin, which might make the issue worse. So, if you notice any redness or stinging, you might want to switch to something milder. This is why Talakoub recommends an exfoliating pad containing glycolic acid. “They reduce the rough texture and also the redness,” she says. “This is what I recommend to my patients at my practice and everyone has responded really positively to it.”
On the other end of the spectrum, there is a more intense exfoliation option: microdermabrasion, “which is a mechanical exfoliator that should always, always be followed up with moisturizer,” Talakoub says. (Think of it like a very intense loofah session.) You can also talk to your dermatologist about stronger topical prescription options that contain higher doses of exfoliating ingredients like corticosteroids.
Whatever you do, avoid “picking” at your skin or extractions, which can make the redness and inflammation of these bumps worse.
Step 2: Hydrate
KP does have some environmental triggers. “Dry air, dry heat and the winter months can exacerbate KP,” explains Talakoub, which means on the flipside, humidity and moisture help reduce the roughness — this is why many people notice the bumps look better during the summer months.
This is great news if you live in a tropical environment (or have a humidifier in your home). If you do not, constant moisturization is key. It will not make the “chicken skin” disappear but it can make the bumps feel markedly less prickly. Pro tip: Moisturizers specifically formulated for treating KP often pack a one-two punch, hydrating skin while also delivering a dose of exfoliating lactic acid or urea.
If exfoliating and moisturizing are not cutting it, and the KP still really bothers you, the AAD recommends laser treatments. “Dermatologists will occasionally use a vascular laser such as a pulsed dye laser to try to improve the redness often associated with KP,” says Marchbein. “A combination of laser treatments can reduce swelling and redness and tackle any pigmentation. However, this is not necessary, nor is there a guarantee to improve redness, since KP is a natural skin variant.”
The major caveat here is that none of these options will cure your KP — to keep seeing the skin-smoothing effects, you will have to keep up the exfoliating and moisturizing routine indefinitely. And more importantly, dermatologists stress that “chicken skin” is totally normal — it does not require treatment and shouldn’t be stigmatized. But if you are looking for an excuse to move to a tropical climate, we will not stop you.