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Keratosis Pilaris

What Is Keratosis Pilaris?

Keratosis Pilaris is a very common disorder in which small, rough bumps occur in hair follicles or pores, often with some redness around the pore.

Who Gets Keratosis Pilaris?

It occurs in about 60% of teens and is more commonly seen in girls.

About 40% of adults will get it in varying degrees. It is more common in those with atopic conditions (asthma, hay fever, eczema), ichthyosis vulgaris, hypothyrodism, Cushing’s disease and a number of rare genetic conditions.

Where Is Keratosis Pilaris Found?

The vast majority of patients will have involvement of the upper outer back of their arms. Over half have some involvement on their outer upper thighs and about 30% have some involvement on their buttocks.

What Causes Keratosis Pilaris?

Hormonal influences have been considered since it appears at puberty and is more common in overweight women who have higher androgen (male hormone) levels. There is a genetic component to this condition. It appears to be autosomal dominant, and there is also an X-linked recessive variant.

When Does It Occur?

It tends to improve with age and lessens in the summer months.

There are rare variants of this condition:

1) Keratosis pilaris atrophicans faciei:
  • Involves the face, starting on the outer eyebrow
  • Causes loss of hair and scarring
2) Keratosis follicularis spinulosa decalvans:
  • Hair follicle plugs start on the scalp, progressing to scarring, and permanent hair loss
3) Atrophoderma vermiculatum:
  • Involves the cheeks and front of ears, causing a honeycomb pattern of scarring

What Other Skin Conditions Look Like Keratosis Pilaris?

  • Lichen spinulosus
  • Pityriasis rubra pilaris

What Can I Do About My Keratosis Pilaris?

Self help:

Some over-the-counter (OTC) treatments include the following, and should be applied after bathing, and at bedtime:

Lactic acid lotions:

  • Lachydrin®
  • Lacticare®

Urea lotions:

  • Uremol® Lotion

Glycolic Acid Lotions:

  • Reversa® solution
  • Neostrata® solution
Medical treatment:

Some topical treatments (creams and lotions) include:

  • Tretinoin cream 0.1%-0.1% applied daily to the affected area, Differin® cream applied daily
  • Tazorac® 0.05% or 0.1% cream or gel Oral therapies (pills and capsules)

Included are:

  • Isotretinoin - This would only be used for the scarring Acitretin
  • Laser treatment - Used for correction of scarring

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