Keratosis pilaris: Understanding and Treating It Naturally

Keratosis pilaris is a skin condition characterized by small keratotic bumps centered around hair follicles. These skin bumps are formed by dead skin cells trapped in the openings of hair follicles and sebaceous glands. These pores are blocked by accumulations of keratin, creating a "cornified plug." Beneath this plug, the hair remains trapped in its follicle and cannot emerge. This situation can lead to mild inflammation around the follicle, manifesting as red spots at each opening (some describe this condition as having the appearance of "strawberry legs"). In addition, these blocked follicles can also become infected spontaneously or after being scratched, which can lead to the appearance of red or pus-filled pimples resembling acne on the areas affected by keratosis pilaris.

These bumps create a rough texture to the touch, giving the impression of rough skin or sandpaper. This skin condition usually appears in childhood. In half of cases, symptoms appear during the first decade of life. The simple form of keratosis pilaris presents as gray, keratotic lesions on the arms, thighs, and buttocks, primarily in women. The erythematous form of keratosis pilaris can progress to atrophy and presents with various clinical manifestations such as ophryogenic erythema, vermiculated atrophodermia, and Siemens alopecia. Keratosis pilaris usually appears on the arms and thighs, but also on the back or face.

Keratosis pilaris can vary in severity from person to person, and even on different parts of the body in the same person. There are generally three degrees of severity for keratosis pilaris:

1. Mild (or grade 1): At this stage, the skin has a few small, rough bumps, usually on the arms, thighs, buttocks, or face. These bumps may be slightly red and give the skin a goosebump-like appearance. Symptoms are generally mild.

2. Moderate (or grade 2): The bumps are more numerous and more pronounced. The skin may appear drier and rougher, with a texture similar to sandpaper. Redness may be more visible at this stage, and the symptoms may be more cosmetically bothersome.

3. Severe (or grade 3): At this level, the bumps are very noticeable and may cover large areas of the skin. The skin’s texture is very rough, and redness is often present. Symptoms may be more uncomfortable and have a significant impact on the skin’s appearance.

Pilar keratosis is estimated to affect 40% of the population. This skin condition most commonly affects people with dry skin, children, and young teenagers. However, keratosis pilaris can occur at any stage of life, depending on the season. In fact, cold weather and dry wind can dry out the skin, thereby promoting keratosis pilaris.

Keratosis pilaris is primarily genetic in origin and may be associated with various hereditary conditions, including Noonan syndrome or vitamin deficiencies. People with fair skin and those prone to being overweight are also particularly susceptible. Some cases of keratosis pilaris may be caused by the use of products applied to the skin, such as tar or oils, and, in rare cases, certain cosmetics. However, it is rare for external factors to be the cause. The exact cause of the formation of keratin plugs is not fully understood by scientists, but it appears to be linked to a dysfunction in the skin’s keratinization process.

If you have keratosis pilaris, the first thing to do is stop scratching the rough bumps and scabs yourself. Treatment then relies mainly on the use of emollients and keratolytics. The goal of these treatments is to improve the skin’s condition by making it softer to the touch. However, this improvement is temporary and requires regular treatment. In moderate cases, no treatment is necessary unless the patient specifically requests it. For limited forms, topical treatments are sufficient. This involves the use of emollient baths, emollient creams (often urea-based), and topical exfoliants (containing, in particular, salicylic acid). In more severe cases, a visit to the doctor should be considered.

We recommend applying a cream containing 10% urea daily after your shower. In addition, once a week, while bathing, perform a exfoliation (without grains!) using an exfoliating glove such as a kessa, loofah, or synthetic one.

Furthermore, keratosis pilaris is most often caused by excessively dry skin. Therefore, we recommend applying a moisturizing cream daily to hydrate your stratum corneum.

We also recommend adopting a varied and balanced diet and avoiding hot showers and baths that are too long. Experts agree that quick showers of no more than 5 minutes with lukewarm water are best. The use of soaps that dry out the skin should also be avoided.

Advice from the experts

To prevent or treat keratosis pilaris, avoid exfoliating your skin more than twice a week. Exfoliating too frequently can irritate the skin and thus worsen keratosis pilaris.

Urea is beneficial for treating keratosis pilaris due to its moisturizing and keratolytic properties. It deeply hydrates the skin by drawing water into the skin cells, which helps prevent dry skin, a factor often associated with this condition. Additionally, as a keratolytic agent, urea helps soften the skin by dissolving dead skin cells on the skin’s surface, thereby reducing the rough texture and bumps characteristic of keratosis pilaris. Regular use in creams and lotions can improve the skin’s appearance and relieve the symptoms of keratosis pilaris.

To relieve your child’s symptoms, you can prepare a lukewarm bath (37 degrees) with emollient colloidal oatmeal. Place the equivalent of a small glass into a clean adult sock, tie it closed, and place it in the bathwater to prevent clogging the drains and make it easier to remove. Limit bath time to a maximum of 20 minutes. After the bath, be sure to dry your baby thoroughly and then apply an emollient balm. Avoid bathing too frequently.

If your baby is experiencing severe itching or if the keratosis pilaris is widespread, we recommend consulting a pediatrician.

Gipsy graduated from ESJ Paris. After 10 years in the general and women's specialist press, she chose to specialise in health and well-being. Now a certified Yin Yoga teacher, she skillfully combines her passion for writing with her love of yoga. Her goal goes far beyond simply informing the reader. She is passionate about helping readers embrace simple, practical habits that support their well-being while encouraging a more mindful approach to the world around them. Each article invites readers to adopt a healthier, more balanced, and fulfilling lifestyle.