Monday, May 10, 2010

What is Keratosis Pilaris???


This blog post is intended for information purposes only. My PHD in internet doctorhood (is that a word?) is not a substitute for medical care and is not a medical professional opinion. You should always consult a real doctor and get a proper diagnosis before starting any treatments.

I have an enormous amount of customers who suffer from this condition. I had no idea it was SO common! I would say that maybe 1 out of every 3 convos that I get on Etsy is from someone who is looking for something to help with their Keratosis Pilaris.

Perhaps you or someone you know may also have this condition and not even know about it!

Keratosis Pilaris
Keratosis pilaris (AKA-  follicular keratosis) is a very common genetic follicular condition that is manifested by the appearance of rough bumps on the skin. It most often appears on the back and outer sides of the upper arms (though the lower arms can also be affected), and can also occur on the thighs,hands, and tops of legs, flanks, buttocks, or any body part except glabrous skin (like the palms or soles of feet). Less commonly, lesions appear on theface, which may be mistaken for acne

Worldwide, KP affects an estimated 40% of the adult population and approximately 50%-80% of all adolescents. It is more common in women than in men. While KP resembles goose bumps, it is characterized by the appearance of small rough bumps on the skin. As a result, many people with keratosis pilaris do not know they have it, and it is often confused with acne.

There are several different types of keratosis pilaris, including :
keratosis pilaris rubra (red, inflamed bumps which can be on arms, head, legs), 
keratosis pilaris alba (rough, bumpy skin with no irritation), 
keratosis pilaris rubra faceii (reddish rash on the cheeks), and related disorders.
Keratosis follicularis (Darier Disease) aka lichen pilaris, or follicular xeroderma:
conditions in which abnormal keratinization (failure of skin to desquamate properly) is
limited to the hair follicles, manifesting itself as discrete, tiny follicular papules (solid,
usually conical elevations)

Ulerythema ophryogenes  involvement of the outer eyebrows

Atrophoderma vermiculata  severe worm-eaten appearance of the cheeks

Keratosis follicularis spinulosa decalvans a rare familial variant which results in bald
areas on the scalp and eyebrows

Lichen spinulosus  solitary or multiple patches of follicular papules topped with scaly
spines on any part of the body

Symptoms and signs

Keratosis pilaris occurs when the human body produces excess keratin, a natural protein in the skin. The excess keratin, which is cream colored, surrounds and entraps the hair follicles in the pore. This causes the formation of hard plugs (process known as hyperkeratinization). Bearing only cosmetic consequence, the condition most often appears as a proliferation of tiny hard bumps that are seldom sore or itchy. Though people with keratosis pilaris experience this condition year-round, it is during the colder months, when moisture levels in the air are lower, that the problem can become exacerbated and the goose bumps are apt to look and feel more pronounced in color and texture.
Many KP bumps contain an ingrown hair that has coiled. This is a result of the keratinized skin's "capping off" the hair follicle, preventing the hair from exiting. The hair grows encapsulated inside the follicle.


Typically the first choice of treatment would be a Lactic or Glycolic Acid Peel. AHAs are normally more gentle on the skin. Lactic acid is my choice because it's so much more gentle than Glycolic acid.
 I make my Lactic Acid scrubs and creams at 12%. You can go as high as 25% but the FDA (and my insurance) will not allow me to go over 15% without having to go thru a bunch of red tape. I will not make anything over 12% for sale because there is too high of a chance that it could be misused and end horribly. I recommend first speaking with a doctor about treatment options.

Other treatment options include:

Exfoliation, intensive moisturizing cremes, lac-hydrin, creams, and lotions containing alpha hydroxy acids and urea may be used to temporarily improve the appearance and texture of affected skin.
Beta hydroxy acids may help improve the appearance and texture of the afflicted skin. Milk baths may provide some cosmetic improvement due to their containing lactic acid, a natural alpha hydroxy acid in milkSunlight may be helpful in moderation. Coconut oil may also be helpful if applied to afflicted areas while in the shower. Scratching and picking at KP bumps causes them to redden, and, in many cases, will cause bleeding.

Creams containing the acid form of vitamin ATretinoin, have been shown to help. Most commonly sold under the trade name Retin-A, it is a topical retinoid medically approved in the treatment of acne. This medicine works by causing the outer layer of the skin to grow more rapidly, decreasing the amount of the keratin in the skin. As a result, the surface layer of the skin becomes thinner and pores are less likely to become blocked, reducing the occurrence of symptoms related to acne. While keratosis pilaris is not acne, some believe this action may be of benefit to those with KP as well.

An alternative is the prescription medication Triamcinolone. Most commonly sold under the trade name Aristocort, Triamcinolone is a synthetic corticosteroid, compounded as a cream, which has been medically approved as an anti-inflammatory agent in the treatment of eczema. As the action responsible for alleviating eczema symptoms is, as with retinoid creams, the reduction amount of keratin in pores, the effect of Triamcinolone on KP is expected to be similar.
As with Triamcinolone, Tretinoin or any other treatment, once therapy is discontinued, the condition reverts to its original state. However, skin treated with Tretinoin may take several weeks or more to revert to its pre-treatment condition, but may, at the same time, take several weeks or more to show optimal results, with the condition commonly worsening initially, as underlying keratin is brought to the surface of the skin. Tretinoin is considerably more expensive and dispensed in smaller quantities than Triamcinolone and other treatments. Although it may be the most effective treatment for keratosis pilaris, it is not considered the first line of treatment
The condition is often dismissed outright by practitioners as being presently untreatable, giving mere moisturizing suggestions or reassurance that the condition will improve or cease with age, typically after 30. Ignorance, accompanied with the price, availability, quantity dispensed, time taken for optimal results to be achieved, more serious side-effects, adverse reactions, and worsening of the condition in the initial treatment phase - coupled with the cheaper, safer, and easier availability of other treatments - has hindered Tretinoin from showing its potential in the treatment of this condition.
Sulfur has been used for skin treatment predating modern medicine. Sulfur soaps, lotions, and exfoliants have been used successfully for treating KP. Methylsulfonylmethane (MSM) supplements used with some success often require dosage as high as 25g per day. Side effects can include thickening of hair and nails, and pale skin.


Mary said...

Wow, it has a name! I suffer from this on my arms, and I've always hated it. I didn't know it was so common or that there was a treatment for it! Thanks for informing us!

vjbakke said...

I too had no idea it has a name! I use your scrubs on the back of my arms and use the mini peel scrub about once week on it. They have gotten a lot better since using them. I somewhat dread wearing tank tops in the summer because of mine on my arms and shoulders. I will have to get hubby to scrub my shoulders and back more often! Thanks for the great info and awesome products!

by BB*Jayde said...

I remember when you asked me about them and it never crossed my mind until Kotibeth said about putting up a blog post and I was looking at the pictures I found on google and I said to myself.. this would be a good one to show Valerie!
I always thought of KP as being much more sever than the pictures look, but I suppose even in it's mild form it's equally annoying!

Miss Muffin said...

Thanks so much for this post! My daughter might have this - still have to check with the doctor. But if it really turns out to be it this information will be very handy! I will be saving this.
(My husband definitely has it - but rather mildly and he is not bothered by it.)

sarah said...

very informative post! my cousin has this but i never really understood it until now.

fertawert AT yahoo DOT com

Emily N. said...

What an excellent and informative post! Most of my family have KP on our arms, so I've come across some of this info before, but I had never heard of keratosis pilaris rubra faceii. I'm fairly certain I have this on my cheeks, but I never knew what it was until now.