Skin Bumps: Keratosis Pilarisby Sue Chung Patient Expert
I have bumps all over my arms. Is this acne? How can I get rid of them?
If these bumps are small and rough and mostly occur on your upper arms and thighs, it's more likely that you have an eczema-related condition known as keratosis pilaris. It's a very common hereditary condition (more than 50% of people have it) that creates raised bumps on the skin. It's more common in women and tends to improve with age.
Keratosis pilaris occurs when skin cells build up in the hair follicle, preventing the hair shaft from reaching the surface of the skin. Often, this results in minor inflammation, causing the appearance of red or brown spots beneath each raised bump. Since this affects the pores, keratosis pilaris can cause or exacerbate blemishes, especially in adolescence. In fact, up to 80% of adolescents experience keratosis pilaris.
Usually, keratosis pilaris is viewed as physically unsightly, but not medically harmful. There is no "cure" for the condition, but you can take steps to reduce the appearance of the bumps by using appropriate products.
If you have keratosis pilaris, exfoliation is your biggest friend. Since the hardened build-up of skin cells (also known as "hyperkeratinization") is the culprit, getting rid of excess epidermal cells will help improve the appearance of keratosis pilaris.
Start off with some gentle physical exfoliation. Twice a week, soak in a warm bath and then lightly scrub affected areas with a loofah or Buf-Puf. Moisturize well after you get out of the water. Look for urea, a skin-softening ingredient that's a favorite with dermatologists. You can find it in Gold Bond Ultimate Softening Shea Butter Lotion or Carmol 20. If you don't see any improvement after a few weeks, step up the treatment with chemical exfoliants.
Again, start off gently. Some people are able to deal with stronger exfoliants while others will find themselves sensitive to certain products. Alpha-hydroxy acids are a good option for fighting rough skin. Glycolic and lactic acids are the most popular AHAs available over the counter. You can find glycolic acid available in DDF's Glycolic Exfoliating Wash 5% or DermaDoctor's KP Duty, a formula specially created to deal with the condition. You can find lactic acid in products like AmLactin (usually located behind the pharmacy counter) and Fresh Milk Bath and Shower Cream.
Another option is vitamin A, or retinol. You can try prescription formulas such as Retin-A or Differin, but you can also go with an over the counter retinol line such as RoC or SkinCeuticals. Be careful and sparing when you use vitamin A products, however. Many people are sensitive to retinol and may experience peeling and irritation with the first several uses.
If you're still not seeing much improvement after trying these options, see your dermatologist for a chemical peel or microdermabrasion. These options will help exfoliate stubborn cases of keratosis pilaris so that you can start treating the problem from there. Since the condition is caused by the skin's failure to exfoliate itself properly, keratosis pilaris is a continual problem. One chemical peel will not keep the skin smooth forever. Instead, view the peel as a jump-start and continue to treat the condition with at-home exfoliation.