Keratosis Pilaris – Causes, symptoms and treatment for ‘chicken skin’

Keratosis pilaris (pronounced ker-uh-toe-sis pih-lair-is) is a harmless, non-contagious skin disorder. This is also known as keratosis follicularis, lichen pilaris and follicular keratosis. Keratin is a substance found in skin, hair and nails, so ‘keratosis' means there is too much of this protein, which makes up the horny outer layer of the skin, while 'pilaris' comes from the Latin for hair (pilus).

An overproduction of keratin blocks the hair follicles and small bumps to form. This causes the outermost layers of skin to thicken, especially on the upper arms and thighs but also on the buttocks and on the face. Small pimples develop and the skin feels rough and uneven − hence why keratosis pilaris is often referred to as ‘chicken skin’. Keratosis pilaris commonly appears on the face, arms and legs.

A genetic skin condition, young people are particularly affected: the first symptoms of keratosis pilaris usually appear during childhood and are very common in adolescents. Chicken skin can clear up as we age, or it can keep coming back. This common condition affects 50-70% of adolescents and around 40% of adults, but keratosis pilaris usually clears up by age 30.

It will be easily diagnosed by your doctor, so a biopsy is rarely needed unless it's associated with acne or eczema, which do not improve with treatment. Sadly, there is no known cure for keratosis pilaris, but its symptoms can be alleviated by regular skincare using appropriate oils, peels and skin creams.

The symptoms of keratosis pilaris are small pimples which tend to be skin-coloured or red on light skin, and brown on dark skin. These pimples are sometimes compared to ‘goosebumps’. Distribution is symmetrical, with keratoses primarily appearing on the face, arms, legs and buttocks but if they occur on other parts of the body, you should consult a doctor or dermatologist.

The pin-head sized bumps (keratoses) are harmless and do not normally cause any pain or itching. When the symptoms appear on parts of the body that are clearly visible, keratosis pilaris can cause issues around self-esteem and what starts as a cosmetic problem can become a psychological one due to the emotional discomfort.

Dry skin is particularly susceptible to ‘chicken skin’. The symptoms of keratosis pilaris worsen in conditions of low humidity (e.g. the winter) and tend to improve when humidity is higher (e.g. the summer). Sometimes, keratosis pilaris is also associated with Atopic Dermatitis.

While the exact causes of keratosis pilaris are not known, it is highly likely that it is genetic and inherited, with a large percentage of those affected by it having a family member who also have the condition (an example being if one twin has keratosis pilaris, the other one usually has it too). It is most common in people with fair skin. Also, hormonal changes during pregnancy for women or puberty or teenagers can also trigger flare-ups.

What we do know is that the bumps form as a result of an overproduction of keratin. Keratin is the protein that gives body tissue its stability and is the building block of our hair and nails. In cases of keratosis pilaris, the excess of keratin produced collects in, and blocks, the hair follicles. Skin thickens as a result and bumps turn into hard plugs.

Even though there is no guaranteed way to get rid of chicken skin, symptoms can be alleviated with a suitable skincare routine and other measures (a healthy diet can help).

Keratosis pilaris may eventually clear up naturally, but since sufferers can have symptoms for many years there are a few methods to help improve the appearance of your skin. The first step to managing keratinised skin is thorough personal hygiene. When symptoms are mild they can be considerably improved by regularly applying moisturiser.

Skin lotions with Urea (one of the skin’s own Natural Moisturising Factors) are particularly suitable for daily skin care. Urea binds moisture in the skin and prevents keratinisation, as well as loosening and removing dead skin cells to soften dry skin. For best results use lotions or creams that are fragrance- and colourant-free and apply the product several times a day to the affected area of the body.

Eucerin UreaRepair PLUS 10% Urea Lotion has been specially formulated for the intensive care of dry skin and is often used as a treatment for keratosis pilaris.

The formula, which combines Urea with other Natural Moisturising Factors and Ceramide (a valuable skin lipid), instantly relieves dry skin. It helps to exfoliate dead skin cells and makes the skin smooth and supple.

Extensive clinical and dermatological studies on dry skin prove the effectiveness of the product in treating both dry skin and keratosis pilaris. Research has indicated a significant reduction of dry symptoms with daily use.¹

1. Treatment of Xerosis with a topical formulation containing Glyceryl Glucoside, Natural Moisturising Factors and Ceramide; Weber et al., JCAD 2012s

It’s a good idea to try out lots of different ways to treat keratosis pilaris to find out what works for you and what doesn’t. Even though the condition can't be cured, people with keratosis pilaris have found that the following self-care treatments and tips can reduce irritation and minimise bumps:

Saunas and steam baths
These help to soften skin making it easier to exfoliate and remove dead skin cells, which you can do by gently scrubbing your skin with a pumice stone or exfoliating sponge.

Cool or lukewarm showers and baths
Use warm, not boiling hot, water when bathing and avoid long bathing times (over 10 minutes) which can remove oils from the skin. Remember to pay skin dry instead of rubbing it.

Avoid tight clothing
Your skin can be irritated by tight clothes that cause friction.

Use humidifiers
Humidifiers can maintain the moisture in your skin by adding moisture to the air in a room, which helps prevent itchy flare-ups.

Nutrition
People who experience keratosis pilaris should be sure to eat a healthy diet. It can also help to avoid foods that can trigger allergies such as gluten, or to have yourself professionally tested for allergies to see if you have any food intolerances. You should also drink at least two litres of water a day and avoid unhealthy food choices such as sugary and fizzy drinks.

Other methods include pulse dye laser treatment, which reduces redness but not the roughness, and laser-assisted hair removal.

Although there is no known cure for keratosis pilaris, an appropriate skincare routine and regular moisturising with a Urea-rich product such as Eucerin UreaRepair PLUS 10% Urea Lotion will help alleviate symptoms and smooth skin.