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Keratosis Pilaris (Chicken Skin): Causes, symptoms & Treatment

Team AckoJan 17, 2023

Keratosis Pilaris, commonly referred to as chicken skin, is a condition in which small bumps appear on the skin with varying degrees of redness or inflammation. It first appears during early childhood and becomes more aggressive during the second decade of life. The most common sites of occurrence of Keratosis Pilaris are the upper arms, thighs, and buttocks. However, the face, trunk, lower arms, and legs may also be affected. Learn more about the causes, symptoms, and treatment of Keratosis Pilaris by reading ahead.

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Contents

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What causes Keratosis Pilaris?

Though the exact cause of Keratosis Pilaris remains unknown, it is thought to be a genetically inherited disorder that runs in families. Mutations in the filaggrin gene may contribute to Keratosis Pilaris by inhibiting skin cells from multiplying and damaging the sebaceous glands (oil-forming glands of the skin), thereby disrupting the skin barrier. 

Additionally, there is an overproduction of “keratin”, a protein that is found abundantly in the skin, hair, and nails. The excess keratin forms a hard plug that causes blockage of the hair follicles, forming red inflammatory papules (small solid elevations on the skin).

Keratosis Pilaris is not infectious, occurring more frequently in individuals with scaly and dry skin. It is reported to be most commonly associated with the following conditions: 

  • Atopic dermatitis (a skin condition wherein the skin turns dry, itchy, and inflamed)

  • Ichthyosis vulgaris (a skin disease that leads to dry, thick, and scaly skin)

  • Scarring alopecia (a skin condition that destroys hair follicles, causing hair loss)

  • Ectodermal dysplasia (a disease causing impaired development of the teeth, hair, nails, and sweat glands)

  • Down’s syndrome (a genetic disorder causing developmental and intellectual delays)

  • Noonan syndrome (a genetic disorder that prevents normal development of the body)

  • Obesity

  • Diabetes

  • Malnutrition

What are the symptoms of Keratosis Pilaris?

Keratosis Pilaris is largely asymptomatic. Therefore persons affected by it are mostly unaware of their condition.

  • Numerous small skin-coloured elevations are found on the skin, which may appear unsightly when they turn red or brownish-black. 

  • Itching may occasionally occur, more frequently in winter than in summer due to the lower moisture content of the air during winters.

How is Keratosis Pilaris diagnosed?

Your skin doctor can make a diagnosis of Keratosis Pilaris based on your past medical history and physical examination findings. Since there are other conditions that can look similar to Keratosis Pilaris, dermatoscopy or biopsy can help with the diagnosis.

  • Dermatoscopy: Dermatoscopy, also known as skin surface microscopy is a non-invasive technique that has been used traditionally for the evaluation of suspicious skin lesions. In patients with Keratosis Pilaris, the skin lesions display abnormalities of the hair follicle such as thin, short, or coiled hair shafts. Scaling and redness can also be found.

  • Biopsy: It is a procedure in which a small piece of tissue around the skin lesions is removed using a sharp instrument. The tissue is then viewed under a microscope for signs of disease. A biopsy of the lesions reveals excessive keratin and granules, clogged hair follicles, mild redness, and inflammation around the blood vessels.

How is Keratosis Pilaris treated?

Keratosis Pilaris usually gets better with time. The following treatment options have been tried to reduce the severity of the condition.

1. Topical Emollients/Moisturisers: They help in softening and soothing the skin. Moisturising creams that contain urea, salicylic acid, lactic acid, or alpha hydroxy acids help to loosen the adherent scales present in the hair follicles.

2. Keratolytics: They act by breaking down the keratin plugs that block the hair follicles.

3. Glycolic acid: Chemical peels containing 70% glycolic acid have been useful in improving the appearance of the lesions. 

4. Retinoids: Your doctor may also prescribe topical retinoids that help in reducing redness and rough texture of the skin. 5. Steroid Therapy: A short course of steroid therapy may be used to deal with itching and inflammation.

6. Laser Therapy: It works by reducing swelling, redness, and discolouration and improving the texture of the skin. Pulsed dye laser, alexandrite laser, Nd: YAG laser, and fractional CO2 laser are some of the lasers that have been used in the treatment of Keratosis Pilaris. 7. Other treatments: Other treatments such as vitamin D3 therapy, dermabrasion, and photodynamic therapy have also been tried. Despite the fact that some of these therapies may have cosmetic benefits, there is no permanent cure for Keratosis Pilaris and it might recur. Always consult your doctor before starting any of the above medications.

Frequently asked questions

Below are some of the frequently asked questions on Keratosis Pilaris.

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Who can get Keratosis Pilaris?

Keratosis Pilaris is mostly seen in children and young adults. It affects about 50–80% of teenagers and 40% of adults. It has been found to be more common in persons with dry and scaly skin. You may be at a higher risk of developing Keratosis Pilaris if you suffer from atopic dermatitis, ichthyosis vulgaris, scarring alopecia, ectodermal dysplasia, obesity, diabetes, malnutrition, Down’s syndrome and Noonan syndrome.

What does Keratosis Pilaris look like?

Keratosis Pilaris appears as numerous small skin-coloured bumps on the skin that may turn red or brownish-black. Itching may occasionally occur during the winter months. They usually occur on the upper arms, thighs, and buttocks, and less commonly on the face, trunk, lower arms, and legs.

What precautions can I take to prevent the worsening of the condition?

It is advised that you practise good hygiene, use gentle soaps and bathing products, and moisturise your skin frequently. A gentle scrub may also be used sometimes. Try to avoid scratching, picking, rubbing, or manipulating the lesions. Use of perfumed soaps, harsh scrubs, hot baths, or showers that tend to dry out the skin should be minimised.

How can Keratosis Pilaris be treated?

There is no permanent cure for Keratosis Pilaris. However, topical agents such as emollients, moisturisers, medicated creams, retinoids, steroids, etc., can improve the condition temporarily by softening the skin texture. Laser treatment has also shown promising results in the treatment of this condition.

References

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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