The Best Way to Treat Keratosis Pilaris

Woman resting elbows on knees after clearing up keratosis pilaris

And after a long winter and drizzly spring spent covered up in sleeves and tights, the first sight of your bare arms and legs in a breezy sundress can be alarming — particularly if you’re one of the 40% of adults that suffers from keratosis pilaris, a condition that causes tiny, red bumps on your arms and legs. The good news: You don’t have to cover up or settle for bumpy thighs. Keep reading to learn how to clear it up.

What is keratosis pilaris?

You probably know it as “chicken skin,” but the condition behind those small, red bumps on arms, upper legs, butt, and — occasionally — face is called keratosis pilaris (a.k.a. KP). It’s caused by a buildup of keratin, the protein that makes up skin, and extra skin cells in hair follicles (why it’s most common on limbs, where hair is denser).

Although KP can resemble acne or eczema, it’s harmless, painless, and less of a skin issue than a skin type. “Having KP doesn’t mean anything is wrong with your skin,” explains Deanne Mraz Robinson, a Westport, Connecticut-based dermatologist and Assistant Clinical Professor of Dermatology at Yale. “I always tell patients that it’s a part of skin. Sometimes it’s a sign of having sensitive skin, and it can be associated with eczema or atopic dermatitis, but it’s really its own skin type.”

What causes keratosis pilaris?

Nobody knows the root cause of KP, but you most likely inherited it from your parents. Still, there are things that aggravate it. Hormones rev up inflammation and skin cell production, Robinson says, making KP worse during teenage years and pregnancy. Dry skin is another trigger; you’ll notice more bumps during and following a long winter. KP can also be provoked by picking or an overly-enthusiastic treatment plan. “If someone loofahs too much or is aggressive with exfoliating acids or other irritating chemicals, it can irritate it further,” Robinson explains. “People think, ‘I’m going to scrub it off and it’ll be better,’ and it just makes it red and inflamed.”

Treating KP successfully

KP can’t be cured, but there are things you can do to minimize it. “You can get it to a point where it’s not as red and keratotic,” Robinson says. Maintenance — and patience — is key. Here’s how it’s done:

Gently exfoliate

Exfoliation is your first step towards improving keratosis pilaris — and a combo method works best, Robinson says. Don’t overdo it, though: “Stick to once or twice a week and let your skin acclimate.” Alternate between physically exfoliating — buffing your skin with a dry brush or clean washcloth — and a chemical exfoliant, such as a lactic acid-spiked body mask. While the act of scrubbing helps slough off dead skin, chemical exfoliants are keratolytic “so they’ll break down the skin cells causing the bumps,” she says. Why lactic acid, specifically? A 2015 study found it to be more effective than salicylic acid at treating KP. Bonus: It’s gentle, renewing skin without causing further irritation. Stay away from granular scrubs, which are too abrasive and can make inflammation worse, and remember SPF; exfoliation makes skin more prone to burns.

Add barrier-restoring moisture

Dry skin — and the excess of dead skin cells and compromised skin barrier that comes with it — can make KP worse, Robinson says. Look for moisturizers containing essential fatty acids and ceramides. Both occur naturally in our skin barrier and topical application helps restore them. A body oil with naturally EFA-packed hemp seed oil nourishes skin post-exfoliation, while antioxidants, such as green tea, will settle inflammation. Use it the moment you get out of the shower — while your bathroom is still steamy and skin is slightly damp — for the silkiest results.

Tweak your diet

A link between diet and keratosis pilaris isn’t proven, but “there are certain foods that can help prevent inflammation in skin and promote optimal hydration,” says Eliza Savage, a registered dietician in New York City. “Large amounts of sugar and refined carbohydrates can wreak havoc on any type of skin, and should definitely be avoided with KP.” Savage recommends a Mediterranean diet (think high fiber fruits and veggies, healthy fats, lean proteins, and grains), plenty of water, and making sure you’re getting omega-3 fatty acids and Vitamins A and D. And don’t neglect your gut: A healthy gut is associated with less inflammation. Try a daily probiotic supplement as well as probiotic foods like sauerkraut and yogurt to build beneficial flora.