Author: Chloe Wilson BSc (Hons) Physiotherapy
There are a number of different options for keratosis pilaris treatment which help to get rid of those annoying and embarrassing bumps typically found on the back of the upper arms. Keratosis pilaris is a common type of arm acne that manifests as small red or white bumps that make the arm look rather like plucked chicken skin. It is caused by excess keratin blocking pores causing areas of rough goose bumps.
Keratosis Pilaris treatment is very similar to the treatment for other types of shoulder and arm acne, so whatever the cause of your spots, these treatments should help. We will look at which ingredients to look out for in creams, cosmetics, moisturisers and body washes, useful daily habits to adopt and what things to avoid!
In Keratosis Pilaris, the body produces too much of the protein keratin. Keratin is the key structure of the outer layer of human skin and protects the skin from damage and infection. The excess keratin accumulates around hair follicles blocking pores and forming small, rough, red or white bumps, anywhere from 10-100 in number. The surrounding skin may be slightly red (known as erythema) due to inflammation or dilation (opening) of the small blood vessel just under the skin.
In some cases a small, coiled hair can be seen trapped underneath a bump. Occasionally, it is accompanied by itchiness.
Keratosis Pilaris is a very common condition affecting nearly 50-80% of adolescents. Symptoms usually develop under the age of 10 and tend to get worse during puberty. It tends to improve with age but does affect up to around 40% of adults. It typically affects the outer part of the upper arms and/or the thighs.
There is a strong genetic link in this condition - it is autosomal dominant meaning that there is a 50% chance of it being passed on to any children. It tends to be worse in people who suffer from dry skin such as eczema. It is a completely harmless condition and although in most cases it improves over time, many people feel self-conscious and therefore seek keratosis pilaris treatment. Symptoms tend to be worse in the winter as the skin dries out.
There are a number of different options for keratosis pilaris treatment. They tend to focus on unblocking pores and hair follicles and are therefore very similar for treatments for other types of shoulder and arm acne. So if you are unsure if your shoulder or arm acne is this or something else, these treatment methods should help anyway!
There is no one specific long-term cure for the condition, but many people notice a real improvement with regular use of arm acne treatments. Different things work for different people but there tends to be most success when treatment is continuous, and a combination of treatments are used.
So let’s look at some of the different options for keratosis pilaris treatment:
Salicylic acid is a popular acne and keratosis pilaris treatment. It is a kerytolytic exfoliator which softens keratin and helps to shed the outer layer of skin. It increases the moisture in skin and helps to dissolve the plugs that block pores and hair follicles. It can also penetrate deep into pores so it exfoliates both inside and out and kills bacteria. It can also reduce sebum production, a common cause of arm acne – visit the shoulder acne section to find out more.
There are a whole range of products out there that contain salicylic acid including pads, serums, sprays, gels, moisturisers and shampoos (it also helps get rid of dandruff!). You should continue to use salicylic acid products even once your symptoms have cleared else the pores will quickly become blocked again and the acne will return and you’ll have to start your keratosis pilaris treatment all over again.
Salicylic acid can irritate sensitive skin so start with a small amount, once a day. Your skin should gradually get used to it, and once this happens you can use it more frequently, up to 2-3 times a day. Here are some of our favourite arm acne and keratosis pilaris products containing salicylic acid:
Retinol based products are another option for keratosis pilaris treatment. Available as creams, gels or lotions, they contain vitamin A which encourages cell turnover, reduces keratinisation and unclogs pores, all of which helps treat keratosis pilaris. It usually takes around 6 weeks or longer of regular use to notice the effects.
As with salicylic acid, using retinoids can make your skin more sensitive to the sun, and can irritate the skin, especially when you first start using it. This usually settles with continued use. These are some of our favourite retinol products for acne and keratosis pilaris treatment.
Soap bars actually tend to clog pores rather than open them. Stick to body wash designed for keratosis pilaris treatment as we have discussed above instead – they are much more effective, if slightly more expensive.
Daily use of non-oily moisturisers is an important part of keratosis pilaris treatment. Symptoms tend to get worse when the skin is dry, so regularly moisturising can really help.
Avoid oil-based moisturisers as they can end up blocking pores. You can opt for regular moisturisers, or there are some that are specially designed for keratosis pilaris.
It can be tempting to try and rub away those annoying bumps but harsh exfoliators, body scrubs and loafers should not be part of keratosis pilaris treatment. You are more likely to make the inflammation worse. Instead, use a soft cloth when washing and rub gently rather than vigorously.
When showering or bathing, stick to lukewarm water. Hot water can dry the skin and cold water closes pores. Try to keep your wash time less than ten minutes to also prevent the skin drying out.
Photodynamic therapy (PDT) is a special treatment where a photosensitising agent (such as Levulan) is applied to the skin and then activated with a light source (such as Blu-U light). The photosensitising agent is absorbed by actively proliferating cells (new cells that are being produced) such as keratin and sebum. When exposed to the light source, the agent is activated which destroys the cells. This helps to reduce pore size and shrink oil glands.
Once the agent has been applied to the skin, you usually wait 30-60 minutes before using the light for just a few minutes. The agent is then washed off. People usually require 3-5 sessions of PDT, 2-4 weeks apart. Some people find it is a very effective keratosis pilaris treatment, but the evidence is lacking at this stage.
Laser hair removal is sometimes used for keratosis pilaris treatment to decrease hair growth in the affected area. Less hairs = less follicles to get blocked and therefore less spots. This is one of the least common treatments used and there is little evidence of long term benefit.
Keratosis pilaris does get better with time, and while none of these treatments is a permanent cure, they can help reduce symptoms when used regularly. Don't stop using them as soon as symptoms have improved or it is likely to return.
If you aren't sure if this is the cause of your arm acne, do see your doctor, but rest assured these keratosis pilaris treatments also work for most other types of acne, so they should help. If you would like to find out more, visit the shoulder acne section.
Page Last Updated: 21/03/19
Next Review Due: 21/03/21