Springdale Mason Pediatrics

Keratosis Pilaris

Definition

  • A chronic condition of dry, rough skin on the upper arms
  • Called Keratosis Pilaris (KP)

Call or Return If

  • After 2 weeks of treatment, KP is not better
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Rough and tiny bumps on the upper outer arms. (100% of patients)
  • Also occurs on the outer thighs (60%) and buttocks (30%)
  • Roughness may be described as sandpapery.
  • The same on both sides of the body
  • Skin is normal colored.
  • It rarely causes any itching.

Causes

  • Dead skin cells plug the hair follicles
  • KP does run in families (genetic). May occur in half of the sibs.
  • Made worse by too much bathing and soap
  • Soap removes the skin's natural protective oils. Once they are gone, the skin can't hold moisture.
  • Dry climates make it worse, as does winter weather. Reason: low humidity inside.
  • Can occur as early as 2 years.

Prevention of Recurrent KP

  • Don't use soaps or bubble bath.
  • You may want to limit use of swimming pools or hot tubs. Reason: Pool chemicals are very drying.
  • Run a humidifier in the winter if the air is dry.

After Care Advice

Overview:
  • Keratosis Pilaris (KP) is a common condition. It occurs in up to 30% of adults.
  • KP is not contagious to others.
  • It is harmless and can be treated at home.
  • Moisturizers are the key.
  • Here is some care advice that should help.
Soap and Bathing:
  • Young children with KP should avoid all soaps. Soaps take the natural protective oils out of the skin. Bubble bath does the most damage.
  • For young children, the skin can be cleansed with warm water alone. Keep bathing to 10 minutes or less.
  • Most young children only need to bathe twice a week.
  • Teenagers can get by with using soap only for the armpits, genitals, and feet. Also, use a mild soap (such as Dove).
  • Never use any soap on the areas with KP. This is very important.
Moisturizing Cream:
  • Buy a large bottle of unscented moisturizing cream. Avoid those with fragrances.
  • Put the cream on the KP areas 2 times per day.
  • After warm water baths or showers, trap the moisture in the skin. Do this by putting on the cream quickly. Use the cream within 3 minutes of completing the bath.
  • During the winter, apply the cream to all the skin. Do this every day to prevent dry skin.
Steroid Cream:
  • Usually KP is not itchy unless you scrub it with soap.
  • For very itchy spots, use 1% hydrocortisone cream. No prescription is needed.
  • Use up to 2 times per day as needed until the itching is better.
  • Eventually, the moisturizing cream will be all that you need for treating KP.
Prescription Creams:
  • There are some peeling agents that make KP look somewhat better.
  • But they are expensive and only give improvement while they are being used.
  • There is no cream that can cure KP.
Humidifier:
  • If your winters are dry, protect your child's skin from the constant drying effect.
  • Do this by running a room humidifier full time.
What to Expect:
  • With treatment, the skin should feel softer within 1 week.
  • KP however will never completely go away.
 

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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