What is keratosis pilaris (KP)?
Have you ever heard of Keratosis Pilaris (KP)? It's often affectionately nicknamed "chicken skin" due to its unique appearance. This dermatological condition occurs when there's an accumulation of dead skin cells and keratin around hair follicles, resulting in the development of little bumps (papules) accompanied by varying degrees of redness around the hair follicles. These papules give the skin a rough texture, and they tend to show up on areas like the thighs, upper arms, cheeks, or buttocks. Interestingly, KP doesn't discriminate based on gender and is more commonly seen in children and adolescents. Now, let's explore some of the different faces of KP.
Typical KP: This is the most common version, and it's quite symmetrical. You'll often find it on the outer-upper arms and thighs. Imagine numerous little rough bumps with different levels of redness around the hair follicles.
Atypical KP: This one likes to branch out a bit more, affecting areas beyond the usual suspects.
Keratosis Rubra Pilaris Faciei Atrophicans: This variant is known for causing prominent redness on the face, particularly around the eyebrows and scalp, which can eventually lead to a bit of thinning of the skin (atrophy).
There are additional variations of KP that can result in atrophy and, at times, even hair loss.
Can you guess which public
figure had this condition in
the past?
Debunking the myths
Myth 1: “Hmmm, it’s because you are not exfoliating enough.” Certainly, proper exfoliation is undoubtedly beneficial, but it's important to strike the right balance. When exfoliating, the goal is to effectively clear away pore-clogging debris while minimizing any potential harm to the skin. However, excessive exfoliation, whether through vigorous physical brushes or too frequent treatments, can disrupt the skin's protective barrier, resulting in dryness and potential flare-ups. Gentle exfoliation can be done once a week while microdermabrasion (medical grade exfoliation) is encouraged monthly.
Myth 2: “Applying lotion helps!”
Balancing skin moisture and oil levels is vital. To prevent further clogging, patients are advised to opt for lightweight, gel-based lotions. Research, such as the study by Piquero- Casals et al. in 2021, underscores the effectiveness of moisturizers containing urea and keratolytics. Given the possibility of KP recurrence, maintaining consistency in your skincare routine is crucial for long-term management.
Myth 3: “They are the same as body acne.”
No, no, there are not the same. Here’s a table for better understanding.
Treatment and Self-Care
Chemical Peels & Emollients
Among the primary therapies for KP, topical keratolytics stand out. We recommend using skincare products infused with ingredients such as lactic acid, salicylic acid, and urea to gently exfoliate and soften the keratin layer, thereby improving skin texture. However, it's worth noting that a combination of treatments may be necessary to address inflammation and redness effectively.
Microdermabrasion
Microdermabrasion shares a similar concept with keratolytics, with the added benefit of
hydration infusion. Using our medical-grade microdermabrasion devices, we can efficiently
exfoliate excess dead skin while infusing much-needed hydration, addressing two concerns in one go.
Topical Retinoids
For individuals who haven't responded well to keratolytics and emollients, topical retinoids are considered a second-line therapy. Commonly used topical retinoids like tretinoin 0.05% and adapalene 0.1% are applied once daily for 8 to 12 weeks. However, it's important to assess tolerance when the treated area is regularly exposed to sunlight due to increased sun sensitivity. Feel free to browse our resource & "Retinol: The New Antiaging Babe" for more details on retinoid usage.
Topical Corticosteroids
Although not the primary therapy for KP, corticosteroids are often used for short-term treatment alongside other topicals to mitigate inflammation. Professionals typically recommend applying them to affected areas once to twice daily for one to two weeks.
Fotona SP Dynamis
Research has shown promising outcomes in smoothing KP-affected skin using customized settings with Fotona SP Dynamis (Maitriwong, P. et al, 2019; Bayazit, S. et al, 2022).Significant improvements in skin texture and pigmentation can be achieved with 3 to 5 sessions spaced three weeks apart. In cases of keratosis rubra pilaris where vascular concerns arise, Fotona SP Dynamis settings can effectively address vascular lesions in 2 to 3 sessions spaced four weeks apart (Saelim, P. et al, 2012).
Depigmentation Cream
For individuals dealing with residual dark spots following KP flares, our depigmentation creams at Dream Clinic, containing cysteamine and hydroquinone, work wonders when used in conjunction with our laser treatments.
The “Maintenance” Plan
While medical professionals continue their unwavering search for a cure for KP, there are small steps you can take to manage those bothersome bumps effectively. Your personalized maintenance plan may be as straightforward as maintaining a healthy diet, regular moisturizing, and entrusting dream clinic to provide the specialized care your skin truly deserves. We invite you to reach out to us with a message or visit our clinic to explore these options further. Your path to smoother, healthier skin starts here.
References
Bayazit, S., Aşkın, Ö., & Kutlubay, Z. (2022). Comparative study of the efficacy of fractional er: YAG 2940 nm laser and q‐switched nd: YAG 1064 nm laser in keratosis pilaris. Journal of Cosmetic Dermatology, 21(9), 3809–3813. https://doi.org/10.1111/jocd.15193
Maitriwong, P., Tangkijngamvong, N. and Asawanonda, P. (2019) ‘Innovative 1064‐nm
nd:YAG laser significantly improves keratosis pilaris, a randomized, double‐blind,
sham‐irradiation‐controlled trial’, Lasers in Surgery and Medicine, 52(6), pp. 509–514.
doi:10.1002/lsm.23184.
Piquero-Casals, J., Morgado-Carrasco, D., Granger, C., Trullàs, C., Jesús-Silva, A., &
Krutmann, J. (2021). Urea in dermatology: A review of its emollient, moisturizing,
keratolytic, skin barrier enhancing and antimicrobial properties. Dermatology and Therapy,
11(6), 1905–1915. https://doi.org/10.1007/s13555-021-00611-y
Saelim, P., Pongprutthipan, M., Pootongkam, S., Jariyasethavong, V., & Asawanonda, P.
(2012). Long-pulsed 1064-nm nd:YAG laser significantly improves keratosis pilaris: A
randomized, evaluator-blind study. Journal of Dermatological Treatment, 24(4), 318–322.
https://doi.org/10.3109/09546634.2012.660518