Dear Doctor: Every winter I get these weird bumps on my skin, kind of like goosebumps, except that they won’t go away. What are they? Is there anything that can help?
Dear Reader: It sounds as though you’re describing a common and harmless skin condition known as keratosis pilaris. Symptoms typically include patches of small, hard bumps that are about the size of a grain of sand. They may match your skin tone, or can appear pink, reddish, white or brown. In some cases, the tops of the bumps are covered in dry skin scales.
The condition occurs when oil pores in the skin, which also contain tiny hairs, become clogged with dead skin cells. (The word “keratosis” refers to keratin, the main building block of the epidermis, or outer layer of the skin. The word “pilaris” pertains to hair.) The affected area becomes rough and in some cases may itch. However, keratosis pilaris doesn’t cause pain.
This is a condition that may be seasonal, as you have experienced, or can last for months or even years. It usually appears on the skin of the upper arm, upper thigh or buttocks, but can also develop on other areas of the body. It sometimes occurs on the face, most often on cheeks, where it resembles acne. It’s more common in young people, and often goes away as they get older. The cause of keratosis pilaris isn’t yet known, but since it’s more common in individuals with certain skin conditions, such as eczema, genes may play a role. It’s distinctive enough that it can usually be diagnosed with a visual and physical exam.
Keratosis pilaris is neither harmful nor dangerous, and it isn’t infectious. It can safely be left alone. But if you’re bothered by the appearance, or if you’re experiencing itchiness, you have several treatment options. Since damp skin absorbs moisturizer more easily than dry skin, and since the products form a barrier that protects the skin, make it a practice to apply moisturizer after bathing or showering. Creams that contain chemical exfoliators -- such as urea, salicylic and glycolic acid, and alpha hydroxy acids -- can help to break down excess keratin. Over-the-counter lotions such as Eucerin, AmLactin and CeraVe, which are gentle and fragrance-free, can be helpful in diminishing the size of the bumps and boosting moisture.
When showering and bathing, keep water on the cooler side, as hot water can contribute to dry skin and irritation. Using a loofah, washcloth or exfoliating mitt can also help minimize bumps, but don’t try to scrub them away. This can easily lead to irritated or even inflamed skin and make symptoms worse. Instead, treat your skin gently.
When toweling off after a shower or bath, dab your skin dry rather than rubbing. If you’re not getting results with this regimen of self-care, your health care provider can recommend prescription creams with vitamin A or Retin-A, which may help improve your skin’s appearance.
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