Keratosis Pilaris

The Chicken Skin Disease

Mar 25, 2009 Hanish Babu

Keratosis pilaris is a common hereditary skin condition which causes small goose bump like rashes on the outer arms, shoulder, thighs, chest and back.

Keratosis pilaris is so named because it produces hard ‘keratotic’ bumps related to hair follicles. Keratin is the protein that provides structural support and toughness to the skin. It is a very common condition which affects 40-50% of adults and 50-80% adolescents. Most people who have the milder variety of Keratosis pilaris may not even realize they have the condition. Resemblance to the spiny chicken skin gives it the name the chicken skin disease.

Causes of Keratosis Pilaris

In keratosis pilaris, keratin accumulates forming hard plugs which blocks the opening of the hair follicles. Why and how the keratin accumulation occurs is not clear. This type of keratin accumulation is common in extremely dry skin conditions seen in icthyosis vulgaris and atopic dermatitis. Keratosis pilaris is also associated with many genetic diseases where dry skin is a prominent feature.

Keratosis pilaris is sometimes seen in healthy individuals as well.

Clinical Features of Keratosis Pilaris

Keratosis pilaris presents as minute, grouped, acne like bumps; grey to brown in color. In some, the rashes are inflamed, red and itchy. Usually, however, itching is not a prominent feature in keratosis pilaris, though a warm discomfort is felt over the affected skin.

The common sites involved are upper arms, shoulder, back, thighs, buttocks and legs. Rarely keratosis pilaris appears on the face, where it resembles blackheads.

On the shoulder and back at times there are islands of spiny bumps with areas of rough, dry skin in between.

Keratosis pilaris is more prominent during winter, and improves in summer. It usually starts at the age of 3-5 years, continues till 20 years of age and then gradually subsides. There are many variants of keratosis pilaris, from mild to moderate and from grey to red. When the spiny rashes are red, this is known as keratosis pilaris rubra.

Treatment of Keratosis Pilaris

Treatment of keratosis pilaris involves general care of the skin and specific care. The aim of the treatment is to moisturize the involved skin and make the keratotic plugs soft so that they can be removed with exfoliating creams.

1. A balanced diet, with regular helpings of fresh vegetables and fruits is essential in the management of any skin disease, especially so in diseases involving disorders of the keratin protein.
2. Some reports indicate intake of vitamin A, essential fatty acids and omega 3 oils helps in improving the dryness of the skin and reducing the keratin plugs in keratosis pilaris.
3. Humidifying the living room and bed room during winter improves both dry skin and keratosis pilaris.
4. A moisturizer containing urea 10-20%, lactic acid etc are applied and rubbed in to the involved skin soon after bath in the morning. A gentle cleanser should be used before applying the moisturizer.
5. During night, keratin removing creams (called keratolytics) containing 2-3 % salicylic acid , 10-20 % glycolic acid, 10-15% AHAs, retinoids like tretinoin 0.05% , adapalene 0.1%, or tazarotene 0.1% are applied. These creams may cause irritation, hence should be used carefully.
6. Special polymer type coating containing salicylic acid which forms a thin film over the skin has been found to be effective in keratosis pilaris.
7. Photo pneumatic therapy which combines pneumatic energy and broad band light has been reported to be effective in some cases of keratosis pilaris rubra.
8. Topical steroids of mild to moderate strength can be used for shorter periods if the involved skin is irritated.
9. Tacrolimus, an immunomodulator, is helpful in resistant cases to reduce the cell turn over which causes the formation of keratin plug in keratosis pilaris.

Keratosis Pilaris : What to Expect after Treatment

Regular treatment of keratosis pilaris will get rid of the horny plugs and improves your skin texture and appearance, but, recurrence is the norm if treatment is stopped. Keratosis pilaris tends to persist for years, before disappearing spontaneously.

Reference

Various Text Books and Journals of Dermatology

Disclaimer

The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.

The copyright of the article Keratosis Pilaris in General Medicine is owned by Hanish Babu. Permission to republish Keratosis Pilaris in print or online must be granted by the author in writing.

Keratosis Pilaris: The Chicken Skin Disease

Keratosis Pilaris Rubra: Red Spiny Bumps.

Keratosis Pilaris not Curable, But Controllable.

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Comments

May 20, 2009 2:54 PM

Guest :

hello. according to my skin doctor i have "chicken skin" he gave me a treatment but it does not work. and it is spreading can anyone help me please

Jun 18, 2009 7:18 AM

Krishnamurthy :

It is claimed that oil pulling has alleviated the symptoms of the condition in people that have tried it. In the morning before breakfast on an empty stomach you take one tablespoon in the mouth but do not swallow it. Move Oil Slowly in the mouth as rinsing or swishing and Dr Karach puts it as ' sip, suck and pull through the teeth' for fifteen to twenty minutes. This process makes oil thoroughly mixed with saliva. Swishing activates the enzymes and the enzymes draw toxins out of the blood. The oil must not be swallowed, for it has become toxic. As the process continues, the oil gets thinner and white. If the oil is still yellow, it has not been pulled long enough.It is then spit from the mouth , the oral cavity must be thoroughly rinsed and mouth must be washed thoroughly. Just use normal tap water and good old fingers to clean.

Jun 18, 2009 7:33 AM

Guest :

Sunflower and Sesame oil have been found to be equally effective in curing diseases. Other oils were not found to be as good. Do not blame oil pulling by practicing with other oils. Use refined oils. If you are allergic to a particular brand of oil, change the brand of oil or oil itself to different oil.Do not swallow. The oil should be spat out. But inadvertently if you swallow there is nothing to worry. It will go out through faeces. Nothing is to be done.

Sep 6, 2009 7:43 AM

Guest :

I Have chicken skin badly on my upper arm and on my sholders its so ugly and i want to get rid of it mine is the non curable one but aparently controlable.
i am a smoker and i dont eat very healthy could this contribute to this?

4 Comments