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Keratosis Pilaris

by James G. H. Dinulos, MD

Keratosis pilaris is a disorder of keratinization in which horny plugs fill the openings of hair follicles.

Keratosis pilaris is common. The cause is unknown, but there is often an autosomal dominant inheritance. Multiple small, pointed, keratotic follicular papules appear mainly on the lateral aspects of the upper arms, thighs, and buttocks. Facial lesions may also occur, particularly in children. Lesions are most prominent in cold weather and sometimes abate in the summer. Skin may appear red. The problem is mainly cosmetic, but the disorder may cause itching or, rarely, follicular pustules.

Treatment is usually unnecessary and often unsatisfactory. Hydrophilic petrolatum and water (in equal parts) or petrolatum with 3% salicylic acid may help flatten the lesions. Buffered lactic acid (ammonium lactate) lotions or creams, urea creams, 6% salicylic acid gel, or 0.1% tretinoin cream may also be effective. Acid creams should be avoided in young children because of burning and stinging. Pulse-dye laser has been used successfully to treat facial redness.

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