Body skincare

Understanding KERATOSIS PILARIS

While keratosis pilaris is a benign skin condition, its presence concerns many clients. Josie Jackson explores how to educate them on the best treatment and homecare options

“Also referred to as ‘chicken skin’ or KP, keratosis pilaris is a benign, often hereditary, skin condition marked by small, gooseflesh-like bumps – typically found on the on upper arms, thighs, buttocks, and sometimes cheeks or torso,” explains Dr Jessica Halliley, founder of Your Beauty Doctor and an experienced NHS GP. While some clients report feeling self-conscious over the appearance of these bumps, they can also result in dry, and sometimes itchy, skin.

What causes keratosis pilaris?

According to Dr Sina Ghadiri, consultant dermatologist and founder of Sinaesthetics in London, keratosis pilaris is caused by “the abnormal plugging of hair follicles by the protein keratin, leading to a possible subsequent inflammatory reaction around the follicle”.

While it is often influenced by genetics (a large proportion of cases are inherited) Candice Gardner, education manager at Dermalogica, notes that lifestyle and environmental factors can significantly influence the severity and visibility of the condition.

For example, over-stimulation through friction can result in hyperkeratosis – abnormal thickening of the skin due to an excess production of keratin, which is a protective protein.

“Fragile follicles are also prone to inflammation when exposed to tight clothing, frequent shaving, or aggressive exfoliation,” she adds. As such, if a client presents to you with keratosis pilaris, Gardner recommends advising loose clothing, minimal scrubbing, and careful shaving to prevent flare-ups.

Clients suffering from dry skin can also be at risk of exacerbating keratosis pilaris. Gardner explains, “In individuals with barrier dysfunction, dry skin accelerates keratin buildup at follicular openings. In this instance, I would encourage them to use gentle cleansers, limit hot showers, and maintain consistent moisturisation, which can support barrier integrity and reduce keratin plugging.”

The best treatment options

Since mechanical friction is best avoided, Gardner advises the use of chemical exfoliants, as these will gently exfoliate and improve skin texture. “Glycolic, lactic, salicylic and phytic acids are popular choices,” she shares. “Salicylic acid is highly effective at penetrating the follicle and so is a favoured option to reduce keratin plugs, while lactic acid also has hydrating properties and tends to be favoured in body creams and lotions.” Meanwhile, Dr Halliley suggests a low-dose retinol or prescriptions such a tretinoin or adapalene, which work to unclog pores, reduce inflammation and normalise skin cell turnover.

However, because retinols and acids can also cause skin dryness and increased sensitivity to the sun, it’s key to ensure your client is also regularly moisturising and applying SPF. “Ceramides, oils rich in essential fatty acids, hyaluronic acid and glycerin are popular choices to boost the skin barrier components and hydrate skin,” shares Gardner.

Another key ingredient considered to be particularly effective at treating and managing keratosis pilaris is urea – a keratolytic emollient. This compound naturally occurs in the body, found in the epidermis, and the urea used in skincare products is chemically manufactured to replicate this.

Professor Firas Al-Niaimi, a consultant dermatologist and laser expert, explains that urea at a 10% concentration is most effective and “works by softening keratin and smoothing the skin's surface”.

“Clinic treatments can also be beneficial, such as chemical peels which help to remove the buildup of dead skin cells and improve skin texture over time,” he adds.

"Salicylic acid is highly effective at penetrating the follicle to reduce keratin plugs, while lactic acid also has hydrating properties"