Keratosis Pilaris

September 14th, 2010

Keratosis Pilaris (KP) is a rash that I commonly see in my Woodlands dermatology and Conroe dermatology clinics most commonly found on the upper arms but can involve the legs, chest, back and even the face as a mimicker of acne.  KP is a genetic condition passed on in an autosomal dominant pattern, so if one parent is affected there is a 50% chance that each child will have the condition.  It usually presents in teenage years persisting through early adulthood but can spontaneously resolve.  Essentially, a hard protein called keratin is made, which “plugs” the pores.  The skin affected by KP feels very rough and has a red appearance.  Friction and rubbing only worsens KP as many patients attempt to use an abrasive or they pick at the lesions in an attempt to smooth the skin.  A moisturizer with a dissolving agent is the mainstay of treatment for KP.  I prescribe Lac hydrin 12% cream, which contains lactic acid and should be used twice a day.  If a patient discontinues the Lac hydrin 12% cream, the keratotic papules will return.  Amlactin is an over the counter cream very similar to lac hydrin, which also contains 12% lactic acid.  Occasionally, I prescribe a steroid cream if the lesions also have an eczematous component.