Better Me

How to Treat the Bumpy Skin on the Back of Your Arms (Keratosis Pilaris)

If you’ve always got bumpy skin, don’t worry — you aren’t the only one.

There’s a good chance that what you’re experiencing is keratosis pilaris. This is a skin condition is common, affecting 50-80% of teens and 40% of adults.

These small bumps often look like plucked chicken skin, or goosebumps. In teens and adults, the bumps are usually on the upper arms, thighs and buttocks. In children, it’s on the upper arms, thighs and cheeks. And in more severe cases, it can spread to the lower legs and forearms. Although it’s medically harmless, keratosis pilaris can still be bothersome for those who have it.

We spoke with Margaret Wat, MD, PhD, a dermatology specialist at Banner – University Medical Center Tucson, about this common skin condition, and the best ways to treat it. There is not a cure for keratosis pilaris and getting rid of it completely may not be an option. But there are lots of things you can do to make it more manageable.

Symptoms of keratosis pilaris

Keratosis pilaris may be a mouthful, but it is very easy to explain. The condition is caused by plugs of dead skin cells (buildup of keratin) clogged in your hair follicles. The American Academy of Dermatology (AAD) explains that this condition causes tiny bumps on the skin that can:

  • Itch
  • Feel rough and dry like sandpaper
  • Become more noticeable during winter or in dry climates
  • Appear in different colors, including the same color as your skin, white, red, pinkish purple (on fair skin), and brownish black (on dark skin)

For some people, it shows up as a few skin-colored bumps. Others have noticeable bumps that look like pimples or a rash. The condition can come and go, depending on external factors like climate/weather, and internal factors like hormones.

Dr. Wat explained that sometimes it’s not possible to completely get rid of keratosis pilaris, but “the good news is that it tends to improve over time and decrease in severity with age, so patience is a virtue in this condition.”

Who gets keratosis pilaris?

As we mentioned earlier, this condition is very common. Sometimes it’s confused for acne. For most people, keratosis pilaris begins either before age 2 or during their teenage years. If you first get it when you’re a teen, it is likely to go away by your mid-20s.

According to the AAD, you’re more likely to get it if you have one or more of the following:

  • Close blood relatives with keratosis pilaris
  • Asthma
  • Dry skin
  • Eczema (atopic dermatitis)
  • Excess body weight
  • Hay fever
  • Ichthyosis vulgaris (a skin condition that causes very dry skin)
  • Melanoma and are taking vemurafenib (Zelboraf®), a targeted therapy medicine approved to treat melanoma that has spread

How can I treat keratosis pilaris?

Treatment for keratosis pilaris can begin when you meet with a physician. They will review your medical history and conduct a physical exam. With the context of your physical health, they will review your symptoms — and how your symptoms affect you —to create a treatment plan.

Once you’ve been evaluated, the AAD suggests a three-step at-home treatment plan and skin care routine:

1. Gently exfoliate: The goal here is to remove dead skin cells from your body’s surface. Using a loofah, buff puff or rough washcloth in the bath or shower will work. But don’t scrub your skin too vigorously — that can irritate it and could make your keratosis pilaris worse.

2. Apply a keratolytic product: Also known as a chemical exfoliator. These products help remove the buildup of dead skin cells. Use a product that contains one of the following ingredients (and use the recommended amount; too much can irritate your skin):

  • Alpha hydroxy acid
  • Glycolic acid
  • Lactic acid
  • A retinoid (retinol, tretinoin, adapalene, tazarotene)
  • Salicylic acid
  • Urea

3. Slather on moisturizer: Since keratolytic products dry your skin, moisturizer is an important final step. Oil-free creams and ointment will help prevent clogged pores. Apply the moisturizer right after bathing, and when your skin feels dry (at least two or three times per day).

Beyond the typical home remedies, Dr. Wat said your physician may also prescribe a topical steroid or laser treatments to reduce redness.

Since flare-ups are common, the AAD also suggested the following prevention tips:

  • Take shorter showers and baths (20 minutes or less)
  • Use warm water instead of hot water when bathing
  • Use a mild cleanser when bathing (bar soap can dry your skin)
  • Avoid bathing more than once per day
  • Avoid self-tanners (can make bumps more obvious)
  • If you shave or wax your skin, do so cautiously, as it can cause more bumps. (Laser hair removal won’t cause flare-ups.)
  • Plug in a humidifier when the air feels dry

Be patient with yourself!

“People often expect keratosis pilaris treatments to immediately make the bumps or the redness disappear,” Dr. Wat said. She explained that people should instead treat this condition as a chronic one that may take years to resolve.

Although this can be bothersome, remember that you aren’t alone. Keratosis pilaris is a common condition. Consulting with a dermatologist, and continuing to work with them during your treatment, is your best bet.

Need help treating keratosis pilaris?

Schedule an appointment with a board-certified dermatologist. You may also want to check out these related articles, written with help from other Banner Health providers: