Keratosis pilaris: when there is excess keratin in the skin

Small bumps (acne-like) on the skin. These are the main signs of keratosis pilaris or follicular keratosis – a benign condition, but which can certainly cause some discomfort from an aesthetic point of view and, therefore, require proper treatment. It is still a chronic problem, that is, it can last for years or a lifetime.

Cíntia Guedes Mendonça, specialist in dermatology at the Brazilian Society of Dermatology (SBD), postgraduate in dermatology at the Faculty of Medical Sciences of Minas Gerais, explains that keratosis pilaris is a genetic disease related to the production of keratin in hair follicles. “It is not a serious condition, having only aesthetic implications”, she highlights.

Daniela Gueriot, dermatologist at All Clinik (RJ), points out that keratosis pilaris is a common skin manifestation that occurs due to an alteration in keratinization. “There is an excess production of keratin in the skin, which blocks the opening of the hair follicles,” she says.

Below you can better understand the symptoms of keratosis pilaris, its causes and risk factors, as well as the diagnosis and treatment of this condition.

Causes and risk factors

Cíntia explains that keratosis pilaris is caused by a genetic change in the production of keratin in hair follicles. “It can appear on any skin type, but it’s more common in people who have atopic dermatitis,” she says.

Daniela reinforces that there is a genetic predisposition to keratosis pilaris and that the condition is more common in people under 30 years of age. “It also tends to appear more in winter, because the skin gets drier. Other predisposing factors are atopic dermatitis, drier skin, rhinitis, asthma and bronchitis,” she explains.

Symptoms of keratosis pilaris

Daniela highlights as the main symptoms:

• Papules (a type of skin lesion/red bumps), especially on the outside of the arms and thighs;
• roughness;
• Skin dryness.

“They are small red bumps on the arms, thighs, buttocks and face, which do not itch. They usually appear in childhood and persist into puberty and adulthood. The skin looks rough and dry”, emphasizes Cintia.

In addition to not scratching, these small lumps (or small balls) do not cause any kind of pain, so they are only aesthetic symptoms.

How is the diagnosis made?

Upon noticing the signs, which are easily identifiable, the person should seek a dermatologist or general practitioner. “The diagnosis is clinical, made through a dermatological examination in the office”, explains Cíntia.

In some cases, keratosis pilaris even dispenses with medical treatment, as it is not a serious condition and can “go away on its own”. However, it is recommended to seek medical advice to evaluate the possibilities of treatment, especially in the case of people concerned about the appearance of the skin.

At the medical appointment, to facilitate the diagnosis, it is possible to arrive with some important information in mind or written down, such as, for example: description of all symptoms and how long ago they appeared; as well as medical history, including medications taken regularly.

Treatments for keratosis pilaris

Cynthia explains that the treatment is done with keratolytic agents, such as salicylic acid, retinoids, moisturizers and even laser. “But it has limited results, as it is a genetic condition,” he says.

That is, treatment options focus on reducing skin keratin deposits, but none of them can promise to permanently end the problem.

It is worth emphasizing that keratosis pilaris is not a serious condition and can often “go away on its own” around the age of 30. However, medical monitoring allows the control of symptoms.