If you’ve ever noticed a bumpy, red rash on your upper arms and thighs, don’t worry—this is not ‘arm acne.’ In fact, the little red bumps are not pimples. They are caused by a common, harmless and easily treatable condition known as keratosis pilaris.
Keratosis pilaris actually is caused by blocked hair follicles. It’s more common in people who have allergies, hay fever or eczema. “Keratosis is Latin for the ‘hair unit,’ and pilaris means ‘crusting,’ so the name is descriptive—hair-unit crusting,” says Dr. Joseph Muccini, a dermatologist with the Mid-America Skin Health and Vitality Center.
“This condition usually presents in childhood with rough bumps on the outer upper arms or the front of the thighs, giving the skin a sandpapery texture,” says Dr. Daniel Ring, a dermatologist with West County Dermatology. “Commonly, the face is involved with similar bumps and a striking circular redness on the lateral cheeks. The facial bumps often are mistaken for acne by parents. Improvement is frequently seen around puberty, but the condition can worsen with puberty, persist into adulthood, and sometimes develop in adulthood.”
Muccini explains that hair follicles are like machines that compact and move skin cells to the surface where they are naturally shed. Oil glands add secretions to the mix, and the dead skin cells and oil are usually excreted and sloughed away. But some individuals don’t have enough oil to lubricate the dead cells’ journey out of the hair follicle, and it becomes clogged with ‘schmutz,’ as Muccini refers to it.
If the resulting raised red spots are squeezed, like pimples, they will not burst and express pus like a typical acne pimple. Instead, the thick, whitish globule of dead cells will be expressed, but Muccini warns that trying to squeeze or pop these small eruptions can lead to infection and scarring.
“The condition is typically a cosmetic concern, initially with bumps and/or redness as the primary complaint. Dry weather can exacerbate the roughness and itching can also be seen. Exercise can make temporarily the redness, especially in the cheeks, much more prominent,” Ring says.
Fortunately, treatment is simple and involves moisturizing the skin and using mild acid-based products to help clear the skin. “This condition is easy to manage,” Muccini says. Moisturizing is key, and he suggests using a gentle soap and tepid water to shower or bathe followed by a good moisturizer applied using strokes in a single direction. Over-the-counter products with salicylic acid or other mild acids, such as AmLactin or CeraVe SA, can help slough away the ‘schmutz.’
“This isn’t a worrisome condition. It’s a nuisance,” Muccini says. “Luckily, it’s a nuisance that can be managed and controlled.”