Keratosis pilaris
Keratosis pilaris is the small rough bumps that give the skin a sandpaper feel or a permanent goose-pimple look.
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Keratosis pilaris is the small rough bumps that give the skin a sandpaper feel or a permanent goose-pimple look. They form because keratin plugs the openings of the hair follicles. It is extremely common — affecting around 40% of adults and most adolescents — completely harmless and not contagious. It cannot be cured, but it softens considerably with the right care, and in most people it improves on its own over the years.
How it looks
- tiny hard papules the size of a pinhead;
- skin-coloured, reddish or brown depending on skin tone;
- a rough, sandpaper-like feel;
- sometimes with a coiled hair inside;
- there may be surrounding redness, particularly on the cheeks and arms;
- sites: outer upper arms — the classic location — thighs, buttocks, cheeks in children and sometimes the back;
- it does not hurt and itches little or not at all;
- it worsens in winter and with dry skin, and improves in summer and in humidity.
Why it happens
- inherited predisposition: this is the main factor, and it usually runs in families;
- dry skin;
- atopic dermatitis and an allergic tendency: frequently associated;
- dry, cold climate and central heating;
- adolescence and hormonal change;
- pregnancy;
- excess weight;
- occasionally thyroid disorders and nutritional deficiencies.
What works
The realistic aim is to smooth the skin, not to eliminate every papule. Results appear after 4–6 weeks of consistent use and disappear if you stop: this is maintenance care, not a cure.
- daily, generous moisturising, applied to damp skin after showering: the foundation;
- creams with 10–20% urea: they soften the keratin plug and are the most effective product for most people;
- lactic acid, salicylic acid or glycolic acid in a cream or lotion;
- topical retinoids for marked cases, prescribed by a doctor;
- gentle exfoliation with a mitt or sponge two or three times a week, without rubbing until the skin reddens;
- short lukewarm showers, not hot, with a syndet rather than soap;
- a humidifier during the heating season;
- laser for the persistent red component, if it bothers you;
- treat any underlying atopic dermatitis.
What makes it worse: harsh scrubs and stiff brushes, squeezing or picking the papules — which leaves marks and scars — very hot water, soaps that leave the skin tight, and waxing over inflamed areas.
When to see a doctor
- you want to improve the appearance and ordinary products are not enough;
- there is intense, persistent redness, particularly on the face;
- areas of hair loss appear in the eyebrows or scalp, or scarring develops: this may be a variant that does leave permanent change and is worth treating early;
- the lesions itch a great deal, become inflamed or discharge;
- they have appeared suddenly in an adult;
- the skin is very dry all over: an associated ichthyosis is possible;
- it is affecting you psychologically — reason enough to attend.
What it is not
- acne: keratosis pilaris has no comedones or inflammatory pustules, and the distribution differs;
- folliculitis: there are pustules, it itches and it usually follows hair removal or swimming;
- eczema: it itches clearly and the lesions are patches rather than hard papules;
- allergy: keratosis pilaris is constant, not appearing in flares after a contact.
Common questions
Is it contagious? No.
Does it go away? In many people it improves clearly after 30 and in some it disappears. In the meantime it is controlled.
Is it a vitamin deficiency? Not generally. Only in very specific cases is there a deficiency behind it.
Can I squeeze the papules? No: they become inflamed, leave marks and can scar.
Do oils help? They moisturise but do not soften the keratin plug. For that you need urea or acids.
Is it a disease? It is regarded more as a variant of normal skin than a disease. It has no health consequences.
Online consultation
In an online consultation the doctor reviews photographs, distinguishes keratosis pilaris from acne and folliculitis, chooses the right strength of urea or acid for your skin, checks for associated atopic dermatitis and sets realistic expectations for what can be achieved.
This material is for information only and does not replace a medical consultation.
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Reviewed on Jul 2, 2026
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