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Yami Gautam Opens Up About Her Skin Condition Keratosis Pilaris: Causes, Symptoms And Treatments

Yami Gautam, in her recent Instagram post, opened up about dealing with and embracing her skin condition called Keratosis Pilaris. She talked about how she has dealt with the condition for several years and finally decided to let go of all her insecurities and accept her flaws wholeheartedly.

What is keratosis pilaris? Is it a common or severe skin condition? Can it go away? What are the treatment methods for the condition? In this article, we will discuss keratosis pilaris in detail. Take a look.

What Is Keratosis Pilaris?

Keratosis pilaris, also known as chicken skin, is a common and chronic skin condition found mainly in the adolescent population (50-80 per cent) and adults (40 per cent). It usually occurs in the upper arms, buttocks, cheeks and thighs and is considered a normal variant of skin.

In most of the cases, this skin condition tends to appear first during the early childhood period and progresses to its extensive form during the twenties. By the age of 30, it may disappear or clear up on its own or improve with time. [1] Also, race and sex are not the predominant factors of the condition.

Keratosis pilaris is not a contagious disease and the bumps and pimples it causes on the skin are not itchy or irritable. This says that though the condition is cosmetically displeasing, it is basically a harmless skin condition that only needs to be managed lifelong with prescribed creams or medications.

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Causes Of Keratosis Pilaris

Studies say that overproduction of keratin (a type of protein found in hair, skin and nails) or hyperkeratinization in the skin blocks the hair follicles and prevents hair from reaching the surface of the skin. This trapping of hair beneath the keratin layer causes follicular bumps on the skin, called keratosis pilaris.

The exact cause of excess production of keratin is still unknown, however, genetics is considered to be the cause in many cases. The mutations in the filaggrin gene and abnormalities of the Ras signalling cascade usually lead to follicular abnormalities and triggering of the condition. [2]

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The Filaggrin gene is a key protein that helps in the terminal differentiation of the epidermis and the formation of the skin barrier. Ras signalling is an important intracellular signalling pathway responsible for gene expression and cell proliferation and differentiation.

Symptoms Of Keratosis Pilaris

Some of the signs and symptoms for keratosis pilaris may include:

  • Tiny, raised bump on the skin follicles. [3]
  • In some, larger lesions are present.
  • Skin rash near the bumps.
  • Rough skin surrounding the bumps.
  • Worsening of symptoms during winter and improvement during summer.
  • Bumps that feel like sandpaper.
  • Different colour bumps such as skin-coloured, red, pink or brown.
  • Scaling around the opening of the follicles.

Who Are More Prone To Keratosis Pilaris?

As aforementioned, adolescents are more prone to keratosis, followed by people with other skin conditions such as:

  • Atopic dermatitis [4]
  • Atopy or allergic diseases.
  • Diabetes
  • Scarring alopecia, an inflammatory hair loss disorder.
  • Ichthyosis Vulgaris
  • ectodermal dysplasia, a genetic disease that affects the development or function of the nails, hair, teeth and sweat glands.
  • Obesity
  • Hyperandrogenism
  • KID syndrome that involves skin impairment and severe deafness. [5]
  • Prolidase deficiency, a rare metabolic condition characterised by severe skin lesions.
  • Children with Down syndrome. [6]

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Diagnosis Of Keratosis Pilaris

Keratosis pilaris is often confused with other skin conditions such as follicular eczema, acne vulgaris, scurvy and perforating folliculitis. This is why, sometimes it's difficult to diagnose the condition. However, some of the diagnostic methods may include:

  • History of the patient: It includes evaluation of the family history of the patient, along with questions regarding the onset, locations and symptoms of keratosis.
  • Dermoscopy: Here, the skin is examined using a skin surface microscope. The presence of circular, twisted or coiled hair shafts within the follicular area is an indication of keratosis pilaris. [7]
  • Biopsy: It may help reveal the clogged hair follicles and inflammation under the skin.

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Treatments Of Keratosis Pilaris

There is no cure for keratosis pilaris. However, in many people, the condition improves with increasing age, while in some, it may persist till late adulthood. Treatment methods are recommended to prevent the condition from getting severe. Some of the treatments may include:

  • Glycolic acid: Creams or lotions containing glycolic acid can help correct the hair follicles abnormalities and prevent accumulation of keratin. Depending on the severity of the condition, the percentage of glycolic acid in creams is suggested. [8]
  • Hypoallergenic soaps: To reduce skin lesions.
  • Creams containing 10% lactic and 5% salicylic acid: The effectiveness of creams based on this content show great improvement within four weeks. [9] Creams containing urea are also suggested.
  • Laser therapies: It helps reduce the inflammation and redness of the skin and improve discolouration and texture.
  • Others: Other treatment methods include the use of topical retinoid and vitamin D3 derivatives.

Management Of Keratosis Pilaris

  • Apply moisturiser soon after every shower or twice or thrice a day.
  • Exfoliate the skin or gently remove dead skin by using a loofah. Do it only after consulting a dermatologist.
  • Use mild bathing and moisturising products suggested by a skin expert.
  • Avoid rubbing the skin after bathing and go for pat drying it.
  • Take cool or lukewarm showers instead of hot ones.
  • Avoid scratching the skin.
  • Avoid using harsh perfumes or body mists on the skin.
  • Use prescribed creams and lotions as suggested.

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To Conclude

Keratosis pilaris is an underreported condition. It is not linked to any mortality or morbidity. The only concern is regarding the cosmetic appearance of the skin which may sometimes lower the self-confidence in people. Consult a medical expert to know more about the condition and its management.

Does keratosis pilaris go away?

In many cases, keratosis pilaris goes away by the age of 30, however, in some, it can be present till late adulthood. Keratosis pilaris is a harmless chronic condition which has no cure. It can only be managed with prescribed creams and lotions. Also, it is not linked to any complications or mortality.

What happens if you scratch keratosis pilaris?

Keratosis pilaris is often not itchy or irritable. It is just a harmless skin condition characterised by tiny, red and raised bumps on the skin follicles. The rough skin surrounding the bumps may cause the skin to itch, however, avoid it as it may lead to deep and severe lesions and can delay the treatment.

How do you treat inflamed keratosis pilaris?

There is no permanent cure for keratosis pilaris, however, certain salicylic acid, lactic acid, urea and glycolic acid based creams and lotions can help reduce the inflammation and redness of the skin and help manage the condition. Other treatment methods may include laser therapy and hypoallergenic soaps.