Keratosis Pilaris: What you need to know about this skin condition.

Keratosis pilaris is a benign skin condition. It is very common, estimated to affect around 40% of adults and between 50 to 80% of teenagers worldwide. Keratosis pilaris is recognised by the small flesh-coloured bumps it causes, sometimes ringed with pink or brown. Although these blemishes can be located on different parts of the body, they generally appear on the outer surface of the arms, thighs and calves. In these areas, the skin is dry, rough in texture and the skin grain is irregular.

Keratosis pilaris typically disappears spontaneously in one's twenties. However, in some cases, it persists over a long period of time and can be a source of discomfort and self-consciousness, particularly in the summer when the weather encourages us to bare our legs and arms. Moreover, although benign, keratosis pilaris can sometimes cause itching. In the event of inflammation following scratching, the small follicular plugs can take on a red colour. In some cases, keratosis pilaris is the cause of an increase in ingrown hairs.

Keratosis pilaris arises from a disruption in the keratinisation process, specifically from an overproduction of keratin by the keratinocytes. Trapped in the hair follicles, the excess keratin accumulates, eventually leading to their blockage. Numerous studies have been conducted to understand the origin of keratosis pilaris and scientists have ultimately highlighted the hereditary nature of this condition. It is transmitted in an autosomal dominant manner, which means that the mutation is located on a non-sexual chromosome and it only requires one copy of the gene to be affected. A mutation in the FLG gene is thought to be responsible. This gene codes for filaggrin, a protein associated with keratin in the epidermis and contributes to its barrier function.

Beyond this genetic component, other factors are suspected to play a role in the development of keratosis pilaris, among which are a hormonal influence, a resistance to insulin, or even an unbalanced diet. It is important to note that these are only hypotheses and more research is still needed to make a definitive conclusion. Finally, individuals suffering from atopic dermatitis or ichthyosis seem predisposed to develop keratosis pilaris, due to the common etiology of these diseases.

To alleviate the symptoms of keratosis pilaris, it is beneficial to adopt a tailored skincare routine.

• A regular and gentle cleansing.

  While cleansing the skin is essential, it is crucial to do so using gentle products that do not harm the skin barrier, which is already fragile in cases of keratosis pilaris. To achieve this, we recommend opting for a gentle and hydrating cleansing care, such as our palmarosa hydrating cleansing care. Thanks to its combination of vegetable oils and butters and its high superfat content, this solid soap helps you maintain the hydration of the skin layer and is ideal for skin seeking softness.

• An exfoliation once to twice a week.

  While all skin types can benefit from the application of an exfoliating treatment once or twice a week, those affected by keratosis pilaris particularly need it. Indeed, these products help toremove dead cells accumulated on the skin's surface, which contribute to the blockage of hair follicles. Moreover, exfoliating treatments assist in softening the epidermis and combating the roughness caused by keratosis pilaris. For a gentle scrub, we recommend our nourishing body scrub. This melting exfoliating gel, enriched with sweet almond oil and super lavandin essential oil, also contains micro grains of apricot kernels and has a triple action on the skin : nourishing, softening, and soothing.

• Daily hydration.

  Daily hydration of the skin is not exclusively for those with dry skin. In addition to protecting the epidermis from external aggressions and limiting water loss, the application of emollients helps to soften the skin and to reduce roughness. These properties are particularly beneficial in the context of keratosis pilaris.

  The use of plant oils and butters such as argan oil and mango butter is highly recommended. Their effects can also be enhanced by our body moisturising cream, a treatment designed for all skin types using only essential ingredients for its function. If you prefer a richer formulation, you can opt for our replenishing balm. Suitable for the whole family from birth, this treatment has been designed for dry to very dry and atopic-prone skin. It combines the replenishing action of ceramides and shea butter with a rebalancing postbiotic to provide a hydration boost and soothe the skin.

There is no need to treat keratosis pilaris as it is harmless to health. Of course, you can certainly seek to remove it for aesthetic reasons.

It is important to note that most treatments aim to alleviate the symptoms of keratosis pilaris, without completely eradicating them. Among the active ingredients studied in scientific research for their keratolytic properties, we can notably mention retinoids such as tretinoin and adapalene, azelaic acid, and calcipotriol, a derivative of vitamin D. The topical application of creams containing these ingredients can to some extent improve the appearance of keratosis pilaris but does not eliminate it.

An effective solution for combating keratosis pilaris is laser treatment. However, it should be noted that this technique is not suitable for pregnant women or individuals undergoing photosensitising treatment. Many aesthetic centres offer laser sessions with the aim of eliminating keratosis pilaris. The type of laser found in these centres can vary, it could be a Nd:YAG laser, a CO2 laser, or even an intense pulsed light laser. These different lasers have a comparable effectiveness on keratosis pilaris. While the results after several laser sessions are often satisfactory, they are unfortunately temporary. Indeed, when the sessions are stopped, a relapse is generally observed.

Hair removal and keratosis pilaris do not always go hand in hand, and a poor technique can quickly lead to the formation of ingrown hairs. To prevent this, we advise you to avoid electric epilators and waxing. Although these hair removal methods are convenient and popular for spacing out sessions, they promote the occurrence of ingrown hairs by pulling the hair directly from the bulb. It can happen that, hindered by an excess of keratin, the hair does not grow straight but curves into the epidermis and becomes ingrown. This then results in inflammation and a small red bump, similar to those caused by keratosis pilaris.

In the event of keratosis pilaris, it is generally recommended to use hair removal cream or laser hair removal.

The depilatory cream and laser are more recommended for individuals with keratosis pilaris. Indeed, the former neither alters the hair bulb nor the hair growth. The depilatory cream works by targeting keratin and softening the hairs, which fall out after a few minutes. The laser, effective in the long term, operates on the principle of selective photothermolysis. The infrared rays it emits target the melanin concentrated in the hair and transform into heat to destroy the entire follicle. Suitable for all phototypes, laser hair removal is however not possible in cases of very light hair, pregnancy, or if taking a photosensitising medication.

• SCHWARTZ R. A. & co. Keratosis Pilaris: A Common Follicular Hyperkeratosis. Paediatric Dermatology (2008).

• KHOPKAR U. S. & THOMAS M. Keratosis Pilaris Revisited: Is It More Than Just a Follicular Keratosis? International Journal of Trichology (2012).

• WANG J. F. & ORLOW S. J. Keratosis Pilaris and its Subtypes: Associations, New Molecular and Pharmacologic Causes, and Treatment Options. American Journal of Clinical Dermatology (2018).

• FELDMAN S. R. & al. Treatment of keratosis pilaris and its variants: a systematic review. Journal of Dermatological Treatment (2022).