Inflammatory
Keratosis pilaris
Keratosis pilaris, often called "chicken skin," is a very common and harmless condition that causes tiny rough bumps, usually on the upper arms and thighs. It is not contagious and not dangerous.
Reviewed by Raashid Haque, MD, board-certified dermatologist
For education only. This guide does not diagnose or treat any condition.
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Urea and lactic acid soften the plugs of keratin that make the bumps and smooth rough texture.
Look for
- Urea (often about 10% for body, higher for thick heels) or lactic acid
- Fragrance-free
- Cream or lotion base that suits your skin
Full details, cautions and sourcesAvoid
- Using on broken, raw, or very inflamed skin
- Combining with scrubs or other exfoliating acids
- Using on the face unless the product is made for it
These are products Dr. Haque has reviewed and recommends for different reasons. Unless a product is clearly marked 'Affiliate link,' it is not one. Most are not.
Food and lifestyle may play a part in Keratosis pilaris too
Anti-inflammatory eating and lifestyleLearn about Keratosis pilaris
Keratosis pilaris (KP) happens when keratin, a protein that helps protect the skin, builds up and partly plugs the openings of hair follicles. The result is many tiny, rough bumps that can feel like sandpaper or goosebumps.
Who gets it: KP is one of the most common skin conditions. Studies suggest it affects a large share of teenagers and a smaller share of adults. It often runs in families and usually starts in childhood or the teen years.
How it looks: Bumps are most often on the outer upper arms and the front of the thighs. They can also appear on the buttocks and, in children, on the cheeks. Some people have only skin-colored bumps. Others have redness around them. On lighter skin, the bumps may look pink or red. On brown and Black skin, they may look darker brown or gray-brown instead of red, and redness can be hard to see. Darker marks can linger after irritation.
Link to dry skin and atopy: KP is often more noticeable when skin is dry and is seen more often in people with eczema (atopic dermatitis), asthma, hay fever, or very dry skin conditions such as ichthyosis vulgaris.
Course: It often looks worse in winter and better in summer. For many people it improves with age, but it can last for years.
What it is not: It is not an infection, not an allergy, not caused by poor hygiene, and not contagious. You cannot catch it or pass it on.
Self-care
What it is
Using mild cleansers, warm rather than hot water, and a regular moisturizer, often applied soon after bathing, to keep skin from drying out.
Often considered when
Bumps are worse in dry weather, skin feels tight or itchy, or KP happens alongside eczema or dry skin.
Less suitable or needs caution when
Heavy or fragranced products may bother people with sensitive skin or contact allergies. Very thick products can bother people who are prone to clogged pores or folliculitis.
What to watch for
Stinging, new redness, or itching after a product, which may mean the product does not suit your skin.
How long to judge it
Skin often feels smoother within a few weeks. Bumps may only soften, not disappear.
Questions to ask
- Which kinds of cleansers and moisturizers fit my skin type?
- Could dry skin or eczema be making my KP look worse?
What it is
Lightly rubbing the skin with a soft washcloth or similar tool to loosen dead skin cells that sit on top of the bumps.
Often considered when
The main concern is rough texture. It is often paired with a moisturizer.
Less suitable or needs caution when
Skin is inflamed, broken, very dry, or sensitive. Hard scrubbing can backfire, especially for people with eczema.
What to watch for
Redness, stinging, or new bumps from scrubbing too hard. On brown and Black skin, too much friction can leave darker marks that last for months.
How long to judge it
Texture may look better within weeks, but it often returns if the routine stops.
Questions to ask
- How gentle is gentle enough for my skin?
- Could scrubbing leave dark marks on my skin tone?
What it is
Because KP is harmless, many people choose to leave it alone, or to focus only on basic moisturizing.
Often considered when
The bumps do not bother you, are not itchy, or treatment feels like more effort than it is worth.
Less suitable or needs caution when
You feel self-conscious, the skin itches or is inflamed, or you are unsure the bumps are KP.
What to watch for
New symptoms such as pain, spreading rash, or signs of infection.
How long to judge it
KP often improves slowly with age, though timing is unpredictable.
Questions to ask
- Is leaving this alone a reasonable choice for me?
- What changes would mean I should come back?
Over the counter
What it is
Moisturizers containing urea, a substance that holds water in the skin and, at higher strengths, also softens thick, rough skin. Several are sold without a prescription.
Often considered when
Skin is dry and rough as well as bumpy.
Less suitable or needs caution when
Skin is broken, cracked, or very irritated, where urea can sting. Use on babies and young children is something to discuss with a clinician first.
What to watch for
Stinging or burning, especially on dry or scratched skin, and redness.
How long to judge it
Many people judge results after several weeks of steady use.
Questions to ask
- Is a urea product reasonable for my skin?
- Should I expect stinging, and what would mean I should stop and call you?
What it is
Lotions and creams with exfoliating acids. Lactic acid (an alpha hydroxy acid) loosens dead skin cells. Salicylic acid (a beta hydroxy acid) helps break up keratin plugs.
Often considered when
Rough bumps persist despite basic moisturizing.
Less suitable or needs caution when
Skin is irritated or eczema is active. Salicylic acid is a concern over large areas of skin, in pregnancy, and in young children, so it is worth checking with a clinician first. Sensitive skin may not tolerate acids well.
What to watch for
Dryness, peeling, stinging, and sun sensitivity. Irritation can leave dark marks on brown and Black skin.
How long to judge it
A few weeks to a couple of months to judge. Results usually fade if the products are stopped.
Questions to ask
- Is an acid product suitable for me, or would it irritate my skin?
- Which of these would you suggest I ask a pharmacist about?
Prescription creams and gels
What it is
Creams or gels related to vitamin A, such as tretinoin, adapalene, or tazarotene, that help skin cells shed more normally so keratin is less likely to plug follicles.
Often considered when
Bumps persist despite moisturizers and gentle exfoliation. A clinician may discuss this option.
Less suitable or needs caution when
Pregnancy or trying to become pregnant (clinicians usually avoid or limit retinoid use), very sensitive or eczema-prone skin, or past irritation from retinoids.
What to watch for
Dryness, redness, peeling, and sun sensitivity. Irritation can cause dark marks on brown and Black skin.
How long to judge it
Often at least a few months to judge. Bumps can return after stopping.
Questions to ask
- Is a retinoid reasonable for me, given my skin and any pregnancy plans?
- How can I lower the chance of irritation or dark marks?
What it is
Prescription anti-inflammatory creams that may calm redness or itch when KP is inflamed.
Often considered when
Bumps are red, itchy, or irritated, or eczema is also present. They help redness and itch but do not remove the bumps themselves.
Less suitable or needs caution when
Long-term use over large areas, or on thin skin. Not a main treatment for plain, non-inflamed KP.
What to watch for
Skin thinning, stretch marks, and lighter patches, especially with prolonged use. Follow what your clinician tells you.
How long to judge it
Redness and itch may settle within days to a couple of weeks. Bumps usually stay.
Questions to ask
- Is my redness from KP, eczema, or both?
- How would we limit the amount of steroid I need?
Procedures
What it is
In-office treatments, such as pulsed dye laser or intense pulsed light, that target redness, and laser hair removal, which may reduce ingrown hairs and bumps in some people.
Often considered when
Redness or bumps bother someone a lot and simpler steps have not helped enough.
Less suitable or needs caution when
Active infection, recent tanning, or a tendency toward scarring or dark marks. Settings must be chosen carefully for brown and Black skin, since some lasers carry a higher risk of color changes.
What to watch for
Temporary redness, swelling, blistering, and darker or lighter marks. Cost can be high and insurance often does not cover it.
How long to judge it
Usually several sessions over months. Improvement is often partial, and results vary from person to person.
Questions to ask
- Do you have experience treating my skin tone with these devices?
- What results are realistic, and what would it cost?
KP does not have a single trigger, but some things are known to make bumps more noticeable:
- Dry air and cold weather, which is why many people see flares in winter
- Long, hot showers or baths, which can dry the skin
- Harsh soaps and rough scrubbing
- Friction and shaving, which can irritate the bumps and cause redness or ingrown hairs
- Tight clothing that rubs on the arms or thighs
- Self-tanners, which can make the bumps stand out more
- Underlying dry skin or eczema, which can make KP look worse
Many people notice it is milder in humid or warm seasons. Family history plays a large role, so some people have it no matter how carefully they care for their skin.
| Topic | Evidence | What it means |
|---|---|---|
| Humidity and dry winter air | Early | Many people see KP flare in dry months, and adding moisture to indoor air with a humidifier is often suggested. Good studies of this are limited. |
| Diet | Anecdotal | No specific food has been shown to cause or cure KP. Some people report changes, but this is not backed by good research. Restrictive diets can cause harm and are not advised for KP. |
| Weight and metabolic health | Early | KP has been linked with higher body weight in some studies, but the connection is not fully understood and weight loss is not a proven treatment for it. |
| Emotional impact | Promising | Even a harmless condition can affect confidence, such as choosing sleeves over short sleeves. Research on skin conditions and wellbeing suggests that talking about it, and getting support when it weighs on you, is worthwhile. |
Read: Anti-inflammatory eating
Avoid very restrictive diets, especially for children, unless a clinician is guiding you.
Keratosis pilaris ·
When to get care soon
KP itself is usually harmless. Contact a clinician soon if you notice:
- Bumps that become painful, swollen, warm, or filled with pus, or crusting and oozing, which can be signs of infection
- Fever along with a new skin change
- A rash that is spreading quickly, blistering, or very itchy and keeps you from sleeping
- Bumps that leave scars, deep marks, or open sores
- Bumps on the face, scalp, or eyebrows that come with hair loss or scarring
- Skin changes that do not match the usual look of KP, so you are not sure what you have
- No improvement after a steady, gentle routine, or a skin reaction to a product
- A baby or young child with widespread rough skin, very dry or scaly skin, or frequent eczema
About the reviewer
Raashid Haque, MD
Board Certified Dermatologist · Charlotte, NC
- 25+ years of clinical experience
- Dermatology at University of Oklahoma - Chief Resident
- Internship at Baylor College of Medicine
- LSU School of Medicine Shreveport - Valedictorian, AOA