S K I N / D E R M AT O L O G Y
KERATOSIS PILARIS www.aestheticmed.co.uk
KP is caused by a disorder of
keratinisation of the lining of the
upper part of the hair follicle. Small plugs
of keratin from dead skin cells block the
hair follicles, instead of the scales exfoliating,
causing an unsightly, rough, spotty appearance.
In-growing hairs may occur in the plugs.
In more than half of the cases it is genetic
(autosomal dominant inheritance), but
otherwise the causes are not fully
understood
The rough
with the smooth
Dr Sarah Norman on how to manage keratosis pilaris in your aesthetic practice
K
eratosis Pilaris (“KP”), or chicken skin arms as it is KP is common on the upper outer arms and thighs but can
commonly known, is a troublesome condition of all also affect the face, buttocks, hands or, in fact, any part of
ethnicities, occurring in one in three adults, and over the body where there are hair follicles. The distribution is
half of all adolescents. Affected skin is rough and always symmetrical. Occasionally the skin can be itchy, but
has the appearance of permanent goose bumps. the condition itself is quite harmless. It tends to be worse in
KP is caused by a disorder of the winter months.
keratinisation of the lining of the There are a number of common types
upper part of the hair follicle. Small of KP including KP rubra (red bumps),
plugs of keratin from dead skin cells KP alba (bumps which are not inflamed),
block the hair follicles, instead of hyper-pigmented KP (brown spots)
the scales exfoliating, causing an and KP rubra faceii (known as KPRF, a
unsightly, rough, spotty appearance. reddish rash on the cheeks, like rosacea).
In-growing hairs may occur in the An uncommon type is KP atrophicans
plugs. In more than half of the cases where loss of hair and small scar-like
it is genetic (autosomal dominant depressions can occur. Eyebrow KP
inheritance), but otherwise the causes Diagrammatic representation of keratosis pilaris (known as Ulerythema Ophryogenes) is
are not fully understood. with blocked hair follicles one manifestation of this.
40 Aesthetic Medicine • May 2016
S K I N / D E R M AT O L O G Y
www.aestheticmed.co.uk KERATOSIS PILARIS
KP Rubra Faceii (KPRF) Ulerythema Ophryogenes
(Eyebrow KP)
Treatment for KP on body skin is not absolutely necessary,
but is often sought for cosmetic reasons. To begin with I
advise avoiding using solid soap (which may irritate the skin
and exacerbate dryness) and also avoid heavy moisturising
creams (which can reduce the skin’s natural exfoliating
cycle). Encouraging exfoliation (for example, with plastic
exfoliating gloves for the body, or a granular exfoliator) will
Keratosis Pilaris
improve affected body skin.
If symptoms persist, topical creams containing chemical protection is similarly paramount. In my practice I find
exfoliators (to help to slough off the skin) can be very thermo-coagulation to be a very effective procedure in
effective. In addition, topical retinoids have a number of reducing the redness associated with KPRF.
beneficial effects: restore natural hydration, Aesthetic practitioners are likely to frequently encounter
increase cell turnover, repair damaged this troublesome skin disorder in their clinical practice.
keratinocytes (epidermal cells) and they also Although it is a life-long condition, providing sound advice
stimulate collagen/ elastin. on management will undoubtedly be rewarding for both
My personal choice is the Oraser Body patient and practitioner. AM
Emulsion Plus by ZO® Skin Health, which
contains retinol, urea, exfoliating plant
enzymes, the anti-oxidants Vitamins A, C and
E, and DNA repair agents. It also treats the
pigmentation, inflammation and dryness which
often accompanies KP. In my clinical practice I
have found it successful in providing relief for
my patients.
Specific subtypes of KP can require further
attention. For example, Ulerythema Ophryogenes
(where the eyebrows are affected) is exacerbated
by UV radiation and, given that loss of hair can
occur, sun protection is particularly important.
In KPRF (rosacea-type rash on cheeks), sun
KP on the knee
KP on the upper arm Pigmented KP
>> Dr Sarah Norman BM BS BMedSci (Hons) DRCOG MRCGP MEWI MBCAM, has been in private practice
for over eighteen years, and is now Clinical Director at BrightNewMe, a facial aesthetics and skincare
clinic in Altrincham, Cheshire. She has a special interest in aesthetic dermatology, having a strong
belief in improving the underlying quality of patients’ skin before they consider non-surgical
treatments. She is Chair of the Trafford Division of British Medical Association.
Aesthetic Medicine • May 2016 41
