Keratosis Pilaris (Chicken Skin): Causes and Gentle Care

Keratosis pilaris, often called chicken skin, is a common and harmless condition in which keratin builds up and plugs the hair follicles, causing rough, tiny bumps, usually on the upper arms, thighs, buttocks and sometimes the cheeks. It cannot be cured permanently, but gentle daily care with exfoliating moisturisers usually makes the skin smoother, while hard scrubbing tends to make it worse.

Many people in India notice these bumps in their teens and assume it is acne, an allergy or a sign of poor hygiene. It is none of these.

What does keratosis pilaris look like?

• Small, rough, pinpoint bumps that feel like sandpaper
• Most often on the back of the upper arms, front of the thighs and buttocks
• On the cheeks in children and teenagers, sometimes with redness
• Bumps may be skin coloured, red, or brown
• On Indian skin, each bump often leaves a small dark dot, which can make the skin look speckled, sometimes called strawberry skin
• Sometimes mild itching, especially when the skin is dry

It usually does not hurt. It tends to be worse in dry weather, in air conditioned rooms and in winter, and may improve in humid months.

What causes keratosis pilaris?

Keratin is a protein that forms the protective outer layer of the skin. In keratosis pilaris, extra keratin builds up and forms a plug around the opening of a hair follicle. Often a tiny coiled hair is trapped beneath it.

It is:

• Genetic, often running in families
• More common in people with dry skin, eczema, asthma or hay fever
• Common in children and teenagers, often improving in adulthood
• Sometimes worse during pregnancy or with weight gain

It is not caused by poor hygiene, diet or infection, and it is not contagious.

Is it keratosis pilaris or something else?

Condition	Key features
Keratosis pilaris	Rough, uniform tiny bumps on arms and thighs, not usually painful
Acne	Pimples, whiteheads and blackheads on face, chest and back, often oily skin
Folliculitis	Itchy or tender red bumps or pustules around hair follicles
Fungal acne	Uniform itchy bumps on chest, back and forehead, worse in heat and sweat
Phrynoderma	Rough bumps with dry skin, linked to nutritional deficiency

If you have itchy, uniform bumps on the chest and back that are worse with sweat, read our guide on fungal acne and Malassezia folliculitis. For acne on the back and body, see our article on back and body acne.

What helps keratosis pilaris at home?

The goal is to soften the keratin plugs and support the skin barrier, without irritating the skin.

Moisturise every day

• Apply a moisturiser within a few minutes of bathing, while the skin is still slightly damp.
• Moisturisers containing urea, lactic acid or salicylic acid gently loosen the keratin plugs. These are widely available in India in different strengths.
• Start with a lower strength and apply once a day. If the skin stings, use a plain moisturiser instead for a few days.

Bathe gently

• Use lukewarm water, not hot water. Hot baths strip the skin’s oils.
• Use a mild, soap free cleanser, and avoid harsh soaps and antibacterial washes.
• Keep baths and showers short.

Avoid scrubbing

Loofahs, scrub mitts, coarse scrubs, sugar and salt scrubs and ubtan rubbed hard on the skin can cause redness, dark marks and irritation, especially on brown skin. Gentle chemical exfoliation in a moisturiser is more effective and kinder to the skin.

Do not pick or tweeze

Picking at the bumps or trying to tweeze trapped hairs causes inflammation and dark marks that last much longer than the bumps.

Protect from dryness

• Use a moisturiser more often in winter and in air conditioned rooms.
• Wear loose cotton clothing to reduce friction.

How might a dermatologist treat it?

If home care is not enough, or the bumps are very red or dark, your dermatologist may consider:

• Prescription strength keratolytic creams or a different combination of exfoliating ingredients
• Topical retinoids to help normalise how skin cells shed (our retinol and tretinoin guide explains this group)
• A short course of a mild anti inflammatory cream for very red, itchy areas, only under medical supervision
• Chemical peels in selected cases
• Laser or light treatments for persistent redness or hair related bumps

Improvement takes weeks of consistent use, and the bumps tend to return if treatment stops. Treatment aims to control, not cure. Please do not use steroid creams from the chemist on your own. Long term steroid use on the skin causes thinning and other side effects, as explained in our article on topical steroid misuse.

What about the dark spots left behind?

On Indian skin, the dots of colour around each follicle can bother people more than the bumps. These are often post inflammatory hyperpigmentation, made worse by scratching, scrubbing and friction.

To help them fade:

• Stop scrubbing and picking.
• Continue gentle exfoliating moisturisers.
• Use sunscreen on exposed arms if you are outdoors a lot.
• Be patient, as dark marks can take months to fade.

Our article on post inflammatory hyperpigmentation and dark spots explains this in more detail.

Do diet, supplements or water intake help?

There is no strong evidence that any particular diet, supplement or drinking more water clears keratosis pilaris in healthy people. It is a genetic tendency in how the skin forms keratin, not a sign of a deficiency in most cases.

That said, a balanced diet supports overall skin health, and a doctor may check for nutritional problems if rough bumps come with other signs such as very dry eyes, poor night vision, weight loss or a restricted diet. Please do not start high dose vitamin A or other supplements on your own, because too much vitamin A can be harmful, especially in pregnancy.

Does it get better in some seasons?

Many people notice that keratosis pilaris improves in humid months and gets worse in dry winters, especially in North India, and in offices with strong air conditioning. Moisturising more often during these times can help.

Does keratosis pilaris affect children?

Yes, it is very common in children, often with red bumps on the cheeks and arms. It is usually mild and harmless. A simple routine of short lukewarm baths, a mild cleanser and a fragrance free moisturiser is usually enough. Check with a doctor before using exfoliating creams on young children, as some ingredients can sting or are not suitable for small children.

When to see a dermatologist

See a dermatologist if:

• The bumps are very itchy, red, painful or spreading.
• You are not sure whether it is keratosis pilaris, acne or an infection.
• Home care has not helped after a couple of months.
• The bumps are leaving dark spots that bother you.
• Your child has widespread rough skin with other concerns such as poor growth or night blindness.

Keratosis pilaris is harmless, but it can affect confidence, especially when wearing sleeveless clothes. Dr. Maria offers online consultations to confirm the diagnosis and help you build a gentle routine that suits your skin.