Introduction

Keratosis pilaris (KP) is common, yet not many people pay attention to it as it is a cosmetic concern. In most cases people who experience Keratosis pilaris, the affected body region can resemble chicken skin - a rough area filled with bumps around the skin surface.^1,2 It often affects the following region of the body; upper arms, thighs and cheeks. Keratosis pilaris is related to genetics through heredity or mutation of genes, and can be linked to other skin conditions or metabolic conditions like obesity.³ This appears to be common in adolescents with 50-80% of their population being affected but keratosis pilaris improves with age.¹

Before diving into diet and keratosis pilaris, discussing skin health and factors that may affect the skin is important. Healthy skin serves as a barrier that protects the body against pathogens and water loss.⁴ The key factors influencing skin health include:

• Lifestyle decisions:  Decisions made regarding diet, hydration and sleep quality as they may influence skin function^5,6
• Environmental factors: exposure to UV radiation, pollution and harsh climates can cause damage to skin integrity⁶
• Other conditions such as chronic inflammations for example eczema and hormonal imbalances may worsen skin problems^1,5 

Here are some points that highlight how diet may influence KP:

• Food rich in sugar and dairy products can worsen KP, while anti-inflammatory diets like omega-3s and antioxidants can help reduce its symptoms⁷
• Nutrient deficiencies like low vitamin A is linked to KP, although the means by which this occurs remain unclear⁸

Understanding Keratosis Pilaris

Keratosis pilaris may be a chronic issue but it often resolves with time without treatment. The intention behind treating KP is to improve aesthetic qualities. KP has no cure and most people may have confused it to be an infectious disease, but on the contrary KP can not be transmitted.⁸ A good understanding of KP is necessary to maintain positive attitudes towards the condition and help people avoid triggers.

The role of diet in skin health

Diet plays a key role in skin health by providing nutrients such as essential vitamins and fatty acids for the production of collagen, antioxidant defense, and skin protection.⁹ When the body is deficient of these important nutrients it may lead to dry skin, slow wound healing, and increase the risk to the damages caused by ultraviolet light.¹⁰ 

How do nutrients supplied by our diet support skin structure and function?

• Vitamin C stimulates collagen production which provides support for the skin and aids  in wound healing¹¹
• Vitamin A, C, and E provide antioxidant defense to the skin as they neutralise free radicals and protect the skin against UV light damage¹² 
• Linoleic acid (LA) and α-linolenic acid (ALA) improve skin hydration¹²
• Trace elements like zinc, copper, and magnesium help regulate the formation of keratin and aid wound healing¹² 

Why is hydration and a balanced diet important?

Staying hydrated and eating foods rich in antioxidants and fiber such as fruits and vegetables helps maintain the moisture and pH of the skin.⁹ Fatty fish and nuts have a low glycemic index and contain omega-3 that mitigate over production of sebum and inflammation.¹⁰ Additionally, the lack of Vitamin B6,B12, and folate may impair skin health.¹³

Nutrients that may improve keratosis pilaris

There are varieties of nutrients that are supplied by diet. The following nutrients can be obtained from our diets and may help to reduce KP. 

• Vitamin A: Found in fish, egg, carrots, sweet potatoes, dark green vegetables and other orange vegetables containing beta-carotene which is a precursor of vitamin A. This vitamin is essential in regulating the process of keratin formation and encourages the removal of dead skin cells, which helps to reduce follicular plugging -  a characteristic of keratosis pilaris^14,15
• Vitamin E: vitamin E is an effective antioxidant obtained from nuts, seeds, and green leafy vegetables. It protects the skin membrane from damage from oxidative stress caused by free radicals. Because of its antioxidant properties it helps reduce inflammation and support skin integrity^15,16
• Vitamin D: vitamin D is endogenously synthesised with the aid of sunlight and can also be found in dairy products and cereals. Vitamin D contributes to skin health by regulating immune response, maintaining the skin barrier function and reducing inflammation which may indirectly benefit keratosis pilaris¹⁷
• Omega-3 fatty acid: the omega-3 fatty acids can be found in fish oil, for example oils from salmon, mackerel etc., flaxseeds and walnuts. Omega-3 has a strong anti-inflammatory effect that may alleviate inflammation linked with keratosis pilaris^18,19
• Zinc: Zinc is found in dietary sources like meat, legumes, nuts and wholegrains. Zinc has antioxidants and anti-inflammatory properties, these enabled it to be effective in various skin disorders. It also plays a role in skin repairs and immune regulation. Zinc supports keratinocyte growth and reduces skin inflammation, making it likely to improve keratosis pilaris^12,20

Foods which worsen keratosis pilaris

• Highly processed foods such as packaged snacks, ready made meals, foods filled with preservatives and additives have shown to increase inflammation of the body. The presences of additives and unhealthy fats in foods worsen keratosis pilaris symptoms by promoting inflammation in the body system and disturbing the function of the skin. Health experts have advised that the intake of processed foods should be minimized to help manage skin conditions like keratosis pilaris²¹
• Foods containing high sugars can worsen Keratosis pilaris. Examples of such foods are candies, sodas, baked products, and refined carbohydrates. When eaten, this spikes blood sugar levels and causes sugar molecules to attach to skin proteins, impairing skin structure and promoting inflammation. Choosing whole grains and fruits with natural sugars is a healthier alternative for those with KP^21,22
• In some individuals, dairy products especially those high in fat and containing artificial additives can worsen keratosis pilaris. Milk proteins like casein and whey can trigger inflammation, especially in people with lactose intolerance or milk sensitivities. Additionally, hormones in dairy may influence sebum production and keratin buildup, leading to more pronounced keratosis pilaris symptoms^21,22
• Gluten may promote inflammation and immune responses that worsen skin conditions. Foods that contain gluten, such as those made from wheat, barley and rye, can increase Keratosis pilaris in individuals with gluten sensitivity²²
• Alcohol and caffeinated beverages can dehydrate the skin, causing the skin to become dry and have a rough texture which are characteristics of keratosis pilaris. These substances make it hard for the skin to repair itself and maintain a healthy function. Reducing alcohol and caffeine intake is recommended to help keep the skin moisturised to manage keratosis pilaris²²

In summary, avoiding highly processed foods, sugary snacks and drinks, dairy, gluten, and excessive alcohol or caffeine can help manage and potentially improve keratosis pilaris symptoms. These dietary adjustments, supported by clinical observations and health expert recommendations, contribute to better skin health and reduced inflammation.

Conclusion

Keratosis pilaris (KP) is a common follicular disorder that is made up of keratin buildup, it has no definitive cure, but emerging studies suggest that diet may modulate its severity through inflammatory pathways and nutrient availability. While the direct link between diet and keratosis pilaris remains unproven, nutritional strategies show promise in managing symptoms alongside topical treatments. Anti-inflammatory diets are broadly recommended to support skin health, although individual responses may vary. Health experts have stressed the importance of hydration, whole foods, and targeted supplementation in improving skin function and health. In summary, while diet alone cannot eradicate keratosis pilaris, optimising nutrient intake and reducing pro-inflammatory foods may alleviate symptoms, particularly in individuals with underlying metabolic or immune imbalances.