Overview

Keratosis pilaris (KP), often referred to as “chicken skin”, is a common and harmless skin condition that affects people worldwide.³ It appears as small, rough bumps that usually form on the upper arms, thighs, cheeks, or buttocks. Although it poses no serious health risks, it can be a persistent source of cosmetic disturbance and discomfort. The condition is primarily caused by a buildup of keratin, a natural protein found in the skin, which clogs the openings of hair follicles.³ Extensive research has proven that maintaining optimal skin hydration is a powerful method of managing the condition effectively. Understanding this relationship is essential if you are seeking to improve both the texture and appearance of your skin when suffering from KP. 

Keratosis pilaris

Keratosis pilaris develops when excess keratin builds up and forms a plug that blocks the hair follicle.³ This results in the formation of small, sometimes red or inflamed, bumps. These bumps often have a sandpaper-like texture and may be more pronounced in colder months when humidity levels are low and the skin tends to be drier.⁴ 

This condition most commonly affects children, teenagers, and young adults.⁴ It is often seen in individuals with a family history of KP or other skin conditions such as eczema or ichthyosis vulgaris.³ 

Although KP is usually asymptomatic, it can cause itchiness and mild irritation, especially when the skin becomes excessively dry. While the bumps are painless, their rough texture and uneven appearance have been shown to be common causes of self-esteem issues and affect confidence, particularly when visible on exposed areas of the body. 

Dry skin and keratosis pilaris

Dry skin does not cause KP directly, but it plays a significant role in worsening its symptoms. When the skin lacks adequate hydration, it loses elasticity and the ability to properly shed dead skin cells.⁴ As a result, keratin accumulates more easily in the hair follicles, worsening the appearance of the bumps. Dryness can also lead to increased irritation, redness, and heightened texture of the skin in areas already affected by KP. 

Environmental factors

Environmental factors, such as cold weather, low humidity, and frequent exposure to hot water, can strip the skin of its natural oils and contribute to dryness.¹ In a similar way, using harsh soaps or over-exfoliating the skin can damage the skin barrier, making it even harder for the skin to retain moisture and control keratin clogs.² For this reason, it is crucial to consider skin hydration as a fundamental component to the management of KP. 

Hydration in managing keratosis pilaris

Hydration is key to an effective KP management strategy. Hydrated skin functions better as a protective barrier, efficiently regulating keratin production and allowing the skin to shed dead cells wihìthout causing blockages.¹ This leads to a smoother, more even skin texture and a noticeable reduction in the roughness and bumps associated with KP. 

Two main types of hydration play a role in managing KP: internal hydration and external hydration. Internally, drinking enough water each day can help ensure that your skin cells receive the moisture they need to function properly.³ Skin that is hydrated from within is less likely to become flaky or irritated, which can reduce the severity of KP symptoms. Externally, applying topical moisturisers is also very effective.¹ Moisturisers that contain urea, lactic acid, glycerin, or alpha hydroxy acids (AHAs) are particularly useful.² These ingredients draw moisture into the skin and help break down the keratin buildup responsible for the bumps. Products specially formulated for rough and bumpy skin have shown substantial success in softening the skin and improving texture when used consistently. These creams gently exfoliate the skin while moisturising it, helping to restore a smoother surface over time. 

Hydration strategies

To keep the skin well-hydrated and minimise KP flare-ups, it is essential to adopt a daily skincare routine that prioritises moisture retention. Start by limiting showers or baths to ten minutes or less and use warm, but not too hot, water.⁴ Hot water can unintentionally remove skin essential oils and exacerbate dryness. Also, it is recommended to use a mild, fragrance-free cleanser to avoid products that contain alcohol or other drying ingredients.⁴ After bathing, gently pat your skin dry with a towel, leaving a bit of moisture behind. This time is suggested as when to apply the moisturiser, as damp skin absorbs products more effectively. It is best to choose a thick, emollient-rich cream or ointment that can seal in moisture and protect the skin barrier.⁴ It is important to make sure to reapply the moisturiser as needed throughout the day, especially if your skin feels dry or tight. 

Another effective strategy is to use a humidifier in your home, particularly during the winter or in arid climates.² Dry indoor air can significantly reduce your skin’s moisture levels, so maintaining a mildly high humidity level can help prevent excessive dryness. Wearing loose-fitting clothes can also reduce friction and irritation on areas affected by KP.²

In some cases, gentle exfoliation can complement hydration; using a soft washcloth or a mild exfoliating scrub a few times a week can help remove dead skin cells.³ It is essential, however, not to overdo this as vigorously scrubbing and using rough exfoliants can damage the skin and worsen the condition. 

Advanced management and when to seek professional support

In most cases, KP can be effectively managed at home through consistent hydration and skincare practices. However, if the condition does not improve after several weeks of dedicated care or if it is causing significant discomfort or emotional distress, it would be wise to consult a dermatologist. You could be recommended with stronger prescription treatments such as retinoids or customised therapy plans.¹ Medical professionals can also help rule out other skin conditions that may mimic KP, such as folliculitis. 

Online resources often provide at-home remedies, which may sound appealing, such as apple cider vinegar, coconut oil, or baking soda.³ While some of these treatments have been helpful to certain individuals, they may not suit everyone and could potentially cause irritation, particularly for those with sensitive skin.³ If this seems like something you want to try, it is always best to test a small area first or discuss these options with a healthcare professional before using it extensively. 

Conclusion

Although not curable, KP symptoms can be significantly reduced with the proper skincare routine, especially one that emphasises hydration. Moisturising regularly, avoiding excessive dryness, and protecting the skin from environmental stressors can make a visible difference in the appearance and texture of the skin. Understanding the link between KP and dry skin can help you take proactive steps to care for your skin and regain confidence in your appearance. Hydration is a foundational strategy for smoothing KP-prone skin and a significant step towards better skin health.

FAQs

Why does keratosis pilaris get worse in winter?

During colder months, humidity levels drop, and indoor heating systems dry out the air. This lack of moisture makes the skin lose its natural oils, aggravating dryness and making the condition more noticeable and uncomfortable. The skin barrier also becomes more fragile when it is dry, which can make keratin buildup more prominent and persistent. 

Is keratosis pilaris contagious?

No, keratosis pilaris is not contagious. It is largely influenced by genetics and skin type, not bacteria, viruses, or fungi, so there is no risk of passing it onto others.³ 

Does gluten intolerance cause keratosis pilaris?

There is no concrete evidence that gluten intolerance causes keratosis pilaris.³ While some rashes associated with gluten sensitivity may resemble KP, they are distinct conditions and should be diagnosed and treated through the guidance of healthcare professionals. 

Will keratosis pilaris ever go away completely?

For many people, KP fades over time, often improving by the late twenties or early thirties. In some cases, it remains a lifelong skin type, but while it may not go away, it can become much less noticeable with regular, gentle care and proper hydration.

Does having keratosis pilaris mean something is wrong with my health?

No, KP is not a sign of an underlying illness. It is completely harmless, though it can be annoying and frustrating to deal with. It is, however, not linked to infections or dangerous skin conditions, and it is not contagious.