Overview

Keratosis Pilaris (KP) is a skin condition caused by the buildup of keratin that is blocked in hair follicles, resulting in tiny red bumps on the skin's surface. It is an asymptomatic condition that does not cause pain or similar symptoms, but it affects the appearance of the skin.¹ This skin condition affects the cosmetic appearance of the skin as it can commonly appear on the upper arms, cheeks and buttocks. A rough, bumpy texture is visible on the skin that sometimes appears to be red and inflamed or dry and rough-textured. This condition can be misdiagnosed as dermatitis, folliculitis, or milia due to its similar clinical appearance. KP could be improved using many treatment methods such as moisturisers, exfoliants and laser therapy.² The first line of management of KP is through skincare, specifically a moisturiser that is effective in treating KP symptoms. In this article, we will explore the best ingredients to look for when choosing a moisturiser for managing keratosis pilaris.

Why moisturising is crucial in KP management

KP can sometimes present with dry, flaky skin that creates a rough texture, and moisturising is crucial for reducing skin dryness. Ceramides are a key ingredient found in moisturisers that hydrate the skin, and are not only beneficial for KP but also known to improve conditions like atopic dermatitis.³ Ceramides are lipids that make up the outer layer of the skin, and this protective layer helps protect the skin against irritants and loss of water. In conditions like KP, the skin barrier is broken, making the skin dry and flaky; therefore, using a ceramide-based moisturiser improves skin barrier function and the dryness of the skin is visibly reduced.⁴ There are many benefits of regularly moisturising the skin in KP and similar skin conditions. These include reducing redness, improving the texture of bumps and hydrating the skin. 

As well as barrier-improving ingredients, exfoliating components of moisturisers are also important in managing KP. Moisturisers that contain urea or salicylic acid help with exfoliating the dead skin cells, which helps reduce the textured look of the skin. A study was conducted with people affected by KP; they were introduced to moisturisers containing 20% urea, and within the first weeks of regular use, improvements in skin smoothness and texture were visible. ⁵ It is important to regularly apply moisturiser to the skin to manage the appearance of KP and help the skin have a smooth texture. Each moisturiser has specific ingredients that target each symptom of KP.

Key ingredients to look for in moisturisers for KP

Exfoliation 

As mentioned before, exfoliating ingredients are key to look for in moisturisers and these include lactic acid, salicylic acid and urea. These ingredients gently exfoliate the surface layer of the skin, which clears out the dead skin cells and hydrates the skin. These ingredients are used in low concentrations, ranging from 4% to 10% in moisturisers that are non-prescription.⁶ A study was carried out to compare the use of 5% salicylic acid and 10% lactic acid by people who are affected with KP, and results showed that lactic acid reduced bumps on skin at a higher rate.⁷ There is various clinical evidence that supports the fact that exfoliation ingredients are important to soothe the skin and clear the bumps that accompany KP. These types of moisturisers are available over the counter in pharmacies and drugstores, making them easily accessible to people who are affected by skin conditions.

Hydration 

Ingredients that hydrate the skin, such as hyaluronic acid, aloe vera and glycerin, are crucial in managing KP symptoms. Clinical efficacy of hyaluronic acid is known to dermatologists; therefore, almost all moisturisers contain hyaluronic acid. It provides deep moisture to the skin, improving symptoms of dryness. Nevertheless, a clinical study proved that using hyaluronic acid on patients affected with KP shows gradual improvement of skin roughness and redness after 24 weeks.⁸ There is not much scientific evidence to support that aloe vera will treat KP symptoms; however, it is a natural ingredient that may soothe irritated red skin. 

Barrier strengthening 

Barrier repairing ingredients are also key in managing KP, and these are ingredients such as ceramides, shea butter and colloidal oatmeal. They work by restoring and nourishing the skin and protecting the skin barrier. Shea butter is rich in fatty acids, which are useful in restoring the lipid layer of skin. These lipids keep the skin barrier strong, which is broken in KP.⁹ They also reduce the water loss in the skin, keeping the moisture in the skin. Overall, this ingredient supports the skin's natural barrier function; however, it does not directly treat the keratin buildup caused by KP. Therefore, this ingredient should be used in combination with exfoliating ingredients. Another natural ingredient to use is colloidal oatmeal, which directly relieves symptoms of itchiness and soothes the skin not only in KP but in conditions like eczema, erythema and skin rashes.¹⁰ Again, this ingredient does not directly get rid of keratin buildup; therefore, it should be paired with other ingredients for a high-strength treatment. 

How to use moisturisers effectively for KP

For an effective treatment of KP, moisturisers should be used correctly by choosing the right ingredients based on the symptoms you have. The frequency of application of the moisturiser is very important, as moisturisers with high concentrations of exfoliants should not be used every day, as this will over-exfoliate the skin, leading to a broken skin barrier. Exfoliating a couple of times a week should be enough; however, moisturisers with hydrating ingredients could be used on a day-to-day basis after showering. Sun protection is very important when using high concentrations of exfoliating ingredients, as it can make the skin more susceptible to sunburns.

Additional tips for managing KP

There are other ways of managing and treating KP, and some of these include changing lifestyle choices. For example, you should use fragrance-free and non-comedogenic cosmetic products on your skin; otherwise, products can worsen KP symptoms. Although moisturisers have been shown to manage and treat KP, chemical peels using very high concentrations of exfoliating ingredients and laser therapy are alternative treatment methods. Laser treatments are done using the following types of lasers: alexandrite, Nd: YAG and pulsed dye. ¹¹ These types of lasers target the hair follicle in the skin, leading to loss of hair, which reduces the chances of keratin buildup in the hair follicle. 

FAQs

What moisturiser should I use for keratosis pilaris?

A cream or lotion that contains either salicylic acid, lactic acid or ceramides is one of the options. 

Is hyaluronic acid good for keratosis pilaris?

Hyaluronic acid has been proven to be effective at managing KP.

Can you use retinol on keratosis pilaris?

Retinol can be used; however, it is not suitable for everyone and is not commonly used.

What aggravates keratosis pilaris?

Winter months and dry skin can trigger KP. 

What percentage of urea is good for keratosis pilaris?

Anything up to 20% is considered a good concentration of urea. 

What does niacinamide do for keratosis pilaris?

Niacinamide could also be used, as it is an alternative for strengthening the skin barrier. 

What can be mistaken for keratosis pilaris?

KP can be misdiagnosed with other skin conditions like eczema, milia and folliculitis. 

What not to use on keratosis pilaris?

Scrubbing the skin and using abrasives can damage and irritate the skin.

Summary

Moisturisers do play a key role in managing KP; however, it is important to choose the right ingredients. A moisturiser that contains at least one type of exfoliating ingredient, one type of barrier strengthener and a hydrating ingredient would be beneficial at treating all KP symptoms. Frequent application of moisturiser is also important, as consistency will lead to improvement of the skin condition. If there is no improvement in the appearance of KP after using moisturisers, then you can opt for alternative methods such as laser therapy; however, this is a costly treatment method that requires a professional to treat you. On the other hand, using a cream or lotion regularly is cost-efficient and easily accessible.