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Image of a strawberry representing strawberry skin.

Strawberry skin – how to treat keratosis pilaris

Written by
Chloë James

Some people call it “strawberry skin” or “chicken skin”, but whatever you know it as, the best thing to call keratosis pilaris is annoying. Nicknamed for the rough red or brown bumps it creates across our arms and legs, the skin condition affects nearly 50 per cent of the adult population – but there’s still a lot of uncertainty about why we get it and how to treat it.

For anyone eager to smooth out these stubborn rough patches, this makes for a frustrating experience. And while it’s nice to know you’re not alone, the fact that it impacts so many people doesn’t lessen its ability to knock your confidence. Thankfully, there are ways to make the condition easier to manage (even if we can’t get rid of it completely).

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How do I know I have keratosis pilaris?

If you’ve ever noticed red or white goosebump-like patches across the upper arms, legs, buttocks, or cheeks, odds are its keratosis pilaris. The condition is infamously stubborn – and can have a huge impact on your confidence.

Sometimes, it’s confused with acne. Both are equally irksome, so it’s an easy mistake to make. A strong indicator that it’s keratosis pilaris, however, is the length of time you’ve had the condition. Acne comes and goes, but keratosis pilaris tends to stick around all year-long.

It also tends to be relatively painless. While acne can be sore to the touch, the most irritating part of keratosis pilaris is occasional dryness. This is because acne is filled with pus and bacteria. Keratosis pilaris, on the other hand, is just a solid build-up of keratin (which also means you can’t pop it like acne).

What causes keratosis pilaris?

Keratin lies at the root of everyone’s keratosis pilaris. Literally. Our bodies naturally produce keratin to strengthen hair, nails, and skin, but sometimes it produces too much and plugs up the hair follicles from the root. And when this reaches the surface, we get keratosis pilaris.

Some people get it, some people don’t – but we don’t really know why. Nobody’s pinpointed what separates those whose follicles do get blocked from those whose don’t. Researchers have theorised that it has something to do with a hair follicle disorder, or that it’s linked to our hormones. For now, however, we’ll just call it luck of the draw.

What we do know is that it usually crops up for the first time before the age of ten. There seems to be a genetic factor, as it often runs in families. It also gets worse when your skin is dry. Unsurprisingly, this makes winter peak keratosis pilaris season, as the lower temperatures and lower humidity sap the moisture from our skin.

On the bright side, our bodies seem to get better at coping with this keratin overload on their own with time. Again, nobody’s figured out why exactly, but rates are highest for babies and teenagers, and start to drop for people in their late twenties and early thirties.

How can I get rid of it?

With enough time and patience, keratosis pilaris might go away on its own. But if you’re looking for a permanent solution in the meantime, we have some bad news: your body is never going to stop producing keratin (and you wouldn’t want it to anyway) so there’s no way to banish these bumps forever. However, you can keep their appearance to a minimum.

Skincare

Exfoliate, exfoliate, exfoliate

As with any kind of skin texture, your first step is exfoliation. The body is more tolerant than the face, so you can combine physical and chemical exfoliants with much more freedom. Start with a body scrub and loofah to slough away the dead skin, then try AHAs or BHAs, such as glycolic or salicylic acid, to increase the cell turnover.

Stay moisturised (especially in winter)

Dry skin can make keratosis pilaris look and feel worse, so any moisturiser will go a long way. If you want to go the extra mile, look for products containing urea. This breaks down keratin, preventing it from plugging up the hair follicles in the first place. For maximum impact, apply after every bath or shower – and try to apply when the skin is still slightly damp, as this will help lock in moisture.

Treatments

Microdermabrasion

Anything that removes the top layer of skin is a solid choice for keratosis pilaris. Microdermabrasion does it extremely gently, using abrasive diamonds and crystals to slough away the dead cells bearing the bulk of the keratin build-up. Skin should look and feel smoother, but you’ll need monthly sessions to maintain the results.

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Laser

The versatility of laser treatments make them ideal for keratosis pilaris. Not only does it specifically target and smooth the rough texture of each bump, but it can also lessen redness. Improving keratosis pilaris can also be a welcome side effect of laser hair removal. The inflammation is partly caused by trapping the hair in the follicle, so zapping and destroying it at the root can help smooth out the skin’s surface.

Chemical peel

A superficial chemical peel won’t get rid of keratosis pilaris, but the results can still be pretty dramatic. When a thin layer of acid is applied to the area, it dissolves the uppermost layer of skin – exfoliating and dislodging keratin along the way. Skin should look more even and feel less sandpaper-like for a few months before you need a repeat session.

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