Understanding & Treating Keratosis Pilaris

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Picture this: It’s finally spring. You’re excited to wear a new tank top, but grab a sweater too because you’re embarrassed of small bumps covering your arms. Or maybe you’re like me and spent most of last summer wearing long-sleeved shirts to hide the unsightly bumps on your skin.

If this sounds familiar, you might be struggling with a condition known as keratosis pilaris (KP).

What is Keratosis Pilaris?

The good news is that you aren’t alone if you have KP. Despite what the internet might lead us to believe, no one has perfect skin. KP is different from acne. It is a very common condition resulting from a buildup of keratin in hair follicles. Keratin is a hard protein which normally works to protect skin from harmful substances and infection. With KP, keratin forms a plug which blocks the opening of hair follicles, resulting in small bumps. As a result, it is sometimes referred to as “chicken skin.” KP is most common on upper arms, legs, and butt. Although the bumps are harmless, KP can cause psychological distress and make people hyperaware and/or self-conscious of their skin.

There are two major factors which contribute to the severity of KP: dry skin and keratin production.

The drier your skin is, the worse KP tends to be. It’s common for KP to get worse as humidity falls during winter months.

Factors influencing keratin production are less straightforward, and researchers aren’t exactly sure what causes the buildup of keratin in KP. It seems genetics may play a role, as KP tends to run in families. Other factors can contribute to the severity of KP, including pregnancy, diabetes, and obesity.

My Struggle with KP

I first started dealing with KP in April 2020 when I finished Accutane. I’ve always struggled with body acne, so I didn’t realize at first that I was dealing with KP. Because of COVID, I couldn’t get in to see my dermatologist. It was actually thanks to Curology I was able to identify my KP and find a treatment regimen that worked for me. I mainly deal with KP on my arms, although I’ve been getting it more on my legs and butt too now that my skin is drier in the winter.

This picture was taken in June 2020, about 2 months after I first started dealing with KP. For most people, KP will never look this severe or inflamed. My skin got to this point as a result of excoriation disorder (aka “skin picking disorder”). I plan on going into more detail about this in a different blog post- in summary, skin picking disorder belongs to a group of conditions called “Body-focused repetitive behaviors” (BFRB) which involves becoming fixated on real or perceived imperfections on my skin. This often results in compulsive picking, scratching, and popping to the point of bleeding. This frequently causes infections, inflammation, and permanent scars (like you can see in this picture). For me, managing my KP has also required management of my excoriation disorder (but that’s a subject for a different post).

How to treat KP at Home

There is no way to cure KP. As with most skin conditions, there are a variety of effective treatments which are available though dermatologists and healthcare providers, including lasers and topical prescriptions like retinoids. However, there are also a number of products you can use at home to help reduce the appearance and severity of KP.

Most products designed to treat KP help exfoliate, hydrate the skin, or both. These are the products I currently use to manage my KP at home.

Products I use

Personally, I’ve had a lot of success treating KP at home. I use a combination of products to help (gently) exfoliate and keep my skin hydrated.

One of my skincare staples is CeraVe Moisturizing cream. I’ve seen this product recommended by basically every dermatologist- it is dye and fragrance free, doesn’t clog pores, and it works. I apply this to my entire body whenever I get out of the shower. It uses hyaluronic acid and ceramides, which work together to help skin retain moisture.

Without getting too technical: hyaluronic acid plays an important role in many areas of our bodies, including our skin. In the skin, hyaluronic acid binds to water, which helps the skin stay hydrated and regulate water balance. Overall, hyaluronic acid is extremely important for our skin structure, physiology, tissue repair, and a lot of other things. By contrast, ceramides are lipids (fats) that make up a significant amount of our skin barrier. In other words, they help hold skin cells together and play an important role in moisture retention. Products which use both hyaluronic acid and ceramides (like the CeraVe cream) don’t just moisturize your skin, they help your skin retain that moisture better.

Another product I rely heavily on is 2% salicylic acid body wash. Salicylic acid is an ingredient which can treat a wide variety of skin conditions, including KP. Generally, salicylic acid makes it easier to shed dead skin cells in the epidermis (the outermost layer of our skin), which can help prevent the clogging of pores. Currently, I use Curology’s acne body wash (with 2% salicylic acid). Another alternative is Neutrogena’s Body Clear Acne Body Wash (also with 2% salicylic acid; $5.94). I try and avoid the versions with exfoliating beads, since they can create micro abrasions that irritate your skin. Tip: for both body acne and KP, I’ve gotten better results by massaging and allowing the cleansers to sit on my skin for 30 to 60 seconds before rinsing off.

The product that really made a difference in my struggle with KP was Amlactin Daily moisturizing body lotion ($12.97). Amlactin uses 12% lactic acid, which is a type of alpha-hydroxy acid (AHA). Like salicylic acid, AHA’s promote exfoliation (shedding of surface skin). I apply this lotion to my upper arms, shoulders, and chest twice a day almost every day, and the results speak for themselves. More recently, I’ve been trying out First Aid Beauty KP Body Eraser Body Scrub (with 10% AHA; $10). This product is more abrasive, so I only use it a couple of times a week. I haven’t been using this long enough to really know how much of a difference it is making.

My results treating KP at home using Amlactin lotion.

Final Thoughts

Keep in mind: products used to treat KP like salicylic acid and AHAs can increase sensitivity to UV rays. If you use these products, make sure to use sunscreen or wear protective clothing whenever you are spending time outside.

Although KP is technically harmless, I know firsthand the toll it can take on your self-image and confidence. If your skin isn’t responding to at-home treatments, it may be time to see a dermatologist.


Do “zit patches” work? The Science of Hydrocolloid Patches

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If you’re like me, you’ve struggled with acne for as long as you can remember. Ever since I was a teenager, I had issues with blackheads, inflammatory acne, body acne, and especially cystic acne. I’ve tried just about everything to treat it- salicylic acid, benzoyl peroxide- you name it, and I’ve probably tried it. (Until I finally reached a breaking point last year and went on Accutane- but that’s a story for another post).

Alternatively, maybe you’re someone that has been dealing with maskne (acne resulting from wearing a face mask for extended periods of time) that is struggling to find something that works.

If either of those sound familiar, I’m willing to bet you’ve tried your fair share of acne-treating products- possibly including hydrocolloid patches.

In recent years, hydrocolloid patches have become increasingly popular as a method to spot-treat acne. Products like Mighty Patch claim to “flatten pimples overnight…pulling the pus out of whiteheads and speeding up healing.” These patches typically have a single ingredient: hydrocolloid.

What is Hydrocolloid?

Hydrocolloid is a gel made of a combination of ingredients like gelatin, pectin, and polysaccharides (large sugar molecules). These compounds work together to absorb moisture from water, pus, and oil, forming a white gel.

Hydrocolloid has been around for a while, and has been used to treat a variety of skin conditions- mainly dressing and bandaging wounds. Its ability to absorb moisture can help drain wounds while also creating a sealed, sterile, and moist environment which facilitates healing. Most hydrocolloid dressings are also waterproof, which makes them more practical than some other methods of dressing wounds. Research suggests hydrocolloid dressings can be effective for treating several skin conditions including burns and skin graft donation sites.

What Causes Acne?

When we think about whether hydrocolloid gel is effective for treating acne, it’s worth discussing why we get acne in the first place.

Generally speaking, acne is a common skin condition which involves (among other things) hair follicles and their adjacent sebaceous glands, which produce oils such as sebum. Sebum is full of lipids (fats) which can serve as a good growing medium (food source) for bacteria. When hair follicles produce excess oil and/or become plugged, it can result in a buildup of sebum and dead skin cells, which creates an ideal environment for the proliferation of bacteria. In particular, the bacterial species Propionibacteria acne tends to cause inflammatory acne- the kind which is raid, painful, warm, and swollen. Research suggests that the severity of acne is in part related to sebum (oil) production. In essence, more sebum provides more food for bacteria, which makes it easier to get acne.

There are many factors which contribute to the severity of acne- including hormones, bacteria, diet, genetics, medications, stress…you get the idea. There are also a variety of different kinds of acne, including blackheads, whiteheads, cystic acne, etc. (I’ll go into more detail about the differences between them in a future post). Because acne is influenced by such a variety of things, treating it can be very complicated. Often, what works for one person may not work for you, depending on the cause and type of your acne.

Do Hydrocolloid patches work to treat acne?

In short, it depends.

Hydrocolloid patches are not a miracle product. They are not pore strips: they aren’t going to do much for your blackheads. They also won’t work well on cystic acne (as someone who has dealt a lot with cystic acne, your best option here is to see a dermatologist).

Remember that hydrocolloid gel is used to absorb moisture and facilitate wound healing. That means that the more wound-like (inflamed, pus-filled, etc.) your acne is, the more hydrocolloid patches can potentially help. Hydrocolloid patches tend to work best with inflammatory acne, especially when pus has come to a head. For these types of acne, the gel can help absorb pus and other fluids while protecting skin and facilitating the healing process.

Personally, I’ve had mixed success with hydrocolloid patches. I can confirm from experience they don’t do much for blackheads and cystic acne. When it comes to inflammatory acne, I’ve found it can be a bit hit or miss. These patches haven’t made much of a difference for my small, barely noticeable whiteheads, BUT can make a huge difference for large and extremely inflamed zits.

Before and after images of a “Mighty Patch” hydrocolloid patch on inflammatory acne. As the hydrocolloid absorbs water and pus from acne, it produces a white gel. Image from Amazon reviews.

There is some science to back this up, too. One study in 2006 tested the effects of 3M Acne Dressing on acne. They found that using hydrocolloid patches for 7 days reduced the severity of acne (improving redness, oiliness, and pigmentation, and sebum production). They also found that the patches reduced damage from UVB light (which can help acne heal faster). In other words: science says hydrocolloid patches can potentially help treat and lessen the severity of acne.

If you’re like me and struggle with picking your acne, there is an added benefit of hydrocolloid patches: it’s hard to pick your skin when it is covered by a hydrocolloid patch. Dermatologists always discourage picking and popping zits because it can increase risk of infection and worsen scarring. In this respect, even if hydrocolloid patches don’t do much to the acne itself, they can help your skin by reducing how much you pick at your acne. If I’m honest, I use these patches more for this reason than anything else.

Final Thoughts

There are a lot of gimmicky skin care items on the market, but hydrocolloid patches are not one of them in my opinion. There is some solid science suggesting hydrocolloid facilitates wound healing. Although they cannot be used to prevent acne, “zit dots” can potentially help spot-treat inflammatory acne. If you’re struggling with inflammatory maskne, hydrocolloid patches could be something worth trying as a backup to your normal skincare regimen.

Although hydrocolloid patches carry minimal risk of skin irritation, be sure to use as directed and check any allergy warnings.

Have you tried hydrocolloid patches? Feel free to share your experiences in the comments!