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Help! I Can't Cure My Keratosis Pilaris Flare-Ups. What Can I Do?
Recently, a reader submitted this #askcharlotte question on how to cure her recurring itchy situation. We reached out to a Charlotte's Book expert dermatologist as well as the founder of Emmaus Beauty, a line specifically formulated to treat KP. This CB reader asks: I suffer from keratosis pilaris and have persistent rough patches and small, acne-like bumps on the back of my arms. I've been using medicated creams containing lactic acid and salicylic acid that supposedly soften the rough keratin deposits in the skin. I'm also using ointments with cortisone to reduce redness. However, the results are not great and the rough patches and bumps quickly reappear regardless of the treatment. Knowing that this condition is common amongst almost 50% of the population, I would imagine there would be better, more effective treatments. Can you help me?
ANSWER—Dr. Diane Berson, Cosmetic Dermatologist
Keratosis pilaris (aka KP or “chicken skin”) is a hereditary skin condition characterized by red, rough and sometimes even scaly bumps on the thighs, arms, and buttocks. Occasionally people even notice KP on their cheeks. The bumps that are associated with KP generally do not hurt, but can be frustrating since they are difficult to diagnose and treat. It can worsen during the colder months when the air outside is cold and the air inside is dry and heated. However, changes in weather can cause symptoms. Also, dryness tends to make KP worse, which is why might also notice it more in the summer, when sun and salt water dehydrate skin. The condition can also flare up when hormones fluctuate. When rough patches and bumps appear, moisturizers containing lactic and salicylic acid should be helpful for sloughing off the rough outer layers of skin and unclogging pores, decreasing the look and appearance of bumps. But often, these aren't enough. These moisturizers can also be supplemented with prescription-strength steroid creams to decrease redness and inflammation. Many patients find keratosis pilaris a stubborn condition that doesn't respond adequately to standard over-the-counter therapies. A dermatologist can prescribe stronger creams, such as those containing retinoids; these are a bit more potent and will also help loosen up the cells clogging the pores. In-office procedures can also be more effective at clearing things up, including microdermabrasion, light peels and even certain light and laser treatments. So if your keratosis pilaris is a nagging, ongoing issue, it is best to consult with a dermatologist who can devise a more successful treatment plan. Whichever course of treatment you and your dermatologist decide to pursue, continue to use of very emollient body moisturizer containing natural oils to help prevent flare-ups after skin has cleared.
ANSWER—Aminah Sagoe, CEO & Founder of Emmaus Beauty
I've been dealing with KP for many years and have tried numerous unsatisfactory products along the way. After much research and unsuccessful trials, I discovered that using a product containing both salicylic and glycolic acids (in conjunction with natural ingredients and moisturizing oils) yielded the best results. Glycolic acid is the most active and beneficial of the Alpha-Hydroxy Acids (AHA) used in skincare. Studies have shown glycolic acid to be the most effective fruit acid for cosmetic application. It has the smallest molecular structure of all AHAs, thus possesses the greatest penetration potential. Inside the cell, it stimulates the collagen and elastin fibers in the dermis, improving the appearance of wrinkles, fine lines and other forms of sun damage. Due to the unique mechanism of action, glycolic acid has also been found to be beneficial for the management of conditions such as KP, psoriasis, acne, eczema, and dry skin. Salicylic acid is a Beta-Hydroxy Acid (BHA), which is a popular and well-recommended treatment for acne, psoriasis, KP, calluses, and other skin conditions. Salicylic acid increases the cellular turnover rate, leading to faster skin renewal and fewer clogged pores, which is the primary cause of many skin issues. It also has the ability to penetrate into the pores, and thus can exfoliate inside the pore as well as on the surface of the skin, which makes it effective for reducing blemishes, including blackheads and whiteheads. The unique synergy of glycolic and salicylic acids produces more effective results when used together. Combining both acids may sound scary, but using them at lower strengths will minimize irritation to the skin. Dealing with my KP has been much more manageable since I discovered this combination. The unfortunate aspect of KP is there isn’t any cure, so once you stop your regimen, it comes right back. So stay vigilant, and good luck!
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