Condition

Keratosis Pilaris

Keratosis pilaris is the patch of small rough bumps on the upper arms, thighs and cheeks that most people know as chicken skin. It is harmless, it is not an infection or an allergy, and it can be smoothed considerably if the texture bothers you.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
16:9 hero for Keratosis Pilaris. Never cropped: the tone strip and the corner logo depend on the full frame.

Start here

Keratosis pilaris is not a disease, it does not turn into anything, and it does not mean your skin is unhealthy, and plenty of people are happier once they know that and leave it alone. If the texture bothers you it is very treatable, with one condition attached: this is maintenance, not a cure. A urea or lactic acid cream used most days will smooth the arms noticeably in about a month, and the bumps come back within a few weeks of stopping. The one thing I ask people to stop is scrubbing, because loofahs, gritty scrubs and picking do not remove the plugs and they do leave marks, especially on deeper skin tones.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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How commonVery common. It affects a large share of teenagers and a substantial number of adults
Who gets itRuns strongly in families. Usually starts in childhood, peaks in the teens, and fades for most people through the twenties and thirties
Curable or managedManaged, not cured. It returns within weeks of stopping treatment
Prescription neededNo. The most effective products are available over the counter
Time to improveAbout four to six weeks of near-daily use before the texture clearly changes

What It Is

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Keratosis pilaris is a build-up of keratin, the protein in the outer layer of skin, in the openings of hair follicles. Each bump is one plugged follicle, and there are usually dozens to hundreds across an area, which gives the skin its sandpaper feel.

The bumps are small, firm and skin-colored, pink or brown depending on your skin tone, and each holds a hair, often coiled and unable to break through. They are not painful and rarely itchy, though the skin around them is dry. Classic sites are the backs of the upper arms, the fronts of the thighs, the buttocks and the cheeks, and it is nearly always symmetrical.

There are a few variants. The plain form is rough bumps. Keratosis pilaris rubra has a red or darker background between them, which bothers people more than the texture. On the cheeks it looks like a flush of tiny bumps, is common in children, and occasionally comes with thinning of the outer eyebrows. A less common form leaves small pitted marks over many years.

This is entirely cosmetic. It does not spread or scar on its own, it is not contagious, and it is not a sign of a deficiency. Nothing has to be treated.

Symptoms

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Upper Arms
Rough goosebump texture

Upper Arms

Small, firm bumps at hair openings across the backs of the upper arms, giving a permanent goosebump feel. Color ranges from skin-toned to red or brown. It is harmless and very common in teenagers.
Thighs and Buttocks
The same bumps lower down

Thighs and Buttocks

The same rough bumps on the fronts of the thighs and the buttocks, often more noticeable in winter. Scrubbing hard irritates it without smoothing it. Gentle exfoliating ingredients work better than force.
Red Cheeks
Bumpy flushing in children

Red Cheeks

Rough bumps with background redness on the cheeks, usually in children, which can be mistaken for acne or eczema. It often fades through the teenage years. Harsh acne treatments tend to inflame it.

How It Looks by Skin Tone

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The back of an upper arm on light skin, covered in small rough bumps at every hair opening. Each bump sits in a faint pink ring, so the arm looks evenly speckled and slightly red.The back of an upper arm on medium tan skin, covered in small rough bumps at every hair opening. The bumps read tan against a faintly pink background, so the arm looks uneven rather than red.The back of an upper arm on brown skin, covered in small rough bumps at every hair opening. Each hair opening sits in a small brown-gray dot, so the arm looks evenly speckled rather than red.The back of an upper arm on deep brown skin, covered in small rough bumps at every hair opening. Each hair opening sits in a dark brown dot and a few flat, evenly darker patches sit where bumps were rubbed.
LightMediumBrownDeep

On deeper skin tones the bumps matter less than what surrounds them. Instead of the pink background most textbooks describe, each follicle sits in a small brown or gray-brown dot, so the arms read as speckled rather than red. Roughness under your hand is a more reliable clue than anything visible.

The practical difference is what irritation does. Deeper skin tones answer friction, scrubbing and picking with flat dark marks, called post-inflammatory hyperpigmentation, that take many months to fade. The usual instinct, scrub harder or dig one out, trades a temporary bump for a mark that lasts far longer. Gentle chemical exfoliants do the same job without the friction. Where discoloration is the main complaint, treat that rather than the texture: consistent moisturizing, a mild acid cream, daily sunscreen on exposed areas, and time. The red variant is harder to see on deeper skin tones, and the lasers used for redness are less useful and riskier for pigment change, so they are not the first suggestion.

Where It Shows Up

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Back view of a whole body with red marks on the backs of both upper arms and on both buttocks. The rest of the body is clear.
The backs of the upper arms
The classic site, and almost always both arms. The bumps sit at the opening of each hair follicle, which is why the skin feels like fine sandpaper or gooseflesh that does not settle. The buttocks are commonly involved too.
Front view of a whole body with red marks on the fronts of both thighs and on both cheeks of the face.
Fronts of the thighs and the cheeks
The fronts of the thighs come next, and in children the cheeks, where it looks like a permanent rosy flush with a rough surface. It does not appear on the palms or soles, because there are no hair follicles there to plug.

What Happens in the Skin

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This is what is going wrong under the skin, in the order it happens. Click a step to see it.

How Keratosis Pilaris happens
Skin basics
BARRIEREPIDERMISDERMISPOREOILGLAND0A NORMAL FOLLICLE1THE SKIN AROUND THE FOLLICLE DRIES2A KERATIN PLUG BLOCKS THE OPENING3THE HAIR COILS UP UNDERNEATH4THE FOLLICLE BECOMES INFLAMED

Every hair grows out through a small opening in the skin. When the skin around that opening holds enough moisture, old cells loosen and fall away on their own. The opening stays clear, and the hair passes straight through it.

The skin around each hair follicle is dry, often for inherited reasons, and dry skin does not shed its old cells cleanly. Those cells stay stuck around the opening instead of falling away. This is why moisturizing is half of the treatment and not an optional extra.

Those cells and the keratin in them pack into a firm plug that seals the follicle opening. Each plug is one of the bumps you can feel. This is the step that acids like urea, lactic acid and salicylic acid dissolve.

The hair that should have grown out of that follicle cannot get through the plug, so it curls up underneath it. That trapped hair is what a dermatologist looks for through a magnifier to confirm the diagnosis, and it is also why picking at a bump feels like there is something in there.

The blocked, stretched follicle and the skin right around it become mildly inflamed. That is the pink, red or darker ring around each bump, and it is the part that bothers people more than the roughness does. Scrubbing, picking and hot water all push on this step.

The outer film of dead cells and oil. It holds water in and keeps irritants out, and it is thinner than a sheet of paper. Almost every dry, itchy, stinging skin problem starts here.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

Four things happen at each follicle, and they build on one another.

First, the skin around the follicle is dry, and dry skin sheds its cells less cleanly. Second, those cells and their keratin pile into a firm plug that blocks the opening, which is the bump you feel. Third, the hair that should grow out is trapped beneath the plug and coils under it. Fourth, the follicle and the skin around it become mildly inflamed, which is the pink, red or darker halo.

The plugging is largely genetic. It runs in families, often across generations, and in some people it is linked to a change in a gene called filaggrin, which also underlies dry skin and eczema. That is why keratosis pilaris turns up so often alongside eczema or very dry skin.

There is no infection in these bumps, no allergy driving them, and no vitamin deficiency behind them. Nothing anyone did causes them.

Risk Factors

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Keratosis pilaris is common enough to be closer to a normal skin variation than a condition. What follows changes how noticeable it is, not whether you have it.

Inherited
Family history
The big one. Most people can point at a parent or sibling with the same arms.
Inherited
Ichthyosis vulgaris
A genetic condition causing dry, scaly skin that very often comes with keratosis pilaris.
Other health conditions
Eczema and dry skin
Both share a weaker skin barrier, and keratosis pilaris is considerably more common with either.
Other health conditions
Hay fever and asthma
Part of the same atopic tendency as eczema, and mildly more common here.
Age & hormones
Being a teenager
It peaks through the teenage years and settles after, which is why many adults remember it more than they still have it.
Age & hormones
Hormonal change
It often appears or worsens around puberty and can change during pregnancy, unpredictably in either direction.
Environment & work
Cold, dry weather
Winter air and indoor heating dry the skin, making bumps rougher and more visible, and it usually improves in summer.

Course

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Keratosis pilaris has a season. Cold, dry months and indoor heating make it rougher and more visible, and humid summers often flatten it without treatment. People often credit a product for a change the weather made. Underneath that, it follows a slow arc from childhood.

ChildhoodSometimes the first few years of life
Usually the first appearance

It usually shows up in childhood, sometimes in the first few years of life.

Backs of the armsCheeks
Teenage yearsThe peak
This is when it is most noticeable

It is most obvious through the teenage years. On the cheeks, the childhood form usually settles by the late teens on its own.

Twenties and thirtiesSlowly fading
It fades for most people

It fades slowly through the twenties and thirties. Redness outlasts the bumps on fairer skin tones, brown speckling on deeper skin tones.

Adulthood40 and up
Most people are left with very little

Many adults keep only a small patch or nothing, and a minority have it for life. It never worsens and never becomes anything else. With treatment the texture softens over four to six weeks, and only stays soft while treatment continues.

Backs of the arms

What Makes It Better & Worse

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Keratosis pilaris is not one problem, it is four — dry skin, a keratin plug, a hair trapped beneath it, and mild inflammation around the follicle. Nearly everything that makes it worse acts on step one or step four, and moisture and exfoliation work better together than alone.

What is driving yours?

FATPOREOILGLANDBARRIEREPIDERMISDERMIS

The skin around each hair follicle is dry, often for inherited reasons, and dry skin does not shed its old cells cleanly. Those cells stay stuck around the opening instead of falling away. This is why moisturizing is half of the treatment and not an optional extra.

Those cells and the keratin in them pack into a firm plug that seals the follicle opening. Each plug is one of the bumps you can feel. This is the step that acids like urea, lactic acid and salicylic acid dissolve.

The hair that should have grown out of that follicle cannot get through the plug, so it curls up underneath it. That trapped hair is what a dermatologist looks for through a magnifier to confirm the diagnosis, and it is also why picking at a bump feels like there is something in there.

The blocked, stretched follicle and the skin right around it become mildly inflamed. That is the pink, red or darker ring around each bump, and it is the part that bothers people more than the roughness does. Scrubbing, picking and hot water all push on this step.

What helps

  • Urea cream Holds water in and breaks down keratin, usually 10 to 20 percent.
  • Lactic acid or ammonium lactate The same two jobs, gentler.
  • A plain thick moisturizer Fragrance-free, twice a day, the part people skip.
  • Applying to damp skin Within minutes of a shower, to trap water.
  • Short lukewarm showers Under ten minutes, gentle non-foaming cleanser.
  • A humidifier in winter Worth it if winter is dramatically worse.

What makes it worse

  • Winter and indoor heating Dry air firms the plugs and roughens the skin.
  • Long hot showers Hot water strips the oils that hold water in.
  • Harsh soap Foaming bars and scented washes leave skin tight.
  • Skipping moisturizer The most common reason treatment fails.

What helps

  • Salicylic acid Oil-soluble, so it dissolves the plug from inside.
  • Glycolic acid Loosens dead surface cells, but stings more easily.
  • A topical retinoid at night Normalizes how the follicle sheds, so go slowly.
  • A soft washcloth, gently Light exfoliation while washing, not a scrub.
  • Give it four to six weeks Judge it at six weeks with photographs.

What makes it worse

  • Stopping once it clears The bumps return within a few weeks.
  • Judging it too early Real change takes four to six weeks.

What makes it worse

  • Scrubbing with a loofah It cannot reach a plug inside the follicle.
  • Picking at the bumps Leaves a mark for months, and the plug refills.
  • Dry shaving over the area The razor catches bumps and causes ingrown hairs.

What helps

  • Vascular laser for redness For redness, not texture, and riskier on deeper skin tones.
  • Sunscreen on exposed areas Keeps the marks from darkening.
  • Leaving it alone Harmless, and most of it settles with age.

What makes it worse

  • Heavily fragranced lotions Fragrance adds redness, not moisture.

How These Treatments Work

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Treatments for Keratosis Pilaris do not all work in the same place. Tap one to see where it acts.

Pick a treatment
Skin basics
BARRIEREPIDERMISDERMISPOREOILGLANDSOFTENS THE PLUGSTOPS PLUGS FORMINGKEEPS SKIN SOFTTREATS THE REDNESS

Breaks down the keratin plug sitting in the follicle opening, so the bump flattens.

Changes how the lining of the follicle sheds its cells, so fewer plugs form.

Dry skin makes the bumps rougher and more obvious. It does not remove them.

Targets the color around the bumps rather than the bumps themselves.

The outer film of dead cells and oil. It holds water in and keeps irritants out, and it is thinner than a sheet of paper. Almost every dry, itchy, stinging skin problem starts here.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

Over-the-Counter Products

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Everything here you can buy without seeing anyone.

Five white jars of 40% urea cream lined up, several also listing 2% salicylic acid16:9 hero for Urea. Never cropped: the tone strip and the corner logo depend on the full frame.
Strong evidence
The single most useful thing for keratosis pilaris, because it does both jobs at once: it holds water in the dry skin and it breaks down the keratin plug. Use 10 to 20 percent on the arms or thighs most days, on damp skin after a shower. It stings a little on cracked skin, and the bumps return within a few weeks of stopping.
Five lactic acid serums lined up on white, from The Ordinary, Glytone, Paula's Choice and Prequel16:9 hero for Lactic Acid. Never cropped: the tone strip and the corner logo depend on the full frame.
Strong evidence
Ammonium lactate or lactic acid lotion at around 12 percent does the same two jobs as urea, slightly more gently, and it is often the easier one to keep using daily. Good first choice if urea stings. Like everything here, it manages the bumps rather than ending them.
Thick fragrance-free moisturizer
Thick fragrance-free moisturizer
Moderate evidence
The half of the treatment people skip. Dry skin is step one of the whole process, so an acid cream without a moisturizer works far less well than the two together. Apply within a few minutes of a shower to trap the water in, twice a day, and choose fragrance-free — scent adds redness without adding moisture.
Paula's Choice 2% BHA exfoliant, La Roche-Posay Effaclar cleanser and a CeraVe psoriasis cream pumpLabeled cutaway diagram of a single skin pore, headed Salicylic Acid. The epidermis is a brick-textured band across the top and the dermis is pink below it, with a yellow oil gland at the base of the pore and a small cluster of bacteria inside it. A single dark navy callout line points into the top of the pore: decreases dead cells in pore. There are no other callouts, so the drawing shows one effect where the other ingredient diagrams show two or three.
Moderate evidence
Oil-soluble, so it gets down inside the follicle and works on the plug from within rather than at the surface. Useful when the bumps are the main complaint and urea has not been enough. It is drying, so it needs pairing with a moisturizer, and it is not the one to reach for on a child's cheeks.
Four glycolic acid toner and liquid bottles lined up on white, one with its box16:9 hero for Glycolic Acid. Never cropped: the tone strip and the corner logo depend on the full frame.
Moderate evidence
Loosens the dead cells stuck at the surface, which smooths the skin around the bumps. It is the most likely of the acids to sting and to leave the skin pink, so it suits the arms and thighs better than the cheeks. On deeper skin tones, build up slowly, because irritation is what leaves the dark marks.
Six retinol products lined up, including SkinCeuticals Retinol 0.5, Murad, CeraVe, First Aid Beauty, RoC and Replenix16:9 hero for Retinol. Never cropped: the tone strip and the corner logo depend on the full frame.
Limited evidence
Changes how the follicle sheds its cells, so fewer plugs form in the first place. It is slower than the acids and more irritating, so it is usually a second step rather than a first one. Start two nights a week on one arm, and always put a moisturizer over it.
Five coconut oil bottles and a jar on white, most labeled fractionated or organic virgin coconut oil16:9 hero for Coconut Oil. Never cropped: the tone strip and the corner logo depend on the full frame.
Weak evidence
It moisturizes, and moisture genuinely softens the texture a little, so it is not useless. It cannot dissolve a keratin plug, so it will not clear the bumps, and the widely shared claim that it cures keratosis pilaris is not supported. If you like it, use it as the moisturizer over an acid cream rather than instead of one.
Body scrubs and loofahs
Body scrubs and loofahs
Weak evidence
Friction cannot reach a plug sitting inside the follicle, so scrubbing removes surface skin without touching the cause. It adds redness, and on deeper skin tones it leaves dark marks that outlast the bumps by months. A soft washcloth used gently while washing is as far as this should go.

Prescriptions

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These need a prescription.

A plain white medicine tube lying at an angle on a white background, capped, labeled Tretinoin in black with a navy blue swoosh curving along its length.Diagram: how Tretinoin works in the skin
Moderate evidence
The prescription version of the retinoid idea: it normalizes how the follicle sheds, so plugs form more slowly. It is used when over-the-counter acids have not been enough after six weeks. It is drying and irritating on arms and thighs, so it is introduced two or three nights a week, and it makes the skin more sun-sensitive.
16:9 hero for Tazarotene. Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Tazarotene works in the skin
Limited evidence
A stronger retinoid cream, occasionally used on stubborn arms when tretinoin has not worked. It is more effective on the plugs and also more irritating, which is the trade-off. It is not used in pregnancy — ask your doctor before starting it if that applies to you.
A plain white ointment tube lying on its side, labeled Hydrocortisone with a blue swoosh16:9 hero for Hydrocortisone. Never cropped: the tone strip and the corner logo depend on the full frame.
Limited evidence
A mild steroid cream used in short courses when the red halo around the bumps is the main complaint, not the roughness. It calms the inflammation for a while and does nothing to the plugs. It is not a long-term answer, because weeks of steroid on thin skin like the cheeks causes its own problems.

Procedures

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These are done in the office, usually over several visits.

A patient in protective goggles lying under a large laser head positioned over their face16:9 hero for Pulsed Dye Laser (V-Beam). Never cropped: the tone strip and the corner logo depend on the full frame.
Moderate evidence
Aimed at the redness rather than the texture, so it is for the variant where the background color bothers you more than the bumps. Several sessions are usually needed and the bumps themselves are left much as they were. On deeper skin tones it is less useful and carries more risk of pigment change, so it is not usually the first suggestion.
16:9 hero for Laser Hair Removal. Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Laser Hair Removal works in the skin
Limited evidence
Removing the hair takes away the thing that gets trapped under the plug, and small studies show the bumps and roughness improve with it. It is expensive for a harmless condition, which is why it is rarely the first plan. It makes most sense for someone already having the area treated for hair.
A small clear glass bowl holding a shallow pool of pale amber liquid on a white background, with a white fan-shaped brush lying beside it, bristles resting against the bowl.Diagram: how Chemical Peel works in the skin
Limited evidence
A stronger version of the acid creams, applied in a clinic to the arms or cheeks. It can smooth the texture for a while, and the effect fades in the same way, so the daily cream is still needed afterwards. It is an add-on for people who want a faster start, not a replacement for the routine.
16:9 hero for Microdermabrasion. Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Microdermabrasion works in the skin
Weak evidence
Sanding the surface has the same problem as a body scrub: the plug sits inside the follicle, below where it reaches. Any smoothness is short-lived, and it adds redness. On deeper skin tones the irritation can leave dark marks, so it is one to skip.

When to See a Dermatologist

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Most people never need a dermatologist for this. Keratosis pilaris is harmless, easy to recognize, and treated perfectly well with pharmacy products. Book if the bumps are painful, itchy, filled with pus or spreading, if they appeared suddenly in adulthood, if a child has red bumpy cheeks with thinning of the outer eyebrows, if pitted marks are appearing, or if six weeks of consistent over-the-counter treatment has changed nothing. The other good reason to come is redness that bothers you more than the texture, which is treated differently, sometimes with prescription creams and occasionally laser. No test is needed, since it is diagnosed by looking and running a hand over it, and a biopsy is essentially never required.

— Dr. Schwarz, Board Certified Dermatologist

Complications

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Lookalikes

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Acne

Both start with a blocked follicle, which is why the mix-up is so common on the cheeks and upper back. Keratosis pilaris bumps are small, all the same size, dry to the touch, painless and spread evenly over both arms or both thighs. Acne has blackheads and whiteheads, spots of different sizes, some tender or filled with pus, and it is rarely so symmetrical. Acne treatments do very little for keratosis pilaris.

Folliculitis

Both are bumps centered on hair follicles, and folliculitis turns up on the same thighs and buttocks. Folliculitis is tender, often itchy, and the bumps have pus in them, come up over days and settle again. Keratosis pilaris is dry, painless, the same size everywhere and has been there for years. Sudden sore bumps on skin that used to be only rough are folliculitis on top, not the condition changing.

Fungal Acne (Malassezia Folliculitis)

This one is confused with keratosis pilaris on the upper back, chest and shoulders, because both are small, even, same-sized bumps at the follicles. Fungal acne itches, which keratosis pilaris usually does not, the bumps have small heads on them, it flares with heat and sweat rather than with winter, and it clears with antifungal treatment. Keratosis pilaris on the back is dry, quiet and constant.

Myths

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  • "It means my skin is dirty." Washing has nothing to do with it. Each bump is a plug of keratin inside a follicle, formed for genetic reasons, and it appears on washed skin just as readily.
  • "It is a vitamin deficiency." Widely circulated and not supported. Vitamin A deficiency can cause a similar-looking rash, but it is rare in well-fed populations, and keratosis pilaris does not respond to supplements.
  • "Scrubbing harder will get rid of it." Friction cannot reach a plug inside the follicle. Scrubbing removes surface skin, adds redness, and on deeper skin tones leaves marks for months. Chemical exfoliants do the job without the damage.
  • "Coconut oil cures it." Oils moisturize, which softens the texture a little. They do not dissolve keratin plugs, so they will not clear it, and no home remedy does.
  • "It is contagious." It is inherited, not caught. Towels, pools and skin contact have nothing to do with it.
  • "If I treat it long enough it will go for good." Treatment keeps it quiet rather than ending it. The bumps return within a few weeks of stopping, and what actually makes it go is age.
  • "It is a kind of acne." It is not Both involve a blocked follicle, but acne also involves oil, bacteria and real inflammation, and acne treatments do very little here.
  • "There is nothing that helps." Usually said by someone who tried one product for two weeks. A urea or lactic acid cream most days for six weeks with a moisturizer changes the texture for most people.

Questions Patients Ask

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Will it ever go away?

For most people it fades substantially through the twenties and thirties with nothing done. A minority keep it for life. Treatment does not speed that up, it keeps the skin smooth meanwhile.

Why does it come back when I stop the cream?

The tendency to plug the follicle is genetic, and the cream only clears plugs that have already formed. Within a few weeks of stopping, new ones build. That is the condition behaving normally, not the product failing.

Is it caused by something I'm eating?

No. No food causes it and no diet clears it. It is inherited and tied to dry skin, not nutrition. The vitamin deficiency story is a myth.

Can I exfoliate it away?

Not with friction. The plug sits inside the follicle where a scrub cannot reach, and scrubbing adds redness and, on deeper skin tones, dark marks. Urea, lactic acid and salicylic acid do reach it.

Why is it worse in winter?

Cold air outside and heated air inside both dry the skin, and dry skin plugs its follicles more readily. Most people find it flattens in humid summer months. Shorter, cooler showers and daily moisturizer take the edge off.

My bumps are red rather than rough. Is that different?

That is keratosis pilaris rubra, the same condition with more inflammation around each follicle. Creams help the texture more than the redness, so if redness is your main complaint see a dermatologist, who has options aimed at it.

References

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