Keratosis Pilaris (Chicken Skin Appearance)

Keratosis pilaris is a common, benign condition characterized by small, firm, and bumpy follicular lesions, particularly on the upper arms, thighs, buttocks, and cheeks in children. It is colloquially described as having a "chicken skin" or "goose skin" appearance.

Keratin buildup at the openings of hair follicles forms small plugs. The skin may appear dry, sandpaper-like, and covered with pinpoint bumps. Genetic predisposition is important and may be associated with atopic dermatitis/dry skin tendency.

Keratosis pilaris is not acne or folliculitis. Harsh scrubbing and intense friction often increase irritation, redness, and dryness. It can become more pronounced in winter due to low humidity.

Treatment is not mandatory; moisturizing and controlled keratolytic treatments may be used if there is cosmetic discomfort or significant roughness. Urea, lactic acid, glycolic acid, and salicylic acid are commonly used options; retinoids may be considered in some patients. Excessive use in sensitive skin may lead to irritation.

Lasers may be considered in selected patients, particularly for pronounced redness, pigment changes, or resistant roughness. While current systematic reviews report positive results with various Nd:YAG and other laser systems, no single laser is the standard treatment for everyone.

In keratosis pilaris rubra, the redness is more pronounced. Facial involvement, especially in young people, can be confused with rosacea; follicular roughness and clinical distribution are important in differential diagnosis.