Dry Skin and Keratosis Pilaris

What are dry skin and keratosis pilaris?

Dry skin and keratosis pilaris are two skin conditions that make the skin feel rough and scaly. Dry skin occurs when the skin does not have enough hydration to maintain its softness. Also called xeroderma, dry skin can range from moderate to severe and leaves the skin looking scaly and potentially itchy. Severe cases of dry skin, called xerosis, may cause the skin to crack and bleed. Patches of dry skin can occur all over the body and in all seasons of weather. Dry skin is very common. 

Keratosis pilaris is a skin condition that appears as rough patches of tiny bumps. The patches typically occur on the upper arms, thighs, cheeks, or buttocks. The bumps typically do not itch or hurt, but some may find them irritating. You cannot prevent or cure keratosis pilaris, but there are effective treatments to help the health and appearance of the skin. The bumps on the skin are clusters of dead skin cells that build up over time. Some refer to the condition as chicken skin because the bumps resemble a plucked chicken. Keratosis pilaris tends to go away as you age. 

What are dry skin and keratosis pilaris?

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Dry skin and keratosis pilaris are two skin conditions that make the skin feel rough and scaly. Dry skin occurs when the skin does not have enough hydration to maintain its softness. Also called xeroderma, dry skin can range from moderate to severe and leaves the skin looking scaly and potentially itchy. Severe cases of dry skin, called xerosis, may cause the skin to crack and bleed. Patches of dry skin can occur all over the body and in all seasons of weather. Dry skin is very common. 

Keratosis pilaris is a skin condition that appears as rough patches of tiny bumps. The patches typically occur on the upper arms, thighs, cheeks, or buttocks. The bumps typically do not itch or hurt, but some may find them irritating. You cannot prevent or cure keratosis pilaris, but there are effective treatments to help the health and appearance of the skin. The bumps on the skin are clusters of dead skin cells that build up over time. Some refer to the condition as chicken skin because the bumps resemble a plucked chicken. Keratosis pilaris tends to go away as you age. 

What causes dry skin and keratosis pilaris?

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A lack of moisture in the layers of the skin causes dry skin. If the skin cannot retain water in its outer layers, the lack of hydration causes deeper dryness in the lower layers of skin. There are various environmental and health factors that can cause dry skin. A lack of humidity in the climate prevents your skin from getting enough moisture. In addition, if you use products that strip your body’s naturally occurring and protective oils, dry skin can result. 

The main cause of keratosis pilaris is a buildup of keratin. Keratin is a protein that protects the skin from infection, but a buildup of keratin can block hair follicles, causing the rough patches to form. Doctors are still trying to understand the exact cause of excess keratin production. The buildup might occur because of a genetic condition or because of other skin conditions. The excess keratin blocks the pores, preventing normal hair growth in the hair follicles. Keratosis pilaris is not contagious, but the condition may be worse for people who also have dry skin or skin conditions like eczema. 

What are symptoms of dry skin and keratosis pilaris?

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The symptoms of dry skin and keratosis pilaris help tell the two conditions apart since the symptoms for both are similar. 

For dry skin, look for skin that’s: 

  • Rough
  • Tight
  • Slightly to severely flaking 
  • Deeply cracked and/or bleeding
  • Itchy 
  • Different color from normal skin tone 

In some cases of dry skin, you could develop a rash on your skin that has small bumps that may be itchy or swollen. This rash may indicate the development of dermatitis, a genetic skin irritation. Dry skin may be temporary or occur with seasonal changes.  In addition, dry skin can impact any area of the body. 

Keratosis pilaris has more distinct characteristics of the patches of bumps that form on the skin. While dry skin can exacerbate the symptoms of keratosis pilaris, the two conditions are separate. 

The main symptoms of keratosis pilaris include:

  • Tiny, painless bumps typically on the upper arms, thighs, cheeks, or buttocks 
  • Dryness in the places with bumps
  • Sandpaper-like feeling of the bumps 
  • More noticeable and worsening bumps with seasonal weather or humidity changes

Keratosis pilaris appears most commonly on the arms though children may experience bumps on the front of their thighs and cheeks. 

Are there any risk factors or groups for dry skin and keratosis pilaris?

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Risk factors exist that make you more likely to develop dry skin and/or keratosis pilaris. 

Your risk of developing dry skin relies on your lifestyle, environment, and other health factors.  Dry skin is very common, so you may not have these risks and still develop dry skin. 

The most common risk factors of dry skin include:

  • Lifestyle: Working outside often and washing your skin too often or with harsh cleansers can lead to dry skin. In addition, bathing with hot water for too long or too often can lead to dry skin since the hot water strip your body’s natural oils as do harsh soaps and detergents. 
  • Environment: If you live in a dry or cold climate without ample humidity, you may be more likely to have dry skin. 
  • Health history: Certain conditions lead to a higher risk. For example, allergies, eczema, diabetes, and kidney disease make you more likely to have dry skin. 
  • Age: People who are 65 years or older are at higher risk of dry skin since your skin’s oil glands dry up as you age. 

You are more likely to develop keratosis pilaris based on key environmental and health history factors. The following list include the most common risk factors of keratosis pilaris: 

  • Age: Keratosis pilaris is more likely to occur in babies, toddlers, children and teenagers. 
  • Family history: Those with close blood relatives who have keratosis pilaris are more likely to develop the condition. 
  • Preexisting skin conditions: Having skin conditions like eczema, ichthyosis vulgaris, or dry skin increase the likelihood of the condition. 

Health history: A history of asthma, diabetes, and obesity pose an increased risk of developing keratosis pilaris.

How is dry skin and keratosis pilaris diagnosed?

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Although the primary symptoms of dry skin and keratosis pilaris are visible on the exterior of the body, a diagnosis of these conditions may seek to diagnose any related or underlying conditions that may be causing the skin condition. 

To establish a dry skin diagnosis, your doctor will perform a visual examination of the skin and conduct a health history to have a complete understanding of your health. For the physical examination, your doctor will look closely at the patches of affected skin and determine if you have dry skin. An examination of your health history will help your doctor determine if you need any follow up testing based on your family history or risk factors. 

Depending on the level of dry skin and your health history, your doctor may run an allergen test, a blood test, or skin biopsy to detect other conditions. 

A keratosis pilaris diagnosis also relies on a physical examination. Typically, no testing is needed to confirm a diagnosis. In the event that your doctor is unsure whether you have keratosis pilaris, they may conduct additional tests to rule out allergies or other skin conditions. 

How is dry skin and keratosis pilaris treated?

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The focus of treatments for dry skin is to restore moisture to the skin. You can treat dry skin with effective home remedies and lifestyle changes. Your doctor may recommend you start a regular regiment of lotions or balms to help protect the skin and add moisture. In addition, you can make lifestyle adjustments like limiting exposure to hot water and harsh cleaners as well as using a humidifier if your home is dry. In some more severe cases of dry skin, your doctor may formulate a prescription cream to calm and hydrate the skin. 

Keratosis pilaris can clear on its own without treatment, but there are some options to help improve the appearance and feel of skin. Creams containing key active ingredients can help remove dead skin cells. The best ingredients that help loosen and remove dead skin cells are alpha hydroxy acid, lactic acid, salicylic acid, or urea. These topical exfoliants not only remove the dead skin but they also add moisture back to the skin. 

Another treatment option is a cream formulated to prevent the blockage of follicles. These types of creams are topical retinoids, and they work by stimulating cell turnover to ensure the hair follicles clear and stay clear.  The main active ingredients in these creams are tretinoin and tazarotene. 

Neither of these treatment options will cure the keratosis pilaris, and the condition could reappear if you stop using these creams. 

Should you see a doctor for dry skin and keratosis pilaris?

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Dry skin and keratosis pilaris are not cause for concern and do not need immediate medical attention. You should call your doctor for your dry skin if you notice that your skin itches constantly, looks or feels infected, becomes painful, or develops into a rash. 

For keratosis pilaris, you should seek treatment if the presence of the condition is bothersome. Your doctor can help you develop a treatment plan to manage the symptoms of the condition and help you feel better about the appearance of your skin. 

What is the outlook for people living with dry skin and keratosis pilaris?

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Dry skin can be chronic and can persist over time. However, the outlook for dry skin is positive with the right lifestyle adjustments and moisturizers. Dry skin can become more severe. If this happens, it is important to visit a doctor. 

Keratosis pilaris often will go away on its own with time over a few years. It is hard to predict when or if the condition will clear completely. The condition is not cause for concern and should not interfere with your daily life. 

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