Keratosis Pilaris: What It Is, Why You Get It & How To Treat It Naturally

Typically, I try to be accepting of my body (after all, it does some pretty amazing things), but there's one thing I really wish I could change: the bumpy skin on the backs of my upper arms and thighs that's plagued me since I was a kid. The technical term: keratosis pilaris (KP), which some refer to as "chicken skin."

So, I reached out to a handful of dermatologists about the underlying cause of these pesky red bumps and how to eliminate them in the most natural way possible.

Keratosis pilaris, or KP, is simply a buildup of keratin and dead skin cells within the hair follicles, which causes them to bulge and become irritated and inflamed1, giving your skin a bumpy texture. "Let’s examine the medical description. Keratosis just means an excess of growth of keratin, one of the proteins that make up our skin and hair. And any medical word with 'pilo' in it is related to hair," says physician and founder of Osmia Organics Sarah Villafranco, M.D. "So, keratosis pilaris is a buildup of keratin and dead skin cells within the hair follicles, causing them to bulge, giving them the bumpy texture, and often causing them to get irritated and inflamed."

Typically, KP appears on the backs of the arms, the fronts of the thighs, and sometimes on your butt, but it can also occur on your face (your cheeks in particular). And loads of people are affected—an estimated 50 to 80 percent of all adolescents and approximately 40 percent of adults. "Anyone can get it, but children and adolescents have a higher incidence of KP than adults: It’s extremely common in people under 50, and less common in the elderly. KP is more common in women than men and often occurs in people with a history of asthma or eczema," says Villafranco.

But what makes you prone to those annoying red bumps while others get to flaunt their gloriously smooth upper arms? Well, it's not totally clear. You can partially blame your parents. "It's a genetic and chronic condition, and dry skin can make it much worse," says Lisa Airan, M.D., an NYC-based dermatologist specializing in natural, high-tech skin care. It can be managed, she says, but only with continued therapy.

But more surprisingly, your diet may also exacerbate symptoms. "What I'm beginning to suspect is that this is a low-grade inflammation in the body that's showing up in the hair follicle," says holistic dermatologist Alan Dattner, M.D., adding that increasing your intake of certain nutrients and eliminating certain foods that contribute to inflammation and leaky gut (like gluten, for some) may help eliminate or reduce KP.

Another possible culprit is your clothing: "My theory is that these areas are the places where your clothing tends to rub back and forth on your skin the most, and it stimulates dysfunctional keratin production in the hair follicles," says Villafranco. "But my theory on why it occurs in these areas is as unproven as the few others out there—we don’t have any actual data to explain why it occurs in some areas and not others."

You can certainly try all of these strategies at once to up your chances of success, but if you do, just keep in mind that it may be hard to tell which particular strategy is working best. So, if you think your KP could be influenced by diet, Dattner recommends changing that first (giving it at least a month to see if you notice your skin calming down) and then incorporating some of the skin-smoothing products on this list to enhance the benefit. Villafranco agrees: "I recommend some less invasive steps first—simple changes may make your KP pack its bags without having to involve the prescription pad."

Because your KP may be exacerbated by chronic, low-grade inflammation, adopting a whole-foods-based, antioxidant-rich diet like the Mediterranean diet can go a long way in reducing inflammation2, supporting gut health, and potentially relieving some of your symptoms. But that won't be enough for everyone.

While his treatment approach varies slightly from patient to patient, Dattner says he often recommends increasing intake of vitamin A and vitamin D, both of which encourage healthy skin cell production. Additionally, he recommends supporting the health of the microbiome and improving digestion with probiotics and digestive enzymes, since a damaged or leaky gut can contribute to chronic inflammation by allowing substances into the body that shouldn't be there. And, of course, if you think you may be sensitive to certain foods like dairy or gluten, you'll want to stop eating them too. Because, again, inflammation.

As mentioned above, dry skin will only make your KP worse. In fact, some people say their bumps clear during the summer only to return in the winter, according to the American Academy of Dermatology. For this reason, derms, like Airan and Villafranco, recommend avoiding long, hot showers or baths, which can suck moisture from the skin, and always following up with a moisturizer of some kind. "Avoid super-hot showers or baths on a regular basis—they contribute to dry skin, which makes KP more likely," says Villafranco.

"There’s a growing suspicion that certain chemicals, such as sodium lauryl and laureth sulfate or synthetic fragrance, are causing a low-level skin irritation. Subsequent abnormal keratin production and inflammation can lead to symptoms of KP. Lastly, some medications used to treat melanoma can cause KP," says Villafranco. "Get rid of all sodium lauryl and laureth sulfate in your hair care, your skin care, and your laundry detergent. Look for it in anything that foams. Eliminate synthetic fragrances from all of those products as well."

"Regular exfoliation is the mainstay of management of this chronic skin condition," says Airan. Any physical exfoliant, body scrub, or chemical exfoliator will do: Just find one you find sensorially appealing so you'll be sure to stick with it.

If you're going the chemical exfoliator route, gentle acids are fan favorites. You can find them infused in body washes or treatments. "An acne body wash containing AHAs or BHAs would be helpful for managing KP," says Airan, who says that a mild 2 percent salicylic acid cleanser can help gently remove buildup and excess skin cells. Try the Alba Botanica Acnedote Maximum Strength Face & Body Scrub ($8) featuring salicylic acid and finely ground walnut shells to clear clogged follicles. We're also partial to lactic or glycolic acid.

Or stick to physical, like these DIY scrubs, just be sure to use a gentle pressure, as over-exfoliating can increase inflammation. Finally, you can even use common household items: "You can do this with a washcloth in the shower," says Villafranco.

This won't unclog your pores right now—but it will help keep your skin soothed long term. "Use a natural body oil on sopping wet skin just out of the shower every day. You provide the water by not drying off, and the body oil seals in that moisture as you rub it in with your hands," says Villafranco. "It contains fewer ingredients, which is always a plus when dealing with irritated skin."

Sometimes, try as we might, tending to skin issues ourselves doesn't get the job done. Well, that's why there are professionals. If you've hit a point that you feel you're out of options, take your concerns to a derm. "If you’ve tried all of these things and still have symptoms, it may be time to talk to your dermatologist about prescription options, or even laser therapy, which is starting to show some promise in treating the condition," says Villafranco. "But with consistent attention to the factors listed above and to an overall healthy lifestyle, most people find that their symptoms improve significantly, and their bumpy skin is a thing of the past."

Listen: This is a totally harmless and common skin condition, so don't worry if you have it. That being said? We totally get it if you want to treat it. Luckily there are plenty of natural options out there, ranging from diet and lifestyle to powerful topicals.