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Problem: Since I was five or six, I
have had little bumps on the backs of my upper arms and
now they have spread to other areas of my body. They don't
hurt (although they itch sometimes) but they are very
annoying. I read that these are Keratosis pilaris, a genetically
inherited skin disorder caused by the skin's inability
to exfoliate itself. Does this sound right? If so, what
treatment options are available?
Solution: The diagnosis sounds fairly
right-on. Keratosis pilaris is very common, finding a
home on the upper arms, thighs, and shoulders. Keratosis
pilaris tends to be more severe during the winter months
but no one is sure why that is the case and it definitely
isn't consistent for everyone. Basically, the bumpy rough
spots are clogged pores that sometimes get red and irritated
but rarely itch. Regrettably there is no available cure
or universally effective treatment, though it is generally
well accepted that unclogging pores and reducing inflammation
can improve matters greatly (Source: eMedicine Journal,
July 2, 2001, Volume 2, Number 7).
Lactic acid (a very effective form of alpha hydroxy acid)
can help exfoliate skin cells, but lactic acid isn't effective
for dissolving lipids, so it can't penetrate into the
pore and exfoliate the lining of the pore that is a major
cause of the problem. For that, you would need a beta
hydroxy acid product with the active ingredient salicylic
acid and a pH low enough for exfoliation to occur. It
is also helpful to avoid bar soaps that can irritate skin
or cause clogged pores. A gentle body shampoo is best.
The recommendation to scrub away the plugs can mean you
inflame the area and still leave the skin feeling rough
and bumpy below the surface where the abrasive can't reach.
Another common condition that can manifest itself as
visible red bumps on the arms and thighs is bacterial
folliculitis. This inflammatory condition involves an
infection of the hair follicle by the bacteria Staphylococcus
aureus. It begins with mild swelling and redness around
the hair follicle and may eventually become small, inflamed
pustules. This condition is most common in persons with
a lot of body hair, but can occur on anyone. The most
common form of prescribed treatment is a course of oral
antibiotics (penicillins, cephalosporins) but topically
applied antibiotics are also helpful (Source: The Skin
Sourcebook, 1998, pages 162-164). You can also try treating
the affected area with daily application of a product
containing 5% or 10% benzoyl peroxide. This topical disinfectant
is often helpful in keeping these inflamed, acne-like
bumps under control.
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