A-Z OF SKIN

Keratosis pilaris is a common condition in which rough, bumpy spots appear on the skin. Keratosis pilaris rubra faciei is a subtype of keratosis pilaris characterised by rough, red bumps on the face, particularly on the cheeks.

Keratosisi pilaris can affect anyone at all ages, but it is most common in children and adolescents. Approximately 50-80% of adolescents are affected to some degree. The cheeks are involved more commonly in children. It is more common in individuals who suffer from atopic dermatitis (eczema) or ichthyosis vulgaris.

Keratosis pilaris is, in most cases, a genetic condition that runs in families. Hair follicle openings become plugged with a build-up of keratin, a protein that lines the hair and skin. Some of the bumps may contain an ingrown hair.

A group of small, rough, red bumps on the cheeks, resembling chicken skin with a prominent background pinkish-red discoloration. In severe cases the bumps may have a tiny pustule. It appears worse in the winter months due to low humidity and consequent drying of the skin. Although the bumps do not cause any symptoms, its appearance can be distressing for affected individuals.

It can be diagnosed by observing the typical appearance of the rash. Further tests are usually not required.

Many individuals seek treatment to improve its appearance. The aim of treatment is to reduce the redness and improve the skin texture.

Treatments include:

• Soap-free cleanser (soap can worsen dryness)
• Regular application of moisturiser
• Gentle exfoliation to smooth the skin
• Creams containing urea, lactic acid, salicylic acid or glycolic acid
• Topical retinoids (vitamin A) and vitamin D creams
• Laser treatment, including pulsed dye laser, vascular laser or intense pulsed light (IPL), may be tried after consultation with a dermatologist.

Keratotis pilaris rubra faceii is harmless, it often improves with age.

Rooks Textbook of Dermatology, 19.73 Keratosis pilaris

ACD A-Z of Skin: https://www.dermcoll.edu.au/atoz/keratosis-pilaris/

Medscape – pediatric keratosis pilaris: https://emedicine.medscape.com/article/

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American Academy of Dermatology : https://www.aad.org/public/diseases/a-z/

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