Keratosis pilaris on black skin may not appear as red or pink bumps. In some people, the bumps may be discolored. In others, they appear like your natural skin color but raised, like goosebumps.
Keratosis pilaris (also called “chicken skin”) is a common and harmless skin condition that causes tiny bumps to appear on your skin.
Keratosis pilaris bumps resemble small pimples or goosebumps that can sometimes itch. The bumps form when dead skin cells form plugs in other skin cells.
On dark skin, keratosis pilaris bumps may appear brown or black. On light skin, they usually appear white, pink, or red. This is why some people with dark skin may not recognize the bumps as keratosis pilaris.
Keratosis pilaris is not contagious and does not need treatment. Treatments to rehydrate or exfoliate your skin can help soothe it, improve its texture, and diminish the appearance of bumps.
Treating any underlying condition causing your keratosis pilaris may also help relieve symptoms.
Why representation matters
If you have dark skin, it may be much harder to find images of what keratosis pilaris or other skin conditions look like on your skin tone.
A 2021 study found that images of keratosis pilaris on light skin were three times more common across printed and online sources than images of the condition on dark skin.
Another
These gaps often create barriers for people of color who are looking for an accurate diagnosis and treatment.
On skin of color, keratosis pilaris can present as small pimples or goosebumps, with or without discoloration.
The discoloration may be one to several shades darker than your natural skin color. These changes in skin color may become permanent hyperpigmentation.
Your skin may also appear dull. The bumps can feel rough and dry like sandpaper and may itch.
The bumps may also change in number or size over time. Such changes may occur when you go through hormonal changes, like during pregnancy.
You may also experience seasonal changes, with bumps getting worse during the colder, drier months.
Which parts of the body does keratosis pilaris affect?
In adults, the condition most often occurs on the upper arms, buttocks, and front of the thighs. In children, it commonly affects the cheeks.
But keratosis pilaris can occur anywhere on your body. In some people, it can cover large areas.
Race does not seem to influence whether or not you develop keratosis pilaris. But skin of color may have qualities that make it more prone to keratosis pilaris.
Dry skin
Although the research is mixed, some studies suggest that people with dark skin tones may lose more moisture from their skin in general. This means dark skin may be more prone to being dry. The National Eczema Association also suggests that dark skin is often drier than light skin.
The outer layer of your skin contains ceramides, fatty acids that help retain moisture in your skin and keep germs out. Research suggests that people with dark skin may have fewer ceramides than people with light skin.
Although people with dark skin may have more other types of lipids on their skin (like sebum), the lower amount of ceramides may cause dry skin. Pores on dry skin can easily clog with built-up keratin.
Underlying conditions
Black people may also be more likely to have certain underlying conditions that are associated with keratosis pilaris. Examples
- atopic dermatitis (1.7 times more common in Black children than white children)
diabetes mellitus (60% more common in non-Hispanic Black adults than non-Hispanic white adults)- obesity (30% more common in non-Hispanic Black adults than non-Hispanic white adults)
Since keratosis pilaris does not cause serious symptoms or complications, there is no need to treat it. However, you may want to relieve itchiness or manage the appearance of the bumps.
A dermatologist might recommend topical creams to relieve itching and improve appearance, such as:
- Moisturizers: Urea 20% cream can help soothe your skin by trapping moisture.
- Keratolytics: Lactic acid or salicylic acid 6% lotion can help exfoliate your skin, removing dead skin cells from your pores.
- Retinol cream: Retinoids like tazarotene not only exfoliate your skin but also help produce new skin cells.
Less common treatments include:
- Laser treatment: Laser or light treatment may help reduce swelling and discoloration or improve texture.
- Microdermabrasion: Microdermabrasion uses a small device to sand away the top layer of your skin.
- Chemical peel: Applying a solution of 70% glycolic acid to your skin for 5 to 7 minutes can help smooth your skin.
- Vitamin D3 derivatives: These can help regulate the production of new skin cells.
Some people experience cosmetic benefits from these treatments. However, there have been no clinical trials into keratosis pilaris treatments.
Will keratosis pilaris go away on its own?
There’s no cure for keratosis pilaris, but it usually goes away by the age of 30.
Until then, you can take steps to reduce its appearance and itchiness. You can also prevent it from affecting other parts of your body.
The most common treatments for keratosis pilaris include exfoliation and using moisturizing cream several times a day, especially after a shower or bath.
While in a shower or bath, use a natural exfoliator like a loofah to gently scrub your skin, especially in areas affected by keratosis pilaris.
Within 5 minutes of leaving your bath or shower, apply a keratolytic cream to your skin, which can help remove dead skin cells. Stop using a keratolytic product if your skin becomes more dry or irritated.
At least two to three times per day — and always after applying keratolytic acid — gently massage moisturizing cream or ointment containing urea or lactic acid into the affected areas of your skin. Use an oil-free formulation to avoid clogging pores.
Caring for keratosis pilaris at home requires regular care and maintenance. You can prevent flare-ups by keeping your skin moisturized. Ways to maintain skin moisture include:
- adding a humidifier to your home when the air feels dry
- avoiding harsh types of hair removal like shaving and waxing
- bathing only once per day
- reducing the amount of time in the shower or bath
- using a mild cleanser on your skin (bar soaps can dry you out)
- using oil-free cream or ointment daily
- avoiding harsh scrubbing
Anyone of any age or race can develop keratosis pilaris. But some people have a higher risk. Risk factors
- a family history of keratosis pilaris
- asthma
- diabetes
- dry skin
- eczema
- overweight and obesity
- hay fever
- ichthyosis vulgaris
- melanoma, if taking vemurafenib (Zelboraf)
Racial disparities exist in all aspects of skin care: research, medical training, and patient care.
People with dark skin may have more trouble finding proper care. While there are amazing doctors, it pays to be your best advocate for your health to ensure you receive the care you deserve.
For guidance on managing keratosis pilaris, you may wish to talk with your primary care doctor or a dermatologist.
When you first meet with the doctor, gauge how attentive they are to you. Determine how willing they are to listen to your opinions and answer your questions. This is a great way to communicate to them that you expect to be heard.
A doctor likely won’t need to order any tests to confirm keratosis pilaris. But if they do order a test or procedure, be sure to ask about its purpose, risks, and possible complications. You’re free to not agree and ask about alternatives.
At the tail end of your visit, ask your doctor to review your visit, including your concerns. “Can we go over what we discussed today?” is one of the most important questions to ask.
Make sure you have all the answers you need from your doctor before you leave and that you and your doctor are on the same page regarding your health.
Keratosis pilaris is a common skin condition that often affects teenagers and young adults.
It often appears on skin of color as raised, darkened bumps on your upper arms, buttocks, and thighs. In young children, it often appears on the cheeks.
While the condition is harmless, you can treat keratosis pilaris through rehydration or exfoliation. These techniques can improve skin texture and reduce the visibility of bumps.
Treating any medical condition that may be associated with keratosis pilaris may also help reduce symptoms.