Keratosis Pilaris
Keratosis pilaris (KP) is a very common, harmless, non-infectious condition. Keratin builds up in the openings of hair follicles instead of shedding, which gives small rough “goose-flesh” or “chicken skin” bumps (DermNet 2022; NHS 2024). It usually begins in childhood, becomes more obvious in the teenage years and runs in families (DermNet; NHS). KP is closely associated with Atopic Dermatitis and Ichthyosis Vulgaris, and has been linked to mutations in Filaggrin, the barrier protein whose loss also predisposes to AD (DermNet). In a toddler with eczema it is often a minor feature of the atopic skin rather than a separate disease (Siegfried & Hebert 2015). Türe Avcı et al. (2026) list it with Pityriasis Alba among the typical findings that accompany childhood AD.
Keratosis Pilaris [relates] Atopic Dermatitis Filaggrin [relates] Keratosis Pilaris Keratosis Pilaris [relates] Ichthyosis Vulgaris
What it looks like and how it differs from eczema. The bumps sit on the outer upper arms, thighs and buttocks, and in young children often on the cheeks. They are skin-coloured, red on white skin, or brown to dark on darker skin (DermNet; NHS). The skin feels rough and dry and may itch a little, but it lacks the weeping, poorly defined itchy patches of an eczema flare (Siegfried & Hebert 2015). KP is worse in winter, when air humidity is low, and better in summer (DermNet; NHS). Facial redness with KP (keratosis pilaris rubra) can be mistaken for eczema on the cheeks. Diagnosis is clinical (DermNet).
Keratosis Pilaris [part-of] Differential Diagnosis of Toddler Eczema
Management. There is no cure, and treatment is optional and cosmetic. For toddlers the NHS approach fits well with eczema care: regular moisturising (Emollient Therapy), unperfumed washes (Soap Substitutes), lukewarm rather than hot baths, gentle washcloth exfoliation, and avoiding harsh scrubs and picking. Moisturisers containing urea or lactic or salicylic acid loosen the plugs (DermNet; see Urea Creams). Urea and acid creams can sting broken or eczematous skin, though, so in young children they are best used only on intact KP skin and after checking with a pharmacist. A short course of steroid is reserved for itch. Retinoids and lasers are adult options that the NHS does not usually provide. KP tends to improve with age (DermNet).
Emollient Therapy [treats] Keratosis Pilaris Urea Creams [treats] Keratosis Pilaris
Connections
- Differential Diagnosis of Toddler Eczema — benign follicular look-alike, source: Siegfried & Hebert 2015
- Atopic Dermatitis — frequent association / minor feature, source: DermNet 2022; Türe Avcı 2026
- Ichthyosis Vulgaris — co-associated barrier disorder, source: DermNet 2022
- Filaggrin — filaggrin mutations correlated with KP, source: DermNet 2022
- Urea Creams — keratolytic moisturisers loosen follicular plugs, source: DermNet 2022