How to get rid of keratosis pilaris

What is keratosis pilaris?

Keratosis pilaris is a plug of dead skin cells in a hair follicle, repeated across thousands of follicles at once. The American Academy of Dermatology describes the rough bumps as plugs of dead skin cells, most often on the upper arms and the front of the thighs, and on children’s cheeks.

It is not an infection, an allergy or a hygiene problem, and it is close to universal. StatPearls, on the NIH’s own bookshelf, gives the adolescent figure as 50 to 80 per cent affected and the adult figure as 40 per cent, and calls it a normal variant of skin rather than a disease.

The mechanism is keratin. StatPearls describes abnormal follicular epithelial keratinization causing an infundibular plug to form, and those plugs produce the scaling and redness around each follicle opening. The hair is often still in there, coiled under the plug, which is why squeezing a bump releases nothing.

The AAD’s list of what raises your risk is mostly not about skincare: close blood relatives who have it, asthma, hay fever, eczema, ichthyosis vulgaris, dry skin and excess body weight. Dryness is the item you can act on, and it is why so many people find the bumps clear during the summer only to return in the winter. StatPearls records the same seasonality in numbers: 49 per cent improve in summer, 47 per cent worsen in winter.

Can you get rid of keratosis pilaris?

Keratosis pilaris cannot be cured, and any product promising to clear it permanently is overselling. The AAD says so in its own words: treatment cannot cure keratosis pilaris, so you’ll need to treat your skin to keep the bumps under control.

The honest timeline is two numbers. The first is when to judge a routine: the AAD asks you to tell your dermatologist if you fail to see improvement after following your treatment plan for 4 to 6 weeks. The second is the one nobody sells, because it is slow and free. The AAD says clearing tends to happen gradually over many years, commonly through the twenties, whether or not it is treated.

StatPearls is blunter about the products. Although they may give a cosmetic benefit, it notes, there are no controlled clinical trials or a cure for keratosis pilaris, and the condition is often refractory to the options available.

The realistic goal is skin that stays smoother for as long as you keep the routine going, plus a reasonable chance the whole thing quietens down on its own within a decade. A cure out of a bottle is not on the table for anybody.

How do you treat keratosis pilaris properly?

Treating keratosis pilaris is a three step routine and then a maintenance plan, and the AAD sets out all four parts: exfoliate gently, apply a keratolytic, moisturise, then drop back to a few times a week.

Exfoliate gently, and never scrub

The AAD’s first step is to slough off these dead cells gently with a loofah, buff puff, or rough washcloth, and the warning attached matters more: avoid scrubbing, which irritates the skin and worsens keratosis pilaris. StatPearls names scarring from traumatically rupturing the lesions as one of the few complications this condition has, and the plug is inside the follicle, so there is nothing on the surface to scrub off.

Then a keratolytic, which is where the five actives live

A keratolytic is a chemical exfoliant, and the AAD names what qualifies: alpha hydroxy acid, glycolic acid, lactic acid, salicylic acid, urea, and a retinoid (retinol, tretinoin, adapalene, tazarotene). StatPearls puts strengths on two, reporting that texture improves with either salicylic acid lotion at 6 per cent or urea cream at 20 per cent, and the AAD elsewhere names ammonium lactate cream or lotion (12%), which is lactic acid neutralised with ammonium hydroxide rather than a sixth ingredient to learn. Use whichever you pick exactly as directed: the AAD warns that too much causes raw irritated skin, and that the right response is to stop for a few days rather than push through. Which of the two acids on that list you reach for barely matters for keratosis pilaris, and our post comparing glycolic acid and salicylic acid sets out the complaints where the choice does matter.

Moisturise on damp skin, and stop drying yourself out

A keratolytic dries the skin it is exfoliating, so this is not the optional step. The AAD wants a thick oil free cream or an ointment rather than a lotion, containing urea or lactic acid, applied to damp skin within 5 minutes of bathing and two or three times a day. Its prevention list is the same idea: showers of 20 minutes or less in warm rather than hot water, a mild cleanser instead of bar soap, a humidifier when the air is dry. Two items on it surprise people. Shaving and waxing over keratosis pilaris can cause more bumps, and self tanner makes them more obvious rather than hiding them. Bumps that appear only after you shave or wax may not be keratosis pilaris at all: our post on bumps after waxing or shaving draws an ingrown hair and an infected follicle beside a normal one, so you can tell them apart.

Lasers, if the creams have failed

Laser and light treatment is where the AAD goes when moisturiser and medicine have not worked, one type aimed at swelling and redness and another at texture. StatPearls lists pulsed dye, alexandrite, Nd:YAG and fractional carbon dioxide among those reported. A dermatologist’s decision, not a purchase.

Is keratosis pilaris treatment safe in pregnancy, while breastfeeding or with PCOS?

Urea, lactic acid, salicylic acid, ammonium lactate and a topical retinoid are the five ingredients every keratosis pilaris routine is built from, and they do not hold the same status across every life stage. One has a firm pregnancy instruction attached. Three have no published instruction at all.

One thing separates this from the advice written about acne. Acne treatment is a spot on a face; keratosis pilaris treatment is a lotion over both upper arms and both thighs, twice a day, indefinitely. Guidance written about a small area used occasionally is being asked to cover a large area used constantly, and the honest response is to ask rather than assume.

If you are pregnant

Pregnancy takes the retinoid off the list and leaves most of the rest unaddressed. ACOG puts topical retinoids in the same drug family as isotretinoin and says it is generally recommended that use of these medications be avoided during pregnancy. A review in Canadian Family Physician weighs four reports of birth defects consistent with retinoid embryopathy against two prospective studies that found no increased risk, and concludes that women should not be encouraged to use topical retinoids during pregnancy.

ACOG’s list of over the counter ingredients that can be used during pregnancy does include topical salicylic acid and glycolic acid, and the review finds glycolic acid should not be of concern given how little is absorbed. ACOG is not the only body with a position on those two though, and the American Academy of Dermatology attaches a concentration limit to one of them. Our post comparing glycolic acid and salicylic acid carries that disagreement in full, with both pages linked, and it is why the matrix above reads caution rather than clear for salicylic acid over both arms and both thighs. What the list does not include, in either direction, is urea, lactic acid or ammonium lactate. That is a gap rather than a warning or a clearance, and ACOG’s instruction for anything not on its list is to contact your obstetrician. The three gentlest ingredients in keratosis pilaris care are the three nobody has written a pregnancy rule about.

If you are breastfeeding

Breastfeeding changes where you put things and leaves the same three ingredients unaddressed. The NIH’s Drugs and Lactation Database considers salicylic acid safe to use during breastfeeding, on the condition that you avoid anywhere it might touch your baby’s skin, and says the same of glycolic acid. On retinoids it splits. Topical adapalene is probably a low risk to the breastfed infant, applied to the smallest possible area and never the nipple. Tazarotene is the one to read twice: LactMed reports that some experts feel it should not be used on a large surface area (perhaps greater than 20% of body surface area) while others recommend against it during breastfeeding entirely. Both upper arms and both thighs is in that territory, and that is the area keratosis pilaris asks you to treat. The database runs to nearly two thousand substances and holds no record of topical urea, lactic acid or ammonium lactate. That is worth stating plainly rather than reading as reassurance.

If you are trying to conceive

Trying to conceive has no published rule of its own, and inventing one would be worse than saying so. Every instruction above is written about pregnancy, and there is a window in which somebody is pregnant before they know it. That is why Truva marks a topical retinoid Not Recommended on a trying to conceive profile and salicylic acid Caution Advised, while urea, lactic acid and ammonium lactate carry nothing at all: a judgement about timing on the two that have a pregnancy instruction to be early for, labelled as one.

If you are postpartum and not breastfeeding

Postpartum without breastfeeding returns you to the general list, with all five actives available as the AAD recommends them. The row earns its place anyway, because keratosis pilaris flares with dry skin and a first winter with a newborn is a lot of hot water and dry indoor air. It is also the shortest of the five profiles in the catalogue: what stays flagged once you are postpartum runs to a couple of hundred entries against more than a thousand in pregnancy, and none of these five are among them.

If you have PCOS

PCOS does not change what you may put on keratosis pilaris, and the more useful thing to say is that keratosis pilaris is not a sign of it. NICHD’s list of the symptoms of PCOS runs to hirsutism, persistent acne, dark patches of skin, insulin sensitivity and weight gain. Keratosis pilaris is not on it. The StatPearls list of conditions associated with keratosis pilaris runs to atopic dermatitis, ichthyosis vulgaris, obesity, diabetes mellitus and malnutrition. PCOS is not on that one either. They touch at one point, body weight, which is well short of a link. If you came here because something on your skin looked like it might be PCOS, the four skin signs a named body does list are set out separately, along with what anybody has actually published about treating them.

This split is what Truva was built to make. The comparison pages set out why a scanner that never asks your situation cannot make it.

When should keratosis pilaris go to a dermatologist?

Keratosis pilaris that has not improved after 4 to 6 weeks of a consistent routine is the point the AAD names for going back to a professional. So is keratosis pilaris that itches enough to bother you, or that has left marks where lesions were picked at. If you are pregnant or breastfeeding, take the ingredient list to your obstetrician or midwife rather than the bottle, because three of the five ingredients likely to be on it are ones no published body has ruled on for you.

Key takeaways

• Keratosis pilaris is a keratin plug in a hair follicle, repeated thousands of times over. StatPearls reports it in 50 to 80 per cent of adolescents and 40 per cent of adults.
• There is no cure. The AAD says treatment cannot cure it and the maintenance plan is permanent, while noting that for many people it fades gradually over many years untreated.
• The routine is three steps: exfoliate gently and never scrub, apply a keratolytic exactly as directed, then moisturise on damp skin within 5 minutes of bathing. Give it 4 to 6 weeks.
• In pregnancy the retinoid comes off the list. ACOG says topical retinoids should generally be avoided. It names topical salicylic acid among the ingredients that can be used, though the AAD asks you to use salicylic acid above two per cent sparingly and to raise it with a dermatologist, which is why the matrix above reads caution rather than clear for a routine covering both arms and both thighs.
• Urea, lactic acid and ammonium lactate are the least contested of the five and the least documented. ACOG’s pregnancy list does not name them and the NIH’s lactation database holds no record of them. That is silence, not a clearance.

Where this came from

Every health claim on this page links to the body that published it. Nothing here comes from another blog.

Every link above was fetched and confirmed to resolve on 6 September 2026.

Truva summarises published guidance from bodies including ACOG, the FDA, the EU SCCS and the Cosmetic Ingredient Review. It has no access to your medical history and it is not a substitute for your doctor, dermatologist or midwife. This post was written by the Truva team from the sources listed above. It has not been reviewed by a clinician, and nothing in it is a diagnosis or a prescription. If you are pregnant, breastfeeding or being treated for PCOS, take the ingredient list to the person looking after you.