Keratosis Pilaris: The Most Frustrating Condition
As a board-certified dermatologist, I’ve seen countless patients frustrated by the tiny, rough bumps on their skin that just won’t go away. This common condition, known as keratosis pilaris (KP), affects up to 50–80% of adolescents and 40% of adults. It typically presents on the upper arms, thighs, buttocks, and even the cheeks, giving the skin a sandpaper-like texture. While KP is completely harmless, it can be a persistent cosmetic concern, and unfortunately, treatment options are limited.
What Is Keratosis Pilaris?
KP is a genetic disorder of keratinization, where excess keratin builds up around hair follicles, forming small, rough plugs. It is commonly seen in patients with a history of atopic dermatitis (eczema) and often worsens in dry or cold weather. The natural course of KP varies—some people outgrow it by adulthood, while others struggle with it for life.
The Challenge of Treating KP
Ask any dermatologist, and they’ll tell you: KP is one of the most stubborn skin conditions to treat. While it’s not medically concerning, it can be a major source of frustration for patients who have tried every lotion and scrub with little success. The truth is, there is no cure, and even the best treatments offer only temporary improvement. Moisturization helps, but the real key is exfoliation—breaking down that excess keratin at a skin-deep level.
Popularly Marketed Products That Don't Work
Many products claim to be "miracle cures" for KP, but in my experience, most of them fall short. One example is First Aid Beauty KP Eraser, which is widely marketed but doesn’t provide meaningful results. Additionally, bead exfoliations and physical scrubs are a big no-no—they can cause microtears in the skin, leading to irritation and inflammation without effectively addressing the underlying keratin buildup. It’s important to be skeptical of skincare fads and instead focus on evidence-based treatments.
My Approach: Amlactin + Glycolic Acid
Over the years, I’ve been testing different combinations of treatments for my patients, and I’ve found that a mix of Amlactin Daily Nourish Lotion with 12% Lactic Acid AHA and The Ordinary Glycolic Acid 7% Toning Solution has shown promising results.
Lactic Acid (Amlactin Daily Nourish Lotion with 12% Lactic Acid AHA): This alpha hydroxy acid (AHA) works as both a chemical exfoliant and a humectant, gently dissolving the keratin plugs while drawing in moisture. It smooths rough texture and helps soften the skin over time.
Glycolic Acid (The Ordinary Glycolic Acid 7% Toning Solution): Another AHA, glycolic acid has a smaller molecular size, allowing it to penetrate deeper into the follicle to break down keratin and promote cell turnover.
How I Cycle These Acids
This routine is not for the faint of heart. Glycolic acid in particular can be very harsh, so I strongly recommend testing a tiny amount on a cotton pad on your arm before applying it to larger areas. If your skin tolerates it, here’s the routine I use:
Amlactin Daily Nourish Lotion – Night 1 & 2: Applied in the evening after showering on damp skin to maximize absorption and hydration.
The Ordinary Glycolic Acid 7% Toning Solution – Night 3: Used in a lightweight lotion or serum form to provide a deeper exfoliation.
Rest Day – Night 4: A break to allow the skin to recover and avoid irritation.
Repeat the cycle.
If glycolic acid is too strong for you or you don’t like the idea of cycling, stick with Amlactin 12% alone—this is likely the most effective single-product approach.
Final Thoughts
If you struggle with KP, know that you’re not alone. It’s a chronic condition that can be improved but not fully cured. While this lactic and glycolic acid combination has been promising, it’s important to remember that what works for one person might not work for another. If you’re struggling with KP, I always recommend working with a dermatologist to tailor a regimen that suits your skin.
Have you found anything that works for your KP? Let me know in the comments!