A guide to managing keratosis pilaris this season

For as long as I can remember, the notion of Jergens lotion ad-worthy skin—impossibly smooth, virtually poreless, and preternaturally glowing—has evaded me. As a 20-year sufferer of keratosis pilaris, I've grown accustomed to the tell-tale permanent goosebumps on the back of my arms and legs, as well as accepted the fact that there is no cure for this common skin condition. That being said, I've also relished doing what I can do to manage it, and know that while nothing can banish the bumps forever (at least not yet), there are plenty of ways to lessen symptoms, particular in the winter when the elements can make things worse. Here, two experts break down what KP is, along with the best ways to treat it, from gentle exfoliation to supercharged moisture.

What is keratosis pilaris, otherwise known as KP?

Keratosis Pilaris, or KP, is an incredibly common skin condition that affects 40% of adults. It typically manifests as small, hard bumps, usually surrounded by red areas of skin, on the upper arms, legs, or buttocks. In simplest terms, KP is a blockage of the hair follicles. "The skin just creates a buildup of a protein called keratin—the same building block for hair, skin and nails—and the keratin creates a plug that blocks the hair follicle, which leads to the little bumps," explains explains New York City dermatologist Rachel Nazarian, MD, of Schweiger Dermatology. "The plug can also trigger inflammation in the skin, which is what causes the redness around each hair follicle." Despite how prevalent KP is, and that it tends to run in families, it's unknown why some people experience it and others don't, though Nazarian says it’s often found with people who have very sensitive skin, or alongside conditions such as eczema or atopic dermatitis.

While KP is usually asymptomatic, it is often worse in the winter and less noticeable in the summer. "Arid climates and dry skin worsens KP as skin cells are more adherent and shed less frequently when they are dry," explains Blair Murphy-Rose, MD, FAAD, dermatologist, and Clinical Assistant Professor at New York Presbyterian Hospital-Weill Cornell Medical Center. "Higher humidity levels and sunlight are believed to help with controlling KP."

What is the best way to exfoliate when you have keratosis pilaris?

Let's start with what not to do. "The most common mistake I see my patients making is trying to 'scrub' the bumps off, or using a rough loofah to exfoliate the bumps away," explains Nazarian. "Although this technique will work temporarily by dislodging the keratin plugs, rough exfoliation will inflame the skin and hair more, ultimately causing increasing redness and making the condition even more noticeable." While physical exfoliators can often be too abrasive on KP, there are specially formulated, finely-milled body scrubs, such as First Aid Beauty KP Bump Eraser, that can be effective. "If you are someone that loves a good body scrub, just make sure to scrub gently and always moisturise immediately after," says Murphy-Rose, who recommends patting skin dry with a towel after bathing and applying a rich moisturiser while still damp.

But while there's instant gratification in a scrub that leaves skin smooth, experts agree that chemical exfoliation, which uses acids to gently dissolve away dead skin, is the best strategy for treating keratosis pilaris. According to Murphy-Rose, options for chemical exfoliation include topical lotions, creams, or serums that contain glycolic acid and lactic acid (AHAs), salicylic acid (a BHA), gluconolactone (a PHA), and urea. Offering next-level treatment are chemical peels ranging from mild daily peels to stronger in-office monthly or bi-weekly peels. Additionally, some patients get great results against KP by using retinol or a prescription-strength retinoid. "These vitamin A derivatives help to regulate skin cell turnover and encourage appropriate shedding of skin cells," says Murphy-Rose.

How can you maximise moisturiser when you have keratosis pilaris?

For controlling KP, moisture is key—especially when the temperatures drop and air becomes more arid. "Anything that dries out skin can make KP more noticeable," explains Nazarian. "This includes arid seasonal changes and many patients find that their KP flares in the winter and fall, when humidity drops and moisture is pulled out of the skin more easily." When looking for lotions and creams to slather on, a combination of humectant, emollient, and occlusive ingredients make for the most effective moisturisers. "Look for ingredients like ceramides, shea butter, petrolatum, dimethicone, glycerin, and hyaluronic acid," says Murphy-Rose, adding that anti-inflammatory properties, like aloe and niacinamide, can be helpful in reducing discolouration in reddish bumps. In the spirit of a practicality, Murphy-Rose advises her KP patients to use a moisturiser that also contains exfoliating ingredients so it can function as a 2-in-1. "The hardest part about KP treatment is sticking to a strict twice daily regimen, so having an ‘all-in-one’ product is always a plus," she says.

It can't be emphasised enough: Sticking to a dedicated regimen of exfoliating and moisturising is key for keeping KP continuously under control. Otherwise, it will return to normal. "The continuous use of the creams will help smooth skin, followed by the eventual fading of the surrounding redness, but once treatment is discontinued the bumps reappear," says Nazarian. "I remind my patients not to get discouraged—many people out-grow the condition and it typically lessens as they get older."

This article originally appeared on Vogue.com

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