What does keratosis pilaris look like on Black skin?

The rough bumps that appear on the skin with keratosis pilaris look like goosebumps and are not contagious.

Keratosis pilaris occurs due to an excess of keratin, which blocks the hair follicles and causes plugs, or bumps, on the skin surface.

Keratosis pilaris may affect 50–80% of adolescents and 40% of adults in the general population of the United States. Research suggests that race does not predispose people to developing the condition.

Certain risk factors for keratosis pilaris may affect Black people, though. Keratosis pilaris commonly occurs alongside atopic dermatitis, or eczema.

According to the National Eczema Association, research suggests that in the U.S., eczema affects around 20% of Black children compared to around 16% of White children and around 8% of Hispanic children. Eczema may also be more severe in Black and Hispanic children than White children.

Black skin has certain structural features, including decreased ceramide levels and increased trans-epidermal water loss, which may result in dry skin. This may make keratosis pilaris more prominent.

Keratosis pilaris causes multiple small bumps on the skin, giving the skin a rough texture like sandpaper.

On Black skin, keratosis pilaris may appear brownish-black or the same color as the surrounding skin. Some people may find that the bumps itch.

Keratosis pilaris commonly occurs on the upper arms but can also appear on the thighs, buttocks, forearms, and lower legs. Children may have keratosis pilaris on their cheeks.

The bumps may be more prominent with dry skin or in drier climates, such as during the winter months.

Keratosis pilaris occurs due to a buildup of keratin, a type of protein, accumulating in the upper portion of the hair follicles.

Instead of exfoliating and shedding as normal, the keratin blocks the follicle, causing bumps.

The underlying cause of this keratinization is not clear. It may link to a genetic mutation involving filaggrin, a protein that helps support the normal function of the skin barrier.

Keratosis pilaris can affect anyone of any race, sex, or age, although the condition may be slightly more common in females.

Risk factors for keratosis pilaris include the following:

• asthma
• atopic dermatitis
• close family history of keratosis pilaris
• dry skin
• excess body weight
• hay fever
• ichthyosis vulgaris
• taking vemurafenib to treat melanoma

Some of these risk factors may disproportionately affect Black people.

According to a 2021 study, atopic dermatitis prevalence may be 1.7 times higher in Black children than in White children, especially in early childhood.

There is also an increased risk of more severe and persistent atopic dermatitis in Black children.

The study also notes that in the U.S., asthma is significantly higher in Black and Indigenous people than in non-Hispanic White people.

Black skin may lose more water and moisture than other skin types, leading to drier skin.

Treatment for keratosis pilaris is not necessary but may help lessen bumps and improve texture. In most cases, keratosis pilaris will gradually improve over time and people may find the condition disappears by the age of 30.

Treatment options include:

• topical emollients
• topical keratolytics
• applying 6% salicylic acid lotion or 20% urea cream
• topical retinoids, such as 0.01% tazarotene
• vitamin D3 derivatives
• laser treatments
• chemical peels with 70% glycolic acid

Applying a thick moisturizer containing urea or lactic acid may help to ease any dryness or itching. In some cases, people may require medicated creams or corticosteroids.

It is not always possible to prevent keratosis pilaris, as it may have a genetic factor.

People may be able to prevent flare-ups of keratosis pilaris with the following steps:

• applying moisturizer to damp skin within 5 minutes after bathing and throughout the day if the skin feels dry
• choosing a thick oil-free moisturizing cream or ointment containing urea or lactic acid
• avoiding shaving or waxing the area and opting for laser hair removal instead
• taking short showers and baths for no more than 20 minutes once a day
• using warm water for bathing rather than hot water
• using a mild, soap-free cleanser
• using a humidifier to prevent dry air from drying out the skin
• avoiding self-tanning products

Keratosis pilaris is a harmless condition and does not require any treatment.

If people have concerns about any symptoms, such as itching or dryness, or the appearance of their skin, and home remedies are not effective, they can contact a doctor.

If a person is unsure if they have keratosis pilaris or another skin condition, a doctor can provide a diagnosis.

The American Academy of Dermatology Association (AAD) provides a search tool in which people can find a dermatologist who specializes in treating skin of color.

Keratosis pilaris causes small, rough bumps on the skin, usually on the upper arms or thighs. In Black skin, the bumps may be brownish-black or the same color as the surrounding skin.

The condition can affect anyone of any race or ethnicity. People with Black skin may have an increased risk of certain factors, such as atopic dermatitis or dry skin, which may increase the likelihood of developing keratosis pilaris.

Treatment cannot cure keratosis pilaris but may help ease any itching or dryness. Treatments include moisturizers, keratolytics, or topical retinoids. Over time, keratosis pilaris may gradually resolve.