Ask Me Mondays: Small Bumps on Upper Arms

Q: I have the most annoying small red bumps on my upper arms and sometimes on my thighs. I know they aren't acne, but sometimes I can squeeze them and something comes out. I know, that's gross. But what are they, and what can I do about them?

It really sounds to me like you have a very common inherited skin disorder called keratosis pilaris. You're right: it's not acne! And don't squeeze them - it doesn't help, and it can lead to scarring if you're not careful.

Here are the basics on keratosis pilaris: it's very, very, very common - up to 50% of adults have it. Sometimes it looks red and inflamed, sometimes it just looks like goosebumps. It can get worse in the winter when the air is dry, but not always. Sometimes it makes your skin feel like sandpaper, if the bumps are small and fine. Basically, there is no one identifying symptom, other than bumps, that makes this stand out.

How do you get it? You inherit it. Thanks, mom! Your skin in the problem areas creates too much of a certain protein called keratin which then builds up in and around the hair folicule, causing the clog which leads to the bump. It is a completely harmless condition, and sometimes goes away completely on it's own as the skin produces less keratin due to aging. Others have it all their lives.

Treatment is usually somewhat ineffective, but I wonder if this is because people eventually stop the treatment altogether. Given the nature of this disorder, you would have to commit to a long term treatment using alpha and beta hydroxy acids which help clear the bumps, and moisturizing, which helps calm the dry skin which can make the situation worse.

Many sources seem to think products containing lactic acid work the best, although it seems that any kind of AHAs are recommended across the board. BHAs (salicylic acid) is also thought to be helpful to penetrate inside the bumps, but may be unnecessary on already dry skin.

One of the few keratosis pilaris treatments I have found is the DERMAdoctor Keratosis Pilaris Regimen Kit. You use the DERMAdoctor KP Duty Dermatologist Body Scrub with Chemical + Physical Medi-Exfoliation in the bath or shower to cleanse and exfoliate dry skin, and then use then apply DERMAdoctor KP Duty Dermatologist Moisturizing Therapy For Dry Skin to arms and/or legs or where needed twice daily or as often as needed. Both items come in the set.

An extremely helpful site for you is here: Help for Keratosis Pilaris