Q My teenage daughter has goose bumps on her arms. They don't go away. She's so embarrassed by them that she will only wear long sleeved blouses. What are they and what can be done?
A She has a very common condition called keratosis pilaris that is so common that the "goose flesh" is almost considered normal. Many people have this condition on their upper arms and thighs. When the bumps appear on the face, which is really rare, it is called keratosis pilaris rubra faciei. Although keratosis pilaris sometimes affects children, it's more common in adolescents and adults.
Keratosis pilaris usually causes no symtpoms. In some cases, small hard "spines," similar to hard blackheads, stretch the follicles on the back of the arms and the outside areas of the thighs. The "goose bumps" have hairs growing from the centers.
Adolescents who become aware of these lesions worry that they have a serious problem and become embarrassed by the appearance of their skin.
There are other skin problems that may be confused with keratosis pilaris. A doctor can usually make the diagnosis by examining the adolescent's skin. A biopsy is rarely necessary. Keratosis pilaris is less noticeable in hot and humid weather.
You can try treating this at home with a lubricating lotion. However, in most cases you will need a prescription lotion containing salicylic acid, lactic acid or urea, applied twice a day, for the best results. Even with proper treatment, it can take years for it to go away.
There is no known cause for keratosis pilaris. Some doctors believe that vigorous scrubbing can aggravate the condition. Keratosis pilaris causes no long-term skin problems nor any scarring. And if your child is resistant to having it treated, you and your child can rest assured it will eventually go away.
Lawrence Charles Parish, M.D., is a clinical professor of Dermatology and Cutaneous Biology and director of the Jefferson Center for International Dermatology, Jefferson Medical College, Philadelphia, PA. Please send your questions and comments to him care of Pediatrics for Parents, P.O. Box 63716, Philadelphia, PA 19147
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