Keratosis pilaris - those little white bumps on the skin

Skin Conditions, nutrition | August 12, 2017 | Author: Naturopath

Skin conditions

Keratosis pilaris - those little white bumps on the skin

Ever had those annoying white pimple like bumps appearing on your upper arms, legs or other parts of the body and wondered what they are?.

Often refered to as "chicken skin" or "goose flesh" Keratosis pilaris (KP), also known as follicular keratosis, is caused by an over-production of the protein keratin which blocks hair follicles and causes bumps to appear on the surface of the skin. Perifollicular erythema, redness surrounding the hair follicle, can often be seen.  

The inflammation and bumps commonly occur on thighs, buttocks, upper arms and sometimes the cheeks of the face, usually on people under the age of 30 and can last a little or a long time. The area affected can feel dry but generally does not itch or produce pain and is considered harmless.

Why does it happen?

keratosis pilarisThe reason for occurrence is not understood but some theories suggest a defect in the keratinization in the hair follicle or a lack of sebaceous gland at the base of the hair follicle. Sebaceous glands are the sebum producing glands that provide the lubrication to soften the skin and support epithelial barrier protection, protection of the skin from loss of water, water penetration and pathogenic bacterial invasion.

These glands are found attached at the base of the hair follicle and it is thought the absence of them in KP is the beginning of the pathogenesis of the condition, resulting in epithelial barrier abnormalities. Perifollicular erythema, inflammation,  occurs possibly because of the breakdown of the skin barrier. The condition can get worse in dry or cold weather and there is an association with vitamin A and essential fatty acid deficiencies.

Who does it affect?

KP seems to appear around the age of 2 or in the teenage years. It can be an inherited condition and often occurs in people suffering from dry skin, Ichthyosis vulgaris (a skin condition that causes very dry skin), atopic dermatitis, asthma and hay fever. The condition is usually diagnosed on appearance with no further testing required and will often resolve on its own without treatment.

Could gluten be to blame?

Could gluten be to blame?Gluten intolerance or sensitivities often gets the blame for many diseases but in this case there is no substantial evidence to imply it is a culprit. What is thought could happen is that gluten may be causing gut inflammation or malabsorption of essential fatty acids and vitamin A.

If you feel you are sensitive to gluten try reducing the amount you eat or eliminating it for a while and see if symptoms resolve.

 

Lack of essential fatty acids

The polyunsaturated fats omega 3 (you may know this as fish oil or flaxseed oil) and omega 6 (think evening primrose oil, sunflower, safflower and borage oil) are essential (need to be provided in the diet) for healthy functioning of the skin. The omega 6’s support barrier functioning of the skin, provide protection from pathogens entering the skin and help maintain fluid balance. The omega 3’s, along with 6’s, support the signalling function and inflammatory response. Oils can be taken internally or applied externally (although I wouldn’t do this with fish oil!). Support the diet of essential fatty acids by eating plenty of fatty fish, flaxseeds, walnuts, almonds, avocado, olives and olive oil, eggs, dark green leafy vegetables and soy.

Vitamin A

 Vitamin A is a fat soluble vitamin that is required for many processes in the body, including development and maintenance of epithelial tissue, such as the skin. 

vitamin AA deficiency of vitamin A has shown to cause many glands, including sweat and sebaceous glands to atrophy (shrink) and to interfere with normal keratinization by replacing the growth of epithelium keratin to a stratified keratinizing epithelium, which has different functional properties. Vitamin A can become deficient in people with digestive health issues such as malabsorption or chronic diarrhoea.

Vitamin A is found in yellow coloured foods such as apricots, carrots, sweet potato, egg yolk, butter; and also kale, spinach broccoli; and cod liver oils. Because Vitamin A is a fat soluble vitamin it can accumulate in the body so high doses for prolonged period of time should be avoided.

Digestive system

It is a good idea to remove or reduce any foods that may be causing digestive upsets, such as wheat, gluten, dairy, salicylates and amines (chemicals found in food that can cause irriitation). Slippery elm is a fibre that can sooth and allow repair of the digestive tract and a good quality probiotic can help support gut barrier function.
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Skin exfoliation

skin exfoliationSkin cells take approximately a month to be created in the dermis and move their way to the surface of the skin where they are considered to be keratinized and naturally sloth off the skin.

Skin exfoliation can help this natural exfoliation process by removing the hardened keratin plugs from the follicle. Creams containing salicylic acid, hydroxy acid and lactic acid can be applied to help loosen and remove the dead skin cells but these products can often cause irritation so using natural based products may be a better alternative.

Natural exfoliants may contain products such as oatmeal, jojoba beads, coconut shell, ground bamboo, ground walnut, sugar and himalayan salt. Or you can use a loofah, which is made from dried fibrous tissue from a marrow-like fruit. Be sure to wash and dry your loofah after use, don’t leave it hanging in the shower where it can grow bacteria, and replace it regularly. Exfoliation will often cause the skin to become inflamed so gentleness is the key.
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Moisturise

Moisturising with creams containing vitamin A (retinoids) can help by causing the cells to accelerate turnover time and unplug the blocked follicles. The down-side to vitamin A creams is they can be harsh on the skin, make the skin sun sensitive and are not recommended in breast-feeding and pregnancy.

Other oils, particularly  rosehip oil, contains natural occurring vitamin A  and can be a safer, gentler alternative. Moisturising can soften the skin allowing for the plugs of harden sebum to exfoliate.
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References

http://www.mayoclinic.org/diseases-conditions/keratosis-pilaris/diagnosis-treatment/treatment/txc-20168391

Sebaceous gland, hair shaft, and epidermal barrier abnormalities in keratosis pilaris with and without filaggrin deficiency https://www.ncbi.nlm.nih.gov/pubmed/25660180

Keratosis Pilaris Revisited: Is It More Than Just a Follicular Keratosis? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681106/

Tortora Gerald J., Derrickson Bryan, 2006 Principles of Anatomy and Physiology 11th edition, John Wiley & Sons, Inc.

https://www.aad.org/public/diseases/bumps-and-growths/keratosis-pilaris#causes

http://theceliacmd.com/2016/02/gluten-and-keratosis-pilaris-chicken-skin/

http://lpi.oregonstate.edu/mic/health-disease/skin-health/essential-fatty-acids#overview

http://lpi.oregonstate.edu/mic/health-disease/skin-health/vitamin-A#deficiency

Osiecki H, The Nutrient Bible 9th edition, Bio Concepts Publishing

http://www.huffingtonpost.com.au/entry/loofah-clean-healthy_n_5613734

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