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Chicken skin – what’s behind it and how to treat it

8.12.2022

Translation: Veronica Bielawski

Keratosis pilaris, or chicken skin, is harmless but doesn’t fit our image of beautiful skin. How can you combat the rough skin?

Our ideal of skin can essentially be summed up in three words: smooth, smooth and smooth. What’s something we certainly don’t want our skin to be? Rough and red. In many cases, we can indeed influence the appearance of our skin. We can eat healthier or quit smoking, for instance. A vitamin or nutrient deficiency can also show up on the skin. But when it comes to certain skin problems, our genes appear to be doing us dirty, and every treatment and lifestyle change we try, no matter how good, seems in vain. This is the case with keratosis pilaris, also known as chicken skin.

According to Dr. Bettina Rümmelein, a dermatologist at the Hautwerk practice in Zurich, chicken skin affects approximately 50 per cent of people in the European region. The number of people affected by chicken skin has increased significantly in recent years. The expert locates this sharp increase in an increased focus on skin problems: «People today have more awareness of and pay more attention to the appearance of their skin than in the past.»

Dr. Kaan Harmankaya has also noted this increase in his practice, Praxis am Kärntner Ring, in Vienna. He’s been seeing an increasing number of patients with chicken skin. Each week, he performs two laser hair treatments on average. This is a popular form of therapy to improve the skin’s appearance, at least temporarily. But more on that later. Let’s start from the beginning: what exactly is keratosis pilaris?

Dear skin, what’s up with you? The causes of chicken skin

First, it’s important to define what chicken skin is *not – a contagious or dangerous disease. It’s primarily a cosmetic problem, characterised by a rough, pimple-like appearance of the skin and usually occurs without itching or pain. It usually develops on the upper arms, thighs and, in rare cases, on the face.

Keratosis pilaris usually first appears in adolescence. In many cases, it disappears on its own by adulthood. Studies show that chicken skin affects about 80 per cent of adolescents – male and female – in Europe. Whether or not keratosis pilaris affects one sex more often than the other remains unknown due to a lack of data. «We lack data on, for example, whether or not sex hormones – male or female ones – play a role in keratosis pilaris,» Dr. Harmankaya says.

But what exactly is chicken skin? The name already says a lot. Keratosis pilaris is thought to be an inherited keratinisation disorder in the hair follicles. What this means is that keratin deposits form around the hair follicles, causing rough skin. «Wherever hair grows on the body, a small keratin disc may form on the surface of the skin,» Dr. Harmankaya elaborates. Why this happens has yet to be definitively answered. But our genes likely play a decisive role.

Research suggests that keratosis pilaris is a genetic disorder of the hair shaft. Patients exhibit a circular rather than straight hair shaft in the affected areas, which leads to irritation in the top layer of skin. This results in inflammation and excessive keratinisation (keratin production) around the hair follicle.

A mutation in the filaggrin gene, which is significantly involved in the keratinisation of the uppermost skin layer, is the suspected culprit. This would explain the increased family incidence observed in keratosis pilaris.

Risk factors: who’s most affected by chicken skin?

Keratosis pilaris affects people with dry skin in particular. «Patients with eczema and neurodermatitis are also more likely to suffer from keratosis pilaris,» Dr. Harmankaya confirms. Researchers have also made this observation in the Journal of Allergy and Clinical Immunology. According to them, the filaggrin gene – which contains a mutation in patients with keratosis pilaris – is also likely to promote the development of atopic dermatitis and related skin diseases.

Which circumstances additionally favour keratosis pilaris is scientifically disputed. There are studies linking chicken skin to common, lifestyle-related diseases such as diabetes or increased BMI (body mass index). However, according to Dr. Harmankaya, these studies are often based on mere observations and are not scientifically sound. «Type 1 diabetes is statistically more common in society, by no means do all diabetes patients also suffer from chicken skin. What we’re really lacking are large-scale studies to confirm these theories.»

So, due to a lack of data, it’s not confirmed that diet and lifestyle play a role in the development of keratosis pilaris.

What are the treatments for chicken skin?

The good news is chicken skin can be treated. The bad news is it can’t be cured. «There’s no perfect therapy available on the market. Because keratosis pilaris has a genetic background, the body will continue producing keratin,» explains Dr. Harmankaya. But, with the right care, you can make the skin much softer and more pleasant to the touch.

The dermatologist Dr. Rümmelein recommends using a suitable moisturiser. Lotions containing vitamin A, greater amounts of urea or lactic acid have proved particularly effective. In addition, those affected should avoid showering too frequently and avoid soap as well as greasy skin care products. «You don’t want to dry out or overstimulate your skin,» says Dr. Rümmelein.

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This is especially true in the case of peeling products. They should only be used in moderation and with purpose. «The keratin calluses can only be removed to a certain extent. Overstimulating your skin will again increase keratinisation,» explains Dr. Rümmelein.

The goal of the treatment should be softer skin. «When you run your hands over your skin, it should feel soft and comfortable. It shouldn’t be flaky or greasy. Ideally, you should use a skincare product that’s easily absorbed and doesn’t irritate you skin.»

Laser hair removal: if the degree of suffering becomes too much

Another treatment for chicken skin is laser hair removal. It reduces redness, smooths the texture of the skin and at least temporarily contains the keratosis pilaris. «Medically, laser hair removal makes perfect sense,» Dr. Harmankaya says. «Keratosis pilaris centres around the hair follicle. If we free the follicle from hair, it has a positive effect on the softness of skin.»

Unfortunately, the treatment isn’t completed in a single session. According to Dr. Harmankaya, it usually takes six to ten sessions to remove hair long-term and calm keratosis pilaris. «Chicken skin is nothing dire So, the decision to use laser hair removal depends on the patient’s level of suffering,» he says. The rule of thumb is that any changes in the skin should always be examined by a doctor first. That way, any other diseases can be ruled out and the optimal treatment discussed.

Dr. Harmankaya stresses that it’s especially important to educate those affected. «Once you know what you’re dealing with, chicken skin is easy to treat in a way tailored to the individual’s needs.»

(Author: Olivia Leth)

/Header image: Shutterstock

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Olivia Leimpeters-Leth

Autorin von customize mediahouse

oliver.fischer@digitecgalaxus.ch

I'm a sucker for flowery turns of phrase and allegorical language. Clever metaphors are my Kryptonite – even if, sometimes, it's better to just get to the point. Everything I write is edited by my cat, which I reckon is more «pet humanisation» than metaphor. When I'm not at my desk, I enjoy going hiking, taking part in fireside jamming sessions, dragging my exhausted body out to do some sport and hitting the occasional party.

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