I need a good keratosis pilaris treatment, but...

November 22, 2022 4:19 PM

...it's not for me. I have a 10 year old with minor sensory issues related to things touching his skin, including any sort of abrasive scrub or creams that are too "sticky" or thick. I know his keratosis pilaris is not really hurting anything, but his upper arms feel like gritty sandpaper and I know that it'll get worse from here.

That's basically it. Looking for solutions for a child that's resistant to using a KP scrub I've been having success with, most creams, etc. Both parents have ongoing KP that didn't disappear at 30 (I wish) so this is probably something the child is going to be dealing with for a while. I want to get them to a point where they can incorporate this into their grooming routine to hopefully minimize scarring later on, but when his current choices are "the stinky cream" or "the awful scrub" it's kind of hard to get him on board.

Personally, I've found success combining Kiehl's Midnight Recovery Botanical Cleansing Oil (apply before shower, let it soak in, rinse off) daily with a long shower and the First Aid Beauty KP scrub 1-2 times a week. Yes, yes, don't exfoliate... except it's the only thing that's worked on mine. Anything easier that I could suggest for my kid (or demonstrate myself)? And is it even safe to use the suggestions from this ask on a kid? (I'd ask his pediatrician, but they're kind of a jerk and we are still looking for a new one.)

Note: I've done no carbs, no sugars before and in addition to making me miserable it did squat for my KP. I also don't want to put the child on a restricted diet if I don't have to as he is otherwise healthy, and I especially don't want to spring this on him right before winter holiday season. I'm interested in products and tools, thanks!

posted by daikaisho to Health & Fitness (23 answers total)

Best answer: The only thing that works on mine is heavy exfoliating plus moisturizer, every single day. I use these scrubby cloths for this. I use a very bland and scentless moisturizer, either CeraVe or the generic equivalent.
posted by blnkfrnk at 4:27 PM on November 22, 2022

Best answer: Ooh, yeah, I feel for your kid - I hate the textures of most KP treatments too. What works well enough for me is specifically glycolic acid *pads*. Chemical exfoliation doesn’t feel abrasive, I can handle a water-like wet texture more than a sticky cream texture, and applying it with a pad means I have more precise control over where it touches, which seems to soothe the sensory yelling part of my brain.

Potential downsides: it can feel chilly, it has a faint odor, and some people’s skin can be sensitive to it so you would want to check whether it’s okay for kids and if so, start with a light concentration to see if it makes his skin unhappy. I go for 20% myself but I know they go down to 5%.
posted by Stacey at 4:33 PM on November 22, 2022 [3 favorites]

Best answer: I tend to get KP on my arms and I've had success using CeraVe SA Body Wash and Paula's Choice Weightless Body Treatment 2% BHA

The Paula's Choice lotion isn't at all sticky and absorbs into the skin right away.
posted by Babytown Frolics at 4:39 PM on November 22, 2022 [2 favorites]

I've had lifelong KP and I'm confused about what "it'll get worse from here" means. If it doesn't bother him, why force him to treat it? I tried treatments for a while, decided the benefit wasn't worth the constant upkeep, and have just lived my life in bumpy reddish peace, which doesn't seem to bother anyone.
posted by trig at 4:51 PM on November 22, 2022 [25 favorites]

Also I'm not sure it's worth making him feel like there's something wrong with his body. My parents rarely brought up my KP, but it didn't feel great when they did.
posted by trig at 4:54 PM on November 22, 2022 [9 favorites]

I use a home made coconut oil and sugar scrub which works better than anything else I've tried. It does the exfoliating and moisturizing in one step (does make the tub a bit slippery if I don't rinse well with very hot water after). Sometimes I add essential oils for scent.
posted by peanut_mcgillicuty at 5:09 PM on November 22, 2022

Response by poster: To clarify - the child is very particular about his appearance. Right now he's just bumpy, but as he's very pale it seems likely that he'll also get the characteristic red marks. He's also made mention of my scarring, and while he accepts it's a part of my skin he doesn't seem thrilled about getting it. Couple that with the fact that he's likely to have bad acne when he hits his teenage years... I'd like to save him some angst if I can.
posted by daikaisho at 5:15 PM on November 22, 2022

Best answer: Seconding Paula's Choice Exfoliating Liquid. He will probably also need a moisturizing lotion.
posted by wryly at 5:26 PM on November 22, 2022

Best answer: I have KP. I have had the best success with the Cerave smoothing lotion, but it smells and has that tacky texture. I manage to keep it quite under control with exfoliating daily (I use one of those shower puffs. Hoping to find a non-plastic alternative at some point) and a gentle moisturizer.
posted by kinddieserzeit at 5:43 PM on November 22, 2022

Best answer: Cerave SA cream. Do it right after showering--its really thick and it's much easier to apply on wet skin.
posted by jessica fletcher did it at 6:02 PM on November 22, 2022 [2 favorites]

Gold Bond Rough & Bumpy cream has a mild and sort of old-person scent, but it's not gendered, which might help him reconcile to it. It's also creamier than others, which tend to be runny. I find it very effective, although possibly not the most effective thing I've used. That would be something like Botanic Tree, Amlactin, or another of the $20 a bottle creams at the drugstore which, yes, do smell bad, although I've been putting up with it since I was his age and stopped noticing.

Don't tell him that, though! Do assure him that there is no reason to cover up his skin, if you suspect he is doing that. I really regret that until about age 18, I was too self-conscious to wear sleeveless shirts. Other people really do not notice it in the same way as we do, not unless you've done awful things to it to try to fix it. One stupid teen trick that I tried for my KP was deliberately getting sunburnt because I thought that it would peel off and give me soft new skin on my arms. People noticed that. In fact I had to go to the doctor and get a shot for it.
posted by Countess Elena at 6:44 PM on November 22, 2022

Get them some super slippery soap and exfoliating gloves of their own. Let them handle it.
posted by Oyéah at 6:56 PM on November 22, 2022

I'm very picky about lotion textures and I don't mind Amlactin. Does it smell like pee a little? Yes. Does it do what it says it's going to do? Also yes.
posted by phunniemee at 6:59 PM on November 22, 2022 [1 favorite]

Both the scent and the (in my opinion, which obviously varies) slightly gooey texture of Amlactin can be mitigated with a drop of a nice smelling body oil, and it doesn’t affect the exfoliating properties.
posted by padraigin at 7:36 PM on November 22, 2022 [2 favorites]

The Cerave SA bodywash cured my KP. I apply it with a silicone "sponge" that has long soft fingerlike projections on it. I prefer that because it doesn't harbor mold and fungus as readily as a net scrubby does.
posted by MagnificentVacuum at 9:34 PM on November 22, 2022 [1 favorite]

Best answer: I use Eucerin UreaRepail Plus lotion with 10% Urea- it works better than anything else I've ever tried, including the Cerave products and Paula's Choice products mentioned above. When I say it works better, I don't mean it works a little better, I mean it has essentially eradicated all traces of the KP, which none of the other products I tried ever did. It has a thin/light texture, isn't sticky at all, absorbs easily, and has no scent whatsoever.
posted by cilantro at 1:36 AM on November 23, 2022 [1 favorite]

Best answer: When I use lotion on my body, I do it just after showering, so it rubs in easily and doesn't feel sticky.

I have KP, this is all useful, thanks.
posted by theora55 at 6:14 AM on November 23, 2022

I only have a couple of spots that sometimes recur, but I find that Cortizone-10 will usually make them disappear in a few days.
posted by Don_K at 7:20 AM on November 23, 2022

Response by poster: OK, I guess I need to be super explicit about it - I'm not going to force this on the boy. He's expressed interest in not having scars like I do, and I really get what it's like to have people force expectations about appearance on you. I've been subject to diets starting in middle school (I didn't even need them back then!), policing of my clothing, being told I needed to shave various parts of my body, etc. - for the record I'm fat and transmasculine so that worked out super well.

The child is neurodiverse and needs time to successfully incorporate things into his routine. Also, I don't want to make him use products he doesn't like because that's cruel. At the same time I want to help him accomplish his goals (specifically regarding scarring). The only appearance-related things I'm forcing on him are as follows:

Brushing teeth, bathing regularly
Brushing hair when needed
Wearing clothing that is at least vaguely seasonally appropriate so he's not too hot/cold

Again. Please be assured that I know how it feels to have your appearance nitpicked and things forced on you. This is not that. This is a parent trying to support their child when they have expressed concern about something but are not at all thrilled about their current options for addressing it.
posted by daikaisho at 8:37 AM on November 23, 2022 [8 favorites]

Is there any way you can coach him through dealing with unpleasant sensations, if the goal is something he wants? Like slowly building up a tolerance, using calming breathing techniques, things like that.
posted by ananci at 9:45 AM on November 23, 2022 [1 favorite]

Best answer: What if he doesn’t use his hands to apply it? Something like this lotion applicator or put the oil that works for you in a spray bottle. Disposable gloves for the creams. Not touching stuff with my hands helps my sensory issues.
posted by Pretty Good Talker at 2:53 PM on November 23, 2022 [1 favorite]

Paula Begoun, founder of Paula’s Choice, has spent many years doing research into skin concerns and ingredients. She digs through the scientific literature to find out what works and then formulates products using ingredients that are proven to be effective. (She sold the company a few years ago but stays involved.) My dermatologist has a copy of Paula’s first book in her office. Here is an article from her website about treating hard bumps and says these treatments may help with KP. (apparently I don’t know how to add a link - sorry)
posted by strasbourg at 9:53 AM on November 25, 2022

Response by poster: Thanks y'all. I went through the options with the kid and made some purchases. We'll be trying things out now. Hopefully we'll both have a great go-forward solution!
posted by daikaisho at 11:43 AM on December 13, 2022