It is a well-known fact that film and sports celebrities form an influential group in society, both in the US and in India. When international boxer Mohammed Ali developed Parkinson’s disease and Superman star Christopher Reeve suffered a spinal injury with paralysis, both evinced interest in the disorder among common people and the scientific fraternity in the quest for better understanding and treatment of the condition.
In India, in the recent past, two film celebrities, Yami Gautam and Samantha Ruth Prabhu, opened up about being affected by Keratosis Pilaris and Myositis, sometimes seen by dermatologists. Since most celebrities approach their skin physician, it is very important for them to establish their beauty and candour with the huge fan following they have in society.
In this context, we herewith discuss keratosis pilaris, which is commonly known as chicken skin and has been in the spotlight due to the general public being exposed to the terminology, which they probably knew but were unaware of whether to seek the attention of a physician or not.
Keratosis is a skin condition that causes rough patches of skin as well as small, skin-colored or red swelling-like bumps. This condition develops when the skin produces too much of a protein called keratin, which can block hair follicles and cause bumps to form. The bumps are usually on the arms, thighs, cheeks, and buttocks. They’re white, sometimes red, and typically don’t hurt or itch.
The condition is difficult to cure completely but can be managed with medicated creams and, occasionally, oral medications. Minor skin procedures may also improve skin appearance.
It is known to be a bit more common in females than males, but both sexes can be affected, and a winter exacerbation of the condition is known to occur, possibly related to xerosis (dryness) and friction due to the extra layers of clothing in winter. In fact, pregnant and lactating mothers are known to have worsening spiny bumps. Improvement occurs as people age, but some activity may persist well into middle age, when they may fade away slowly.
In some people, mild redness around the spiny red dots or some pigmentation around the spiny skin bumps can occur, which makes them seek medical attention. This can occur on the face, cheeks, and neck. The condition may coexist with other disorders like Ichthyosis (fish like scaly skin disorder) and Atopic dermatitis (Eczema) and they too get flared up in Winter perhaps showing us grouping of the common drying skin disorders that flare up in certain seasons.
The diagnosis is straightforward for an experienced dermatologist looking at the spiny bumps in the hair follicular area involving the arms, thighs, trunk of the body, and occasionally the face and neck. It must be distinguished from a few other similar disorders seen in children, such as lichen spinosum and phrynodermas (caused by a lack of vitamin A and fatty acids due to a poor diet). An experienced dermatologist will be able to reach a diagnosis with good observation and, if necessary, a few diagnostic tests.
Treatment of the condition is based on simple measures like simple emollient creams and keratolytic agents (that exfoliate the outer skin areas), but the condition itself can improve spontaneously as there are seasonal changes from winter to spring and summer. Other treatments include topical retinoid creams (Vitamin A synthetically derived agents), short-term topical steroid creams, and oral therapies with oral retinoids.
Minor cosmetic procedures such as microdermabrasion and laser therapies such as long pulsed diodes or pulsed dye lasers have also been tried with success in some people.
Overall, the condition can be managed with a bit of cooperation from the patient and the doctor, a good explanation of the benign nature of the condition, and realistic expectations from the treatment.
Dr Sunil Kumar Prabhu is a Consultant Dermatologist and Aesthetic Physician at Aster RV hospitals.