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Rough, Bobbly Skin: Keratosis Pilaris on the Arms, Thighs and Cheeks

Name: Faciem Dermatology & Medical Clinic
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Keratosis pilaris is a common, harmless condition in which keratin plugs the hair follicles and raises small rough bumps, giving skin a permanently goose-pimpled feel. The backs of the upper arms, the thighs, the buttocks and sometimes the cheeks are the usual sites. Bumps may be skin-coloured, ringed with pink, or brown in deeper skin tones. It is harmless but persistent, and easily made worse by the wrong products.

This page reflects how keratosis pilaris is assessed and managed at Faciem, and is reviewed for clinical accuracy.
Last reviewed: 15 September 2026.
Patient information only. Keratosis pilaris is harmless but persistent, and what suits your skin depends on how it presents and on your skin tone. Any treatment plan follows a face-to-face consultation with Dr Prasad.

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TL;DR

Keratosis pilaris is a build-up of keratin that blocks hair follicles and produces small, rough bumps, most often on the backs of the upper arms, the thighs and the buttocks. It runs in families, is closely linked to dry skin and eczema, and frequently eases with age. It is controlled rather than cured: gentle chemical exfoliation with daily moisturising usually shows in the texture after four to six weeks, and a HydraFacial in clinic speeds up built-up areas. Assessment at Faciem is by Dr Prasad, a GMC-registered doctor.

About the Condition

What Is Keratosis Pilaris?

Keratosis pilaris is a harmless skin condition in which keratin, the protein that forms the outer layer of skin, builds up and plugs the openings of hair follicles. Each plugged follicle raises a small firm bump, and hundreds together give an area of skin a rough, bobbly texture often likened to sandpaper.

What keratosis pilaris looks and feels like

Keratosis pilaris bumps are small, firm and evenly spread, each one sitting over a hair follicle, and running a hand across the area tells you more than looking at it does. The backs of the upper arms are the classic site, followed by the fronts of the thighs, the buttocks and, in children particularly, the cheeks. Colour varies with skin tone: bumps may be skin-coloured, ringed with pink or red in fair skin, or brown to dark brown in deeper skin tones, where the discolouration often bothers people more than the roughness does. A coiled hair is sometimes visible trapped inside a bump, and the surrounding skin is usually dry. Keratosis pilaris may itch mildly but is not painful, and it does not scar unless it has been picked at.

Who tends to get keratosis pilaris

Keratosis pilaris is very common, affecting a substantial proportion of children and adolescents and a smaller proportion of adults. It usually appears in childhood, becomes most obvious during the teenage years and often eases gradually from the mid-twenties onwards, although it can persist for life. It runs strongly in families. People with dry skin, atopic eczema, hay fever or asthma are more likely to have it, and it is reported more frequently during pregnancy and where there is excess weight. Every skin tone is affected, but the after-effects differ: fair skin tends to show redness around the bumps, while brown and black skin more often retains flat brown marks where bumps have settled. Those marks are frequently the reason people seek advice, long after the roughness itself has stopped bothering them.

What keratosis pilaris is often confused with

Keratosis pilaris is most often mistaken for acne and treated with products meant for oily facial skin, which dry the arms without touching the plugs. Acne produces blackheads, whiteheads and inflamed spots of varying size; keratosis pilaris bumps are uniform, dry and sit over follicles. Folliculitis is inflammation or infection of the follicles and produces tender, pus-topped spots that come and go. Ingrowing hairs are larger, individual and often sore, with a visible trapped hair. Milia are small white cysts, usually on the face, and simple dry skin flakes and feels tight without the distinct bump over each follicle. Uniformity is the giveaway: keratosis pilaris bumps are all much the same size and evenly spread, while spots and ingrowing hairs vary and appear in crops.

Causes & Contributing Factors

What Causes Keratosis Pilaris?

Keratosis pilaris happens when keratin accumulates at the opening of a hair follicle and hardens into a plug instead of shedding normally. Exactly why the skin does this is not fully established, but the tendency is strongly hereditary and closely linked with dry skin. It is not caused by poor hygiene, and there is no evidence that diet affects it.

Keratin plugging the follicle

Keratin that would normally shed from the surface instead collects at the follicle opening and hardens into a plug. Each plug raises a small bump, and the hair beneath it may coil under the surface instead of emerging.

Inherited tendency

Keratosis pilaris frequently runs in families and is thought to be inherited in most cases. A parent or sibling with the same rough upper arms is one of the more consistent findings when the history is taken.

Dry skin and a weakened barrier

Skin that holds water poorly sheds cells less efficiently, so plugging builds faster. This is why keratosis pilaris tends to worsen in winter, in centrally heated homes and after long hot showers, and eases in humid weather.

Eczema and atopic tendency

Keratosis pilaris is more common in people with atopic eczema, hay fever or asthma. The same barrier weakness that underlies eczema appears to contribute to the plugging, which is one reason treating the dryness helps both.

Hormonal and other associations

The condition often becomes more noticeable during adolescence and pregnancy, and is reported more frequently where there is excess weight or an underactive thyroid. These are recognised associations, not direct causes, and none of them needs treating to improve the skin.

Treatments We Offer

How Keratosis Pilaris Is Treated at Faciem

Keratosis pilaris is treated by breaking down the keratin plugs and keeping the skin around them well moisturised, since plugging rebuilds faster in dry skin. Medical-grade topical treatment is the mainstay and usually shows in the texture after four to six weeks; a HydraFacial gives built-up areas a head start, with more resistant cases needing two or three treatments. Treatment controls the condition, and stopping altogether usually allows the bumps to return over several months.

Medical-Grade Skincare

Active ingredients such as glycolic acid, other alpha-hydroxy acids, urea and retinoids break down the keratin plugging the follicles and encourage the surface to shed normally. This is the mainstay for keratosis pilaris, generally working after four to six weeks of consistent use, then continuing at a lower strength as maintenance.

Best for: ongoing control of texture and bumps

Read about Medical-Grade Skincare

HydraFacial

HydraFacial combines exfoliation, extraction, a glycolic acid step and LED light, which together lift the keratin plugs and soften the surface. It can be performed on the arms, thighs or buttocks as readily as on the face, and more built-up areas may need two or three treatments before maintenance. It works alongside a daily skincare regime, not instead of one.

Best for: a head start on stubborn, built-up areas

Read about HydraFacial

Chemical Peels

For resistant areas a chemical peel can lift plugging that topical treatment alone has not shifted. In deeper skin tones the skin is prepared with creams beforehand, because peeling unprepared skin of colour risks leaving it darker instead of smoother.

Best for: resistant patches after skin preparation

Read about Chemical Peels

Prescription-strength topical treatment may be considered after assessment where medical-grade skincare has not been enough. Which of these options suits your skin, in what order and at what strength, is decided face to face with Dr Prasad, and results vary between individuals.

When to Seek Medical Advice

When Should You See a Doctor About Rough, Bobbly Skin?

Keratosis pilaris is harmless and does not need medical attention on its own. See a doctor when the diagnosis is uncertain, when bumps are inflamed or itchy enough to disturb sleep, when marks are being left behind, or when several months of home treatment have made no difference at all.

Worth getting checked

Conditions that can look similar

Self-Care & Prevention

Managing Keratosis Pilaris Between Appointments

Home care carries most of the work in keratosis pilaris, because the condition is driven by dryness and plugging. Gentle chemical exfoliation and consistent moisturising, kept up over months, achieve more than any short intensive effort.

Do

Avoid

Picking or squeezing the bumps — the brown marks left behind can take six to twelve months to fade
Loofahs, body brushes and gritty scrubs, even once a week — physical scrubbing inflames follicles that are already blocked
Acne washes and spot creams meant for oily facial skin — six weeks of them dry the arms without shifting any keratin
Waxing, shaving or epilating an inflamed area, or any hair removal within 48 hours of an exfoliating acid

This is general guidance and does not replace individual assessment. Exfoliating acids suit some skin and irritate other skin, and in deeper skin tones over-treatment can leave darker marks, so what is appropriate depends on how your own skin behaves.

Why Patients Choose Faciem

Rough, Bobbly Skin Treated for What It Actually Is

Keratosis pilaris responds well when the plugging and the dryness are treated together, and badly to scrubbing and to products meant for oily facial skin. Four things shape how well it goes.

Experience & Expertise

Why Keratosis Pilaris Is Worth a Doctor’s Assessment

Keratosis pilaris is harmless, and being told so is usually where people are left. That is medically correct and practically unhelpful, because the condition is highly visible, lasts for years and is remarkably easy to treat badly. Two mistakes come up constantly. The first is scrubbing: abrasive exfoliation irritates follicles that are already plugged and, in brown and black skin, leaves brown marks that outlast the bumps by months. The second is reaching for acne products, which dry the arms without breaking down keratin and frequently provoke redness. A diagnostic question is worth settling too: folliculitis, ingrowing hairs and rarer follicular conditions look almost identical and are treated differently. Dr Prasad confirms what the bumps are, sets the strength of active ingredients against the skin tone being treated, and addresses the discolouration alongside the texture.

Dr Anamica Prasad — MBChB (1999), Dip Dermatology (2001), MRCGP, DFFP, DRCOG · a GMC-registered doctor
Member of the Joint Council for Cosmetic Practitioners (JCCP), British Medical Laser Association (BMLA), Royal Society of Medicine and the Aesthetic Complications Group
Clinic operated by Derma Medical UK Ltd, registered with the Care Quality Commission for diagnostic and screening procedures, surgical procedures, and treatment of disease, disorder or injury · CQC Location ID 1-25573003746
Face-to-face medical consultation and examination before any treatment is prescribed
20 years’ experience in dermatology, including follicular and keratinisation disorders across every skin tone

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Keratosis Pilaris FAQs

Your Questions, Answered

Common questions about keratosis pilaris and rough, bobbly skin — what causes it, what shifts it, what the brown marks are, and how far ahead of a holiday or a pregnancy to plan. Anything specific to your own skin is better settled face to face.

What causes keratosis pilaris?

Keratosis pilaris is caused by keratin building up at the openings of hair follicles and forming plugs instead of shedding normally. The tendency is largely inherited and closely linked to dry skin and eczema, which is why it worsens in winter and in centrally heated homes. It is not caused by poor hygiene, and there is no evidence that diet or particular foods affect it.

Can keratosis pilaris be cured?

Keratosis pilaris cannot be cured, but it can be controlled. It is a long-term condition managed by breaking down the plugs and keeping the skin moisturised, and consistent treatment usually gives a marked improvement in both texture and colour. Many people also find it eases naturally from the mid-twenties onwards. If treatment stops, the bumps generally return over several months, and results vary between individuals.

How do I get rid of rough, bobbly skin on my arms?

Rough, bobbly skin on the arms is treated by combining a gentle chemical exfoliant containing lactic, salicylic or glycolic acid with daily moisturising, applied to damp skin after showering. A HydraFacial in clinic gives stubborn, built-up areas a head start. Scrubbing removes surface flakes but irritates the follicles underneath and tends to backfire, particularly in deeper skin tones where it can leave darker marks.

How long does keratosis pilaris treatment take to work?

Medical-grade skincare for keratosis pilaris usually works after four to six weeks of daily use, with the texture continuing to improve over the following months. A HydraFacial acts faster on built-up areas, and more resistant cases need two or three treatments. Because the plugging rebuilds once treatment stops, most people keep a lighter maintenance routine going afterwards.

Can I treat keratosis pilaris while pregnant or breastfeeding?

Most keratosis pilaris treatment is suitable in pregnancy, with one exception: topical retinoids are avoided throughout pregnancy and while breastfeeding. Lactic acid, urea and gentle glycolic creams with daily moisturising are used instead, and they are the mainstay for most people anyway. Keratosis pilaris often becomes more noticeable during pregnancy and settles again in the months after birth. Say at the consultation if you are pregnant, trying to conceive or breastfeeding, and the plan is built around it.

Does keratosis pilaris leave dark marks on brown or black skin?

Keratosis pilaris can leave flat brown marks in brown and black skin, typically where bumps have been picked, scrubbed or over-treated with strong acids. These marks are post-inflammatory pigmentation, not scarring, and they fade slowly on their own. Skin tone is assessed on the Fitzpatrick scale before exfoliating acids or a peel are chosen: Fitzpatrick IV to VI skin is treated, but at lower acid strengths, introduced more gradually and often after a preparation cream, because the risk being managed is the pigmentation, not the bumps. Marks already present are treated alongside the texture.

How long before a holiday or a wedding should I start treating it?

Start at least six weeks before, and eight to twelve if you can. Medical-grade skincare for keratosis pilaris takes four to six weeks of daily use to change the texture, and the brown marks left by old bumps fade more slowly still. A HydraFacial gives built-up areas a head start, with resistant areas needing two or three treatments. Starting the week before an event changes little and is exactly when people scrub, inflame the skin and make the arms look worse.

Sources & Further Reading

Keratosis pilaris — symptoms and treatment — NHS
Keratosis pilaris patient information leaflet — British Association of Dermatologists
Keratosis pilaris — DermNet NZ

These are general sources of patient information and do not replace individual medical assessment. Your own diagnosis and treatment plan are established at consultation.

Keratosis Pilaris in Kensington, London

A Doctor-Led Clinic in the Heart of Kensington

Keratosis pilaris is diagnosed and treated at Faciem Dermatology & Medical Clinic on Kensington Church St, London, led by Dr Prasad. The clinic sits between High Street Kensington and Notting Hill Gate stations — a few minutes’ walk from one, about ten from the other — with Kensington council underground parking below. Appointments run Monday to Saturday, 10am–7pm, and are convenient from Notting Hill, Holland Park and Chelsea. Arms, thighs and backs are examined as readily as faces.

Plan Your Visit

Faciem Dermatology & Medical Clinic
Phone: +44 20 7131 3539
7 Kensington Church St, London W8 4LF, United Kingdom
Tube: High Street Kensington (few minutes’ walk) · Notting Hill Gate (~10 minutes)
Parking: Kensington council underground car park nearby
Open Monday–Saturday, 10am–7pm · Sunday closed
Consultations bookable online; body areas assessed as well as the face
Consultation-first — no treatment without medical assessment
Serving Kensington, Chelsea, Notting Hill & Central London

Continue Exploring

Related Conditions & Treatments

Acne

The condition keratosis pilaris is most often mistaken for, and the features that tell the two apart.

Eczema & Dry Skin

The barrier weakness that so often accompanies keratosis pilaris and speeds the plugging up.

Ingrowing Hair

Trapped hairs that can look like keratosis pilaris bumps but are larger, sorer and treated differently.

Faciem Dermatology & Medical Clinic · Kensington

Have Rough, Bobbly Skin Looked At Properly

Book a consultation with Dr Prasad to confirm the diagnosis, choose active ingredients your skin will tolerate, and treat the texture and the discolouration together.

Prefer to talk? +44 20 7131 3539

Monday – Saturday	10am – 7pm
Sunday	Closed