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Keratosis Pilaris vs. Eczema: How to Tell the Difference

Are your skin bumps keratosis pilaris? We explore its causes, symptoms, and treatment, and how to differentiate it from eczema.

Female arm showing signs of keratosis pilaris in the form of reddish spots

Keratosis pilaris, also known as “chicken skin”, is a common skin condition that affects many people. These small, rough bumps are harmless and often clear up as you age. But the way it looks may make you self-conscious. Below, we discuss its causes, treatments, and how it differs from eczema. 

Keratosis Pilaris Causes

Woman sitting up in bed, checking her upper arm for dryness and bumps
Cold, dry air can worsen the symptoms of keratosis pilaris.

Keratosis pilaris is caused by a build-up of keratin, a protein that helps protect the skin from infection and other harmful substances. Too much keratin can block hair follicles and cause the small, raised, rough bumps.

It can affect people of all ages, genders, and ethnicities, but is typically seen in adolescents and young adults. Although its exact cause of isn’t fully understood, the condition is believed to be: 

  • Hereditary, passed down through families 
  • Exacerbated by environmental factors such as cold, dry air, and low humidity 
  • Linked to a vitamin deficiency— particularly vitamin A 
  • Aggravated by hormonal changes during puberty and pregnancy 
  • Common in people with dry skin or certain skin conditions, such as eczema 

Keratosis Pilaris vs. Eczema

Woman scratching her arm, suffering from a skin condition
Though both conditions cause skin dryness and uneven texture, keratosis pilaris and eczema have several differences.

If you’re experiencing skin bumps, dryness, and redness, you may be wondering if you have keratosis or eczema since both share some similar symptoms. Here’s how to spot the difference:  

 Keratosis Pilaris Eczema 
Appearance Small, rough bumps that look like goosebumps or a plucked chicken’s skin Dry, inflamed patches of skin that can be accompanied by symptoms such as oozing, crusting, and swelling 
Colour Bumps can look red, brown, white, or skin-coloured Pinkish or red and raw 
Sensations Typically has no itchiness, but some people may experience mild itching or discomfort Itchy and painful 
Location Typically, on the back of the upper arms, thighs, buttocks, and sometimes on the face Anywhere on the body – elbows or knees, nape, face, upper arms and back of the arms, wrists, hands, fingers, feet, and toes 
Causes Overproduction of keratin Can be triggered by a variety of factors, including genetics, allergens, irritants, and stress 
Treatment Moisturisers and lasers Moisturisers, corticosteroids, OTC medications such as antihistamines or pain relievers 
Affected Age Group  Typically children and young adults All ages 

Skin Conditions in TCM 

Female TCM physician doctor measuring pulse of woman, testing acupressure point of patient
Identifying the underlying imbalance can point your TCM physician to the right treatment tailored to you.

In Traditional Chinese Medicine (TCM), both conditions aren’t necessarily treated differently. “Both may be classified as skin disorders that involve inflammation and excess keratin production,” explains TCM Physician Kelvin Goh. The key is to identify and treat the underlying imbalance that’s causing the symptoms. 

Keratosis Pilaris is classified in TCM as “ 肌肤甲错” (ji fu jia cuo), which means rough, dry, red/brown bump that looks scaly, says Physician Goh. It may be due to:  

  1. Lung Yin Deficiency: Lungs oversee skin health so if it isn’t functioning well, it prevents skin pores from filtering out elements that cause skin conditions. A deficiency in Lung yin energy also means depleted skin moisture since yin energy represents liquid in the body. “With a reduced level of Lung-Yin in our bodies, it dries our skin easily and slows the skin’s metabolism level,” Physician Goh clarifies. 
  2. Blood Deficiency with Wind Dryness: This leads to “Heatiness” since the body lacks blood to nourish and cool it down. The lack of blood will lead to the generation of Wind pathogen in the body, which normally invades the skin. “Wind pathogen tends to combine with other factors, in this case, causing Wind-Dryness,” says Physician Goh. This causes the skin to be dry and scaly. 

Eczema is a term used to describe a group of inflammatory skin conditions that’s often triggered by environmental factors such as irritants or allergies

While TCM is a holistic approach to healthcare, treatment is tailored to each individual based on their underlying imbalances. 

Keratosis Pilaris Treatments 

Exfoliation with a natural bristle brush, dry brush massage on legs
Gentle exfoliation can help remove dead skin cells and unclog pores, improving the appearance of keratosis pilaris.

According to Physician Goh, TCM can help alleviate symptoms through a combination of these treatments: 

1. Acupuncture stimulates the circulation of qi and blood, improving the overall functioning of skin’s yin and yang. Acupoints that may be helpful are:  

  • Qu chi (LI11, 曲池): Helps relieve itching 
  • Xue hai (SP10, 血海): Reduces pain and alleviates red, itchy, inflamed skin 
  • Tai chong (LV3, 太冲): Boosts immunity and improve circulation 

2. Cupping results in red spots or marks after the treatment. “These marks are due to the breaking of capillaries under the skin,” clarifies Physician Goh. “These bleeding will be helpful to regenerate new blood around the area. Therefore, promoting a better skin environment.” 

3. Herbal remedies can help nourish and moisturize skin, as well as increase Yin in the body and reduce Heatiness, says Physician Goh. Helpful herbs include: 

  • American ginseng (xi yang shen, 西洋参): Cooling in nature; helps improve Lungs’ qi 
  • Astragalus root (huang qi, 黄芪): Tonifies and improves blood circulation  
  • Radix Ophiopogonis (mai dong, 麦冬): Clears Heat, improves Lung function 

4. Dietary changes include increasing your intake of nourishing, moistening foods and reducing intake of drying (Heaty), irritating ingredients. Try EYS Birds Nest with Collagen, which gives your skin double the moisture. 

5. Lifestyle changes can also help improve your skin condition. Physician Goh suggests the following: 

  • Moisturise regularly 
  • Exfoliate gently 
  • Avoid hot showers 
  • Use gentle, fragrance-free products 
  • Protect skin from the sun 
  • Stay hydrated 
  • Use humidifiers 

Other clinical treatments include topical creams, chemical peels, and microdermabrasion to improve skin appearance. Studies have found laser therapy to be successful in treating keratosis.

If you have keratosis pilaris (or eczema), consult a dermatologist and a qualified TCM practitioner. With a proper treatment plan, you can improve your skin’s symptoms. 

Bookmark this article if you’ve found the tips useful and take control of your skin health today. 

References

  1. Dermnet. 2022. Keratosis Pilaris. [Online] [Accessed on 1 March 2023]
  2. StatPearls Publishing. Updated 2022. Keratosis Pilaris. [Online] [Accessed on 28 February 2023]
  3. Skinmed. 2022. Keratosis Pilaris Treatment: Evidence from Intervention Studies. [Online] [Accessed on 28 February 2023]
  4. The Journal of Dermatological Treatment. 2022. Treatment of keratosis pilaris and its variants: a systematic review. [Online] [Accessed on 28 February 2023]
  5. World Journal of Clinical Cases. 2021. Clinical outcomes and 5-year follow-up results of keratosis pilaris treated by a high concentration of glycolic acid. [Online] [Accessed on 28 February 2023]
  6. Dermatologic Surgery. 2020. Light and Laser Treatments for Keratosis Pilaris: A Systematic Review. [Online] [Accessed on 28 February 2023]
  7. American Academy of Dermatology Association. KERATOSIS PILARIS: OVERVIEW. [Online] [Accessed on 1 March 2023]
  8. American Academy of Dermatology Association. KERATOSIS PILARIS: SYMPTOMS. [Online] [Accessed on 1 March 2023]
  9. American Academy of Dermatology Association. KERATOSIS PILARIS: WHO GETS AND CAUSES. [Online] [Accessed on 1 March 2023]
  10. American Academy of Dermatology Association. KERATOSIS PILARIS: DIAGNOSIS AND TREATMENT. [Online] [Accessed on 1 March 2023]
  11. American Academy of Dermatology Association. KERATOSIS PILARIS: SELF-CARE. [Online] [Accessed on 1 March 2023]
  12. International Journal of Trichology. 2012. Keratosis pilaris revisited: is it more than just a follicular keratosis? [Online] [Accessed on 28 February 2023]

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