This is a common problem where small bumps like “goose bumps” appear on your skin. It is a disorder of keratinization where small papule (bumps) form with occasional redness around the bumps. It is commonly seen and felt on the anterior thighs, triceps area and cheeks. It is commonly seen in children who previously were diagnosed as having atopic dermatitis. Up to 10% of all children may experience this rash. It is commonly seen in children and teens and can be seen in infants.
The cause is not clearly known. There appears to be a familial pattern. Under a microscope plugs of skin cells (keratin) with one or more twisted hairs block hair follicle openings. The most common complaint is “rough and raised” bumps on the skin. It increases during the winter months and seems to be worsened by friction from clothing. Although it often persists into adulthood it usually improves after the teen years. It may increase during pregnancy.
Patience, lubrication and time are usually the best treatments. Emollients and topical keratolytic medications containing lactic acid, salicylic acid or urea can help soften the plugs. They do not help with any surrounding redness. A common preparation has 2% salicylic acid in 20% urea cream. It must be applied consistently for several weeks to see a benefit.
If your child does not respond to the above treatment then topical retinoids such as tretinoin 0.05% cream or adapalene 0.1% cream may be used. These usually require 2-3 months of treatment to see benefits. If there is redness and signs of inflammation then a topical low to medium strength corticosteroid can be used for several weeks.