Keratosis Pilaris During Pregnancy - All About the Bumps

Introduction

Keratosis pilaris is a skin disorder that is common during pregnancy. However, it can also be seen in teenagers and babies. This condition usually worsens during the winter season and low-humid conditions or during pregnancy and after childbirth. Variations in hormonal homeostasis (balance) during pregnancy can result in various skin conditions. Keratosis pilaris is also due to hormonal changes during pregnancy.

What Is Keratosis Pilaris?

Keratosis pilaris is a hyperkeratotic (thickening of the outer layer of the skin that is made of keratin, a protective protein) skin condition. It is characterized by tiny, painless bumps that present as skin-colored lesions surrounded by erythema (redness). These lesions often appear as a group of lesions on the upper arms, cheeks, thighs, and buttocks. The exact reason for the occurrence of keratosis pilaris is not known. These lesions are formed by dead skin cells that plug the hair follicles and appear red or brown in color. These lesions are not contagious, and they usually do not cause pain, itching, or discomfort. These lesions cannot be cured but can be prevented from getting worse.

What Are the Symptoms Associated With Keratosis Pilaris?

The common diagnostic symptom of this skin condition is its appearance. These visible tiny bumps resemble goosebumps or the skin of a chicken. The keratotic bumps can occur anywhere on the skin region with hair follicles and do not appear on the soles of the feet or the palms of the hands. Keratosis pilaris pregnancy is common on the upper arms and thighs and can extend to the forearms and lower legs. Other associated symptoms include the following:

• Pinkness or redness around the bumps.

• Dry skin.

• Hard and rough bumps that feel like sandpaper.

• Itchy and irritable skin.

• Bumps can be skin-colored, white, red, brown, pink, or black.

What Are the Causes Associated With Keratosis Pilaris?

The exact reason for keratosis pilaris is not known, but it can be due to the formation of ortho keratotic plugs (buildup of keratin) that block the pores and the opening of hair follicles, resulting in the formation of bumps that block the growing hair. A small hair emergence can be seen inside the bump. Though the exact etiology remains unknown, it is thought to be associated with genetic diseases and atopic dermatitis (a skin condition that causes patches of dry, itchy, and inflamed skin). In addition, studies have shown that hormonal imbalances can cause the development of keratosis pilaris. The subtypes of keratosis pilaris are sometimes a part of genetic diseases associated with neuro-cardio-facial-cutaneous syndromes, intellectual disability, RASopathies (mutations that alter the cellular proteins), ectodermal dysplasia (a condition that affects the teeth, hair, nails, sweat glands, facial structures, and other external structures of the body) and certain myopathies.

How Does Keratosis Pilaris Develop?

Excessive production of the skin protein keratin results in the formation of tiny, raised bumps in the skin, surrounded by redness. The color of keratin is the same as the individual's skin tone. The excess keratin surrounds and blocks the hair follicles in the pores. This results in the formation of hard plugs called hyperkeratotic plugs. Many bumps contain ingrown hair as a result of hyperkeratinization that prevents the exit of the growing hair.

Why Is It Common in Pregnant Women?

Pregnancy hormones may trigger excessive sweating, leading to heat rashes or skin irritation. In addition, hormonal variations during pregnancy result in flare-ups of keratosis pilaris, leading to keratosis pilaris pregnancy. Also, pregnant women with dry skin are prone to develop this condition. However, it can affect anyone susceptible to this condition. It is commonly seen in children and teenagers and often develops during late infancy or adolescence. Also, it subsides in the mid-20s; in most cases, they are completely resolved by age 30. It is common in children, women, teenagers, and those with the following conditions:

• Dry skin.

• Ichthyosis (a condition in which the skin does not shed its dead cells).

• Eczema (a condition in which the skin is red, itchy, dry, and irritated).

• Hay fever (a seasonal disease that causes fever, irritation, inflammation of the nose, and other symptoms).

• Obesity.

What Is the Connection Between Keratosis Pilaris and Pregnancy?

• Keratosis Pilaris and Pregnancy: Keratosis pilaris can be aggravated by hormonal changes during pregnancy and therefore women are often affected. Most women experience bumps on the arms postpartum, thighs, or even on the skin of the stomach where there is the keratosis pilaris. This is attributable to the synthesis of keratin which forms a sort of plug at the root of hair leading to the formation of the typical pimples.

• Keratosis Pilaris Postpartum: In the postnatal period, some women develop skin changes called bumpy skin postpartum. This may show as keratosis pilaris postpartum or in other body areas that are normally affected by the illness. Keratosis pilaris often tends to be worse after pregnancy because the woman’s body has more hormonal shifts during the postnatal period. This condition is associated with keratosis pilaris hormones known to change at this time after birth.

• Bumpy Skin After Pregnancy: This skin irregularity is quite irritating to many new mothers and can be attributed to pregnancy. KP is mainly asymptomatic, although the texture and appearance of the skin can be irritating to the patient. Keratosis pilaris after pregnancy can occur, and the bumps can either remain or increase after delivery.

• Management: Caring for keratosis pilaris during and after pregnancy entails moisturizing and exfoliating the skin. In some cases, hormone levels may normalize, and the problem disappears; however, some patients may suffer from the condition for a long time, requiring constant treatment.

If bumpy skin postpartum is an issue, it is wise to visit a dermatologist for advice on a course of action and possible treatment.

What Is Keratosis Pilaris After Pregnancy?

Keratosis pilaris after pregnancy is a condition whereby after giving birth, you develop some small, rough bumps, which are commonly known as ‘chicken skin’. This condition is associated with the hormonal changes that occur before and after pregnancy.

1. Causes: After pregnancy, the levels of estrogen in the body are also high and they attempt to reach the pre-pregnancy status. These hormonal changes can worsen or cause keratosis pilaris, which causes the skin to have a rough, bumpy appearance; they are common on the arms, thighs, and, in some cases, the buttocks and face.

2. Common Symptoms:

• Bumps on Arms Postpartum: It is one of the arms in which a lot of women observe the formation or aggravation of small rough bumps after pregnancy. These bumps can be rough and sometimes slightly itchy and may appear to be pimples or goosebumps on the skin.

• Bumpy Skin Postpartum: Besides the arms, some women develop bumpy skin on other parts of the body, including the thighs, buttocks, and even the face, which becomes rough after childbirth. The skin appears to be coarse, and the nodules are often the same color as the skin or slightly pinkish.

• Keratosis Pilaris on Stomach: However, in as much as these conditions are rare, some women may develop or notice keratosis pilaris on their stomachs after delivery. This can be especially so if the skin has been pulled tight during pregnancy and the lumps become more conspicuous as a result.

Why Does Keratosis Pilaris Worse After Pregnancy?

The worsening of keratosis pilaris after pregnancy is mainly a result of hormonal influences on the skin, particularly on keratin. If keratin, a type of protein that prevents skin infection, rises, the hair follicles become blocked and cause the small, raised bumps of keratosis pilaris.

Further, the postpartum period can also be quite challenging, and stress, in general, influences skin states. Typically, hormonal fluctuations, stress, and possibly decreased personal care may also lead to the deterioration of keratosis pilaris in this period.

How Is Keratosis Pilaris Diagnosed?

The diagnosis of keratosis pilaris depends on medical history and physical examination. It also includes factors such as the age, appearance of the lesion, and the area affected. There is no specific test to diagnose keratosis pilaris. The healthcare provider diagnoses this condition based on the appearance of the skin and the symptoms described by the patient.

How Is Keratosis Pilaris Treated?

Keratosis pilaris is a harmless condition that cannot be cured and usually resolves on its own with age. Some treatment measures can help alleviate the appearance of the lesion, but it is usually treatment-resistant, and improvement takes time.

Dermatologists may recommend a moisturizer to soothe dry skin, improve its appearance, and prevent bumps during pregnancy. Various prescription creams can help remove dead skin cells and prevent the blocking of hair follicles. Moisturizing treatments with urea and lactic acid can help soften the dry skin and dead cells and remove them. Other treatment methods such as microdermabrasion (a minimally invasive procedure that is performed to remove the outer layer of the skin), chemical peels (a procedure in which high-strength chemical exfoliants are used to remove the outer layer of the skin), and retinol creams are used to remove the dead skin. Other experimental procedures, such as photopneumatic therapy (a light-based therapy) and vascular laser therapy (lasers are used to reduce the lesions and the erythema), are also available. However, the treatment during pregnancy focuses only on gentle methods to remove dead cells, dirt, and excess oil from the skin's surface.

How to Prevent Keratosis Pilaris?

Keratosis pilaris cannot be prevented, but a gentle skincare routine can prevent flare-ups, minimize the appearance of lesions, and reduce bumps during pregnancy. An oil-free moisturizer can help moisturize the skin and prevent the clogging of pores that cause the development of keratosis pilaris. Regular exfoliation with gentle scrubs can also help remove dead skin. Hydrating lotions help hydrate dry skin and also improve cell turnover.

Conclusion

Keratosis pilaris is a skin disorder that is common in pregnant women and young people. Though it cannot be cured, it resolves on its own in some cases. The skin changes during pregnancy can be an overwhelming period of rapid change. Many treatment options for keratosis pilaris are unsafe during pregnancy, and it is essential to discuss with the healthcare provider to know about gentle methods that treat dryness and skin bumps.