Seborrheic keratosis

Follicular hyperkeratosis is a common and mild skin condition. It has a genetic basis and is classified as a disorder of keratinization.

In this condition, the skin excessively keratinizes, especially at the openings of hair follicles. This phenomenon, called hyperkeratosis, involves the accumulation of excess keratin - a protein that is the main component of the epidermis. The excess keratin blocks the hair follicles, leading to the formation of hard plugs, visible as small bumps on the skin. Although it is a chronic condition, it is usually treated solely as a cosmetic defect, not posing a serious threat to health.

Follicular hyperkeratosis manifests as small, hard papules that make the skin feel rough to the touch and resemble "goosebumps". It is often accompanied by redness of the skin around the hair follicles and dryness of the epidermis. Sometimes itching or burning sensation may also occur.

Typically, the changes localize on the arms, thighs, and buttocks. In the youngest children, they may also appear on the face. Characteristic is the exacerbation of symptoms in the winter, which is associated with lower air humidity.

It is worth avoiding scratching the lesions, as it can lead to inflammation, ingrown hairs, and even the formation of unsightly discolorations.

Follicular hyperkeratosis is a characteristic disorder of keratinization of the skin, which has a genetic basis and affects hair follicles. It is inherited in an autosomal dominant manner, which is often confirmed by a detailed family history.

Despite the genetic predisposition to the disease, certain factors can exacerbate the visibility of skin changes. The most important ones include vitamin A deficiencies or problems with its absorption. Hormonal fluctuations, typical of adolescence or pregnancy, also have a significant impact. Furthermore, other dermatological conditions, such as atopic dermatitis or ichthyosis, can worsen the skin condition. Additionally, skin dryness, especially in winter, significantly exacerbates this problem.

Follicular keratosis occurs in three main variants, each characterized by unique features.

The most common form is white follicular keratosis. It is characterized by rough skin with numerous white or gray bumps, without visible signs of inflammation.

Another form of the disease is red follicular keratosis. It manifests as distinct redness around the bumps, often resembling acne.

The rarest and most serious form is atrophic follicular keratosis. It leads to progressive hair follicle loss, resulting in the formation of scars and permanent baldness in the affected areas.

In the care of skin with follicular hyperkeratosis, two key pillars are crucial: regular removal of dead skin and intense skin moisturization.

It is worth reaching for appropriate exfoliating agents. Effective will be urea in a concentration above 10%. Equally beneficial are AHA acids, such as lactic acid, as well as salicylic acid (BHA). They prevent excessive skin keratinization.

Intense moisturization is crucial for rebuilding the skin's natural protective barrier. It is worth using dermocosmetics containing:

• emollients (e.g., shea butter, plant oils) - protecting the skin from moisture loss,
• humectants (glycerin, hyaluronic acid) - binding water in the epidermis,
• ceramides - supporting skin regeneration,
• niacinamide - supporting skin regeneration,
• panthenol - soothing irritations,
• allantoin - soothing irritations.

Avoid aggressive detergents, hot/chlorinated water, and mechanical skin rubbing. Gentle dry brushing of the skin supports the removal of dead skin.

The therapy of follicular keratosis aims to normalize the process of keratinization and alleviate the troublesome symptoms of the disease.

In daily care, or local therapy, retinoids such as tazarotene or adapalene, as well as calcipotriol, are often used. In more severe cases, a dermatologist may recommend oral treatment, such as isotretinoin or acitretin.

Complementary treatment includes professional cosmetic procedures that effectively support therapy. These include:

• chemical peels, e.g. with glycolic acid,
• microdermabrasion,
• hydropeeling,
• laser treatments, e.g. CO2 laser and vascular lasers that reduce redness and improve overall skin texture,
• laser hair removal, especially helpful in cases of ingrown hairs,
• spa therapies, e.g. utilizing sulfur-rich waters.

Although diet will not cure keratosis pilaris, it can significantly support therapy and alleviate symptoms of the disease. A balanced diet rich in anti-inflammatory components is important. Your skin will especially appreciate a diet rich in:

• vitamin A,
• vitamin C,
• vitamin D,
• vitamin E,
• vitamin B group,
• zinc,
• unsaturated fatty acids, especially omega-3, known for their anti-inflammatory properties.

In case of identified nutritional deficiencies, it is always worth consulting a doctor who can recommend targeted supplementation.

To avoid exacerbating the disease, limit the consumption of processed foods and products with pro-inflammatory properties.