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Ask an expert: Is it a pimple or is it keratosis pilaris?

Learn to identify keratosis pilaris and discover other possible explanations for those tiny bumps on your skin.

Curology Team Avatar
by Curology Team
Updated on Jul 6, 2023
Medically reviewed by Meredith Hartle, DO
Young man keratosis pilaris on his upper arm
Curology Team Avatar
by Curology Team
Updated on Jul 6, 2023
Medically reviewed by Meredith Hartle, DO
We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.

You’ve typed “Why do I have little bumps on my knees?” into the search bar and the first few articles that pop up talk about pimples and keratosis pilaris. These are two conditions that don’t appear on the knees, but they can appear elsewhere on the body!  

Keratosis pilaris is a common, harmless skin condition that appears in the form of non-contagious, small, painless bumps around the upper arms, thighs, and buttocks. Bumps on the knees that look like pimples aren’t pimples (or keratosis pilaris!). We’ll touch on that in a bit. But first, let’s unpack keratosis pillars symptoms, causes, and treatment. 

Keratosis pilaris: What is it?

Some people refer to keratosis pilaris as chicken skin. It can also resemble goosebumps. These little growths most commonly appear on the upper arms, thighs, or buttocks.¹ It’s a harmless condition caused by an overproduction of keratin, a protein found in hair, skin, and fingernails. When keratin builds up in your hair follicles, tiny bumps can appear.² They’re not painful and may go away on their own. That said, there are also ways to help manage them. We’ll share those below.

Female arm showing signs keratosis pilaris

Contributing factors to keratosis pilaris 

Keratosis pilaris develops when hair follicles get clogged with a protein called keratin. It can block hair follicles or pores and cause bumps to develop. It’s not from a fungus, bacteria, or virus, and it’s not contagious. It occurs in roughly 50-80% of adolescents and 40-50% of adults.³ Pimples on the knees of a child likely aren’t keratosis pilaris (or acne!). It develops on extensor surfaces (typically on the upper arm, thighs, and buttocks) and can develop on the cheeks, especially in children. It can worsen during pregnancy or after childbirth. The good news—often improves or clears up with age.

What causes the body to overproduce keratin remains unknown, but potential risk factors may include:  

  • A family history of keratosis pilaris

  • Specific genetic changes⁴ 

  • Other skin conditions, like eczema 

  • Obesity or excess body weight

  • Medical conditions such as diabetes and down syndrome 

  • Dry skin

What do these bumps look like?

Keratosis pilaris is usually easy to recognize based on its location on the body and the characteristics of the bumps. We’ll share the common characteristics, but before we do, we want to say the information we share here shouldn’t replace qualified care from a licensed dermatology provider or medical provider. Your healthcare provider is the one who will make the official diagnosis. If you’re experiencing bumps—be it keratosis pilaris or something else—and they become painful or don’t clear up on their own, or you have other symptoms, it’s important to see your medical provider.

You’ll notice tiny patches of rough bumps on your skin. Other common characteristics may include: 

  • Itchy or dry skin: This is usually most prevalent on your upper arms, legs, or butt. The itchiness can be more intense when your skin is dry. 

  • Discoloration: When the bumps become irritated, they can become discolored and more noticeable. Bumps can be skin-colored, red, white, brown, or black depending on the person’s skin color. 

  • Rough, sandpaper-like skin: Your skin may become rough or feel sort of like sandpaper in the affected area. 

  • Noticeable differences in winter or dry climates: Keratosis pilaris may worsen in the winter or dry climates and improve during the warmer months.⁵

  • Painlessness. Keratosis pilaris is generally painless, so if you experience pain while pressing or prodding at your bumps, it may be something else.

Ingrown hairs keratosis pilaris folliculitis

How do you treat keratosis pilaris?

There’s no cure for keratosis pilaris yet, but you can do things to help minimize the symptoms Spoiler alert: Popping them is not one of them! Picking, squeezing, and attempting to pop little bumps often makes matters only worse. Instead, we recommend using one or a combination of the following options:  

  • Use ingredients that promote cell turnover or remove dead skin cells.⁶ Retinoids (including prescription-strength tretinoin), alpha-hydroxy acids (AHAs), and beta-hydroxy acids (BHAs) are exfoliants that remove dead skin cells and promote cell turnover. Most are available over the counter. Common AHAs include lactic acid and glycolic acid. Salicylic acid is a common BHA.

  • Keep your skin moisturized. Dry skin is a common symptom of keratosis pilaris, so keep your skin hydrated. Choose hydrating ingredients, including glycerin, aloe, and hyaluronic acid, to attract and lock in moisture.

  • Wear soft, loose-fitting clothes. Friction from clothing can aggravate keratosis pilaris. Give your skin room to breathe by opting for soft, breathable fabrics like cotton or linen. 

  • Gently exfoliate. A konjac sponge can gently remove dead skin cells from the skin’s surface. Avoid harsh salt or sugar scrubs.

What about the pimples on my knees?

While pimples can occur on the face, neck, chest, back and shoulders, they don’t appear on the knees. Most often, small bumps on the knee cap are from another cause like ingrown hairs, shaving irritation, folliculitis, or a reaction from lotion or another comedogenic (aka pore-clogging) product. 

Keratosis pilaris can happen when your pores become clogged due to the buildup of keratin. In contrast, acne forms when your pores become clogged with excess sebum and dead skin cells. Bacteria thrive in the excess sebum and lead to inflammation. This is what causes the formation of whiteheads, blackheads, papules, pustules, nodules, and cysts. Acne is an inflammatory skin condition that currently has no cure, but it is treatable

Can Curology treat keratosis pilaris? 

While your personalized Curology formula typically treats acne, anti-aging, and rosacea symptoms on your face and neck, as a Curology member, you can talk to your dermatology provider for help with other skin issues, like keratosis pilaris. We’re always here to help. And with a team of dedicated licensed dermatology providers, we have the resources to find answers to your questions! 

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FAQs

Keratosis pilaris: What is it?

Some people refer to keratosis pilaris as chicken skin. It can also resemble goosebumps. These little growths most commonly appear on the upper arms, thighs, or buttocks. It’s a harmless condition caused by an overproduction of keratin, a protein found in hair, skin, and fingernails. When keratin builds up in your hair follicles, tiny bumps can appear. They’re not painful and may go away on their own.

What do these bumps look like?

You’ll notice tiny patches of rough bumps on your skin. Other common characteristics may include: 

  • Itchy or dry skin

  • Discoloration

  • Rough, sandpaper-like skin

  • Noticeable differences in winter or dry climates

  • Painlessness

How do you treat keratosis pilaris?

There’s no cure for keratosis pilaris yet, but you can do things to help minimize the symptoms. We recommend using one or a combination of the following options:  

  • Use ingredients that promote cell turnover or remove dead skin cells

  • Keep your skin moisturized

  • Wear soft, loose-fitting clothes

  • Gently exfoliate

What about the pimples on my knees?

While pimples can occur on the face, neck, chest, back and shoulders, they don’t appear on the knees. Most often, small bumps on the knee cap are from another cause like ingrown hairs, shaving irritation, folliculitis, or a reaction from lotion or another comedogenic product. 

Keratosis pilaris can happen when your pores become clogged due to the buildup of keratin. Acne is an inflammatory skin condition that currently has no cure, but it is treatable

• • •

P.S. We did the homework so you don’t have to:

  1. Thomas, M., & Khopkar, U. S. Keratosis pilaris revisited: is it more than just a follicular keratosis?. International journal of trichology. (2012).

  2. American Academy of Dermatology. Keratosis Pilaris: Overview. (n.d.).

  3. Brandt, F., et al. A clinical investigation on the improvement and apparent resolution of keratosis pilaris with a novel photopneumatic therapy: A pilot study.Journal of the American Academy of Dermatology. (2008, February 1). 

  4. Pennycook, K.B., et al. Keratosis Pilaris.StatPearls. (2022, June 27).

  5. Pennycook, K.B., et al. Keratosis Pilaris. Ibid.

  6. American Academy of Dermatology. Keratosis pilaris: Self-care. (n.d.). 

* Curology dermatology providers include NPs, PAs, MDs, and DOs.

** Subject to consultation. Subscription is required. Results may vary. 

• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
Curology Team Avatar

Curology Team

Meredith Hartle, DO

Meredith Hartle, DO

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