Keratosis pilaris and psoriasis are both skin conditions that tend to run in families, but their similarities end there. The way the conditions look on the skin and how they’re treated is different.
Keratosis pilaris is a common skin condition that causes small bumps on the skin, much like goosebumps. It’s also called “chicken skin.”
Psoriasis is an autoimmune condition that often affects more than the surface of the skin. It’s associated with psoriatic arthritis and is linked to other conditions such as heart disease, diabetes, and Crohn’s disease.
Both of these skin conditions tend to run in families and appear in patches on the skin. Keratin, a type of protein, plays a role in both these and many other skin conditions. Keratin is important to the structure of your:
- skin
- hair
- mouth
- nails
Other than that, psoriasis and keratosis pilaris are very different. Read on for more information on both conditions, their differences, and their treatments.
The following is a summary of the differences in symptoms between these conditions. More detailed information follows below.
| Symptoms of psoriasis | Symptoms of keratosis pilaris |
|---|---|
| thick, raised red or pink patches with whitish silver flakes; on darker skin, they appear violet and gray | patches of small bumps that feel like sandpaper to the touch |
| patches often become red and inflamed | skin or bumps may become pink or red; in dark skin, bumps may be brown or black |
| skin on the patches is flaky and sheds easily | very little shedding of skin occurs beyond the typical flaking associated with dry skin |
| commonly found on the elbows, knees, scalp, lower back, palms of the hand, and feet; in more severe cases, patches may join and cover a greater portion of the body | typically appears on the upper arms, cheeks, buttocks, or thighs |
| patches itch and can become painful | minor itching may occur |
Psoriasis is one of several autoimmune disorders in which your immune system mistakenly attacks harmless substances within the body. The response, in the case of psoriasis, is your body speeding up skin cell production.
In people with psoriasis, skin cells reach the surface of the skin in 4 to 7 days. This process takes about a month for people who don’t have psoriasis.
These immature skin cells, called keratinocytes, build up on the skin’s surface. From there, these cells form raised patches covered by layers of silver scales.
According to the American Academy of Dermatology Association, a Hispanic person is more likely to have salmon-colored psoriasis. In African Americans, psoriasis often looks violet and the scale may be gray. In dark skin, psoriasis can also be dark brown and difficult to see.
Although there are several different types of psoriasis, plaque psoriasis is the most common.
About 80% of people with psoriasis have plaque psoriasis. Some people who have plaque psoriasis will also have nail psoriasis. This is when nails become pitted and crumble easily. Eventually, some nails may be lost.
Research is still being done to find the cause of the condition. Experts have suggested there’s a genetic component. It’s estimated that a child has a 10% chance of getting psoriasis if one parent has it. If both parents have psoriasis, the chance increases to 50%.
The type of psoriasis and severity of the disease determine which approach to take for treatment. Initial treatments include topical medications, such as:
- corticosteroid creams and ointments
- salicylic acid
- vitamin D derivatives, such as calcipotriene
- retinoids
Treating People of Color
People of Color may be disproportionately undertreated and misdiagnosed because some clinicians do not always recognize the condition in darker skin tones as they do for people who have lighter skin tones.
According to the National Psoriasis Foundation, this may often be the case despite the fact that psoriasis can be more severe in skin of color, covering a larger surface area of skin.
Biologics, ultraviolet light therapies, and photochemotherapy may be used to treat more severe cases of psoriasis. Sometimes a doctor may prescribe biologics if someone cannot tolerate topical corticosteroids or a large surface area is affected.
However, People of Color do not always get equitable access to these treatments. For example, Black people with moderate to severe psoriasis who receive Medicare are
Keratosis pilaris happens when keratin builds up in hair follicles. Hair follicles are small sacs under the skin from which your hair grows. When keratin plugs the sacs, the skin develops bumps that look like tiny whiteheads or goosebumps.
Keratin is also the main meal for the fungi that cause:
Generally, the bumps are the same color as your skin, but these bumps may appear red or dark brown on light skin.
Keratosis pilaris often develops in patches that have a rough, sandpapery feel. These patches appear most commonly on:
- cheeks
- upper arms
- buttocks
- thighs
The condition tends to worsen in the winter when your skin is more likely to be dry. Although anyone can get keratosis pilaris, it’s more commonly seen in young children. Doctors do not know what causes the condition, though it tends to run in families.
Keratosis pilaris is not harmful, but there are some things you can do to manage it if it bothers you.
Applying moisturizing cream containing urea or lactic acid several times a day may be beneficial. You may also be prescribed a medication to exfoliate your skin. These medications usually contain ingredients such as:
- salicylic acid
- retinol
- alpha hydroxy acid
- lactic acid
In some instances, your doctor may recommend using a corticosteroid cream or laser treatment.
Neither plaque psoriasis nor keratosis pilaris requires immediate medical attention. You may not need to be treated for keratosis pilaris unless you find it uncomfortable or unhappy with your skin’s appearance.
Psoriasis, particularly in more severe cases, warrants a doctor visit to manage the symptoms. Your doctor will work with you to determine if you need treatment and decide which is the best treatment plan for you.