March 31, 2014

Skincare Q&A: Salvaging Your Skin From Body Acne & Keratosis Pilaris

As an online esthetician, I spend much of my time answering questions about adult acneingrown hair problems, rosacea, or general skin sensitivities. So! I thought that I would feature a skincare Q&A on my blog to address some of these issues.

There are some questions that are sent to me via email or through ChickRx, a site where anyone can ask questions that relate to various lifestyle topics and experts (like myself) can offer valuable advice or suggestions. 

If you have any questions that you would like to ask (or have featured on the blog), please don't hesitate to speak out in the comments below! If you would rather have a question be answered privately, I am always available by email. :)

This week's Skincare Q&A features concerns about body acne breakouts and treating Keratosis Pilaris (KP).


"Is there a way to get rid of acne on the back of my arms?"

Believe it or not, it's not actually acne.

It's a condition known as Keratosis Pilaris.

What happens is, during the normal stages where your skin cells mature and start to die, they move up to the surface of your skin to become the layer of dead skin cells that make up the protective barrier that protects your body from all sorts of nasties.  This is one of the purposes of your skin.  The way this happens is there are granules of protein that start to accumulate in the cells, making them suffocate and then get flat, as the cells get so full of this protein, that's all there is to them.  As they're filling up with protein, the cells look kind of prickly.   Eventually the cells smooth out and flatten.

In a case of Keratosis Pilaris, or KP, this process goes kind of haywire.  Too many protein granules make the cells too prickly, the pores get a little clogged with this, and oils and dead skin cells can't come up to the surface of the skin the way they're supposed to.  This is why the skin is not only bumpy, but also quite dry.

The answer is exfoliation from inside pores and on the skin's surface, plus non-clogging moisturizers featuring ingredients called Ceramides.  Exfoliating spa gloves with a salicylic acid body wash is a great start, followed by a hydrating, non-clogging, exfoliating body lotion.


"I suffer from Keratosis Pilaris and have black spots all over my legs. I use Amlactin, coconut oil, and a sugar scrub, but there's no effect."

You're definitely on the right track as far as moisturizing and exfoliating.  The problem is, any effort at exfoliating is being counteracted by the pore clogging nature of the coconut oil and two of the ingredients in the Amlactin, one of which blocks pores (doesn't clog, but blocks) and other other which is low enough on the list not to be a problem in itself, but irritates in the presence of the lactic acid which is the main ingredient.

There are two aspects of KP that have to be addressed in order to combat it.  One is the accumulation of dead skin cells inside pores which are abnormally prickly, and the other is the lack of ceramides produced in the skin which would normally add to the softening function of the skin's natural barrier.  

This means exfoliation has to come from inside the pores as well as outside, which is why Amlactin is recommended, but the lotion used has to be better formulated.  Moisture would also have to come in the form of replenishing missing ceramides, which the Amlactin lotion does not have. This might mean getting a pricier lotion, but it's well worth it.  One that I recommend that was created specially for this condition is this body lotion. It has glycolic acid to get further into pores to exfoliate, plus ample moisturizers to replenish what your skin isn't making enough of.

Additional exfoliation and prevention of dryness can come in the form of exfoliating body gloves, and making sure your body wash is not too fragranced (that often results in dryness), and is not meant to leave you squeaky clean. One for dry skin is a good idea.  Using the body gloves alternating between up and down motions and circular motions will also coax trapped hairs out from underneath the top layer of dead skin cells.

Make sure, of course, that you do not pick at your skin, as tempting as it may be. Dark marks usually come from this, though not always. Even just plain inflammation that comes with KP can cause these black spots.


"Why do I get pimples on my back?"

There are three possibilities for this.
  • A sudden increases in oil production in your skin from hormonal changes like new birth control, stress or period, resulting in impactions when this oil mixes with dead skin cells to make blackheads, which then can get inflamed and result in breakouts.
  • An already oily skin being newly introduced to pore clogging materials from products such as hair conditioner or styling product, body lotion or fabric softener, creating impactions.
  • Pores getting inflamed by new pressure and/or friction from sitting back in a chair or working out.  One thing I've learned in 17 years in the skincare business - skin hates being bothered.
Not to worry, there are a few things you can do :

1) All types of fabric softener, sheets or liquid, can leave a pore clogging film on the body.  Use rubber dryer balls instead.  It also doesn't hurt to make sure laundry detergent is fragrance free.

2) Be aware of your hair conditioner.  Much of the time rinse-out hair conditioner has pore clogging ingredients that wash down your back and shoulders, and can also get onto the skin from your pillows and sheets, which cause impactions leading to breakouts.  If you're experiencing a back breakout, switching your hair conditioner to a salon brand can sometimes solve the problem.

3) Take a quick shower before working out, and make sure you shower thoroughly right after working out !  Do not drive home without showering after a workout - the moisture and salts from your sweat will irritate skin as your shirt creates friction against the skin causing further breakouts.

4) Wash with an exfoliating, medicated body wash using a pair of exfoliating body spa gloves, massaging your skin with gentle, circular motions.  After drying off, follow every other night with a not too thin but not too thick layer of 5% Benzoyl Peroxide, let dry.  Be aware that BPO can bleach clothes and sheets, so it's a good idea to wear a white t-shirt to bed, and necessitates sunscreen.

5) If you need to moisturize, a really good choice is Cerave Moisturizing Lotion, even though it says it's for face, which I don't recommend since it's quite heavy, but it's perfect for acne prone body skin because it is not pore clogging.  Apply every other night when you don't apply BPO.

6) For sunscreen, a good choice is a non-clogging, hydrating SPF face lotion from a salon, as it's the safest way to make sure you don't end up re-clogging your skin.  It might be pricier, but it'll be worth it.  Hydrating, broad-spectrum SPF lotions that are also non-clogging are really hard to find.

7) Make sure you don't wear anything that doesn't fit properly whether snug or loose, or that doesn't scratch or cause a lot of friction.  Be mindful of bra straps, shoulder straps and leaning back into a chair for much of the day.

Every body acne condition is different, so if you'd like more guidance beyond all the advice in this post, please feel free to contact me directly or to ask a question in the comments section below.

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