Hyperkeratosis pylaris

Archived Q&A and Reviews

July 2003

My 11-year-old son suffers from pilaris (something or other, the hour's late and I can't remember the darn name). It's on his arms and face. My pediatrician has recommended Hydrocortisone l% which helps when the skin is very scaly and inflamed but I have some reluctance about using it. I'm looking for a dermatologist who specializes in children. My mobility is somewhat limited so I'm looking for a physician located in Berkeley, Albany, El Cerrito, possibly Oakland. I've had bad luck with the McCalmont office in El Cerrito (5 minute, very rushed visits, unfriendly office staff) so please don't bother to recommend them. Anyone have someone great to recommend? We are not members of Kaiser BTW
at her wit's end

This is not a dermatologist recommendation, but I wanted to let you know that my daughter (now 2 1/2) has hyperkeratosis pylaris, on her arms and face (has since about 6 months old). In our experience, the hydrocortisone cream initially recommended by our pediatrician did nothing long-term for the little bumps and scales.

What has worked (on the recommendation of Dr Kathy Fang , out of the McCalmont office you've had bad luck with--sorry!) for us is:

--baths no more than once a week, if we can get away with it
--no more soap--only soap-free moisturizing shower gel (ShiKai at Trader Joe's is a good one) or Cetaphil
--Lacticare lotion--this is key. We apply it to her arms and face once or twice a day, and there has been real improvement. The lactic acid breaks down the keratin plugs, and facilitates the sloughing of skin cells so new plugs don't form again. The generic brand is called Amlactin, and is available at Costco, but we found Amlactin to be not as good as Lacticare (both are OTC, no 'scrip required), so we shell out for the good stuff. My daughter told us the Amlactin stings, actually--this may not be the case for your son. We didn't see immediate results--it took at least a month for initial improvement, but now, a year or so after starting the treatment, you can really tell the difference.

Keeping our daughter's skin well-hydrated, in combination with the lactic acid lotion, seems to be working well. The condition gets worse when we travel to Southern California (dryer air, dryer skin) and improves when we visit family in the humid Southeast!

Good Luck- Donna