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Dermatology/Very tiny bumps and dry skin


Hello Dr. Fisher,

I have very tiny red oil-filled solid bumps on my upper left arm and shoulders, chest and upper stomach and a few on my back. They look shiny, most of them are skin-colored but have a red ring around them so they look red in general. They are not very persistent but reoccur from time to time. Sometimes they itch, sometimes not. Sometimes some areas on my arms get dry and scaly and sometimes a few narrow red veins appear around these areas. Generally, it doesn't look serious but I really want to get rid of it, whatever it is.
My doctor didn't say (or didn't know) what my problem was but said it was some kind of harmless genetic disease and that it was some kind of Eczema. Then he prescribed Tretinoin (RetinA) (I know it's an over-the-counter medicine but he prescribed it). I've been using it for some time now. Some of the tiny bumps which were located on my lower arm faded away but the rest either remained where they were or disappeared but appeared again later.
I read an article about Keratosis Pilaris on PubMed health encyclopedia that I think pretty much fits my symptoms, so I think that's what my problem is.
What's your diagnosis? How can I treat it?
I really need your help. I'm not going to see my doctor again. It's just a waste of money.
Thank you very much in advance for your help.


Keratosis pilaris is a common skin condition in which a protein in the skin called keratin forms hard plugs within hair follicles.

Causes, incidence, and risk factors

Keratosis pilaris is harmless (benign). It seems to run in families.  It is more common in people who have very dry skin, or who have atopic dermatitis (eczema).

The condition is generally worse in winter and often clears in the summer.


Symptoms include:

Small bumps that look like "goose bumps" on the back of the upper arms and thighs

Bumps feel like very rough sandpaper

Skin-colored bumps are the size of a grain of sand

Slight pinkness may be seen around some bumps

Bumps may appear on the face and be mistaken for acne

Signs and tests

Your doctor or nurse can usually diagnose this condition by looking at your skin. Tests are usually not needed.


Treatment may include:

Moisturizing lotions to soothe the skin and help it look better

Skin creams that contain urea, lactic acid, glycolic acid, salicylic acid, tretinoin, or vitamin D

Steroid creams to reduce redness

Improvement often takes months and the bumps are likely to come back.

Expectations (prognosis)

Keratosis pilaris may fade slowly with age.


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Michael S. Fisher, <B>Ph.D., M.D.</B>


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