A common problem usually starting in childhood is a persistent rough “sandpaper-like” rash on the outer arms and upper thighs. It may also involve the upper back, chest, and buttock areas.  This rash, also known as keratosis pilaris, is inherited and consists of “horny” plugs blocking the pores.  Essentially, there is an accumulation of cellular debris that blocks the pores and produces a rough, sometimes irritated rash.  It is most prevalent in adolescence and less common in adult life. 

Suggestions for Treatment:  This condition is similar to acne, in that the pores are blocked by cellular debris.  The emphasis of treatment is to loosen and remove the cellular debris.  The alpha and beta hydroxy acids greatly help in removing the horny plugs.  

Hydroxy acid washes are used in the shower.  Using a washcloth or loofa is helpful; however, you cannot scrub away the rash.  The purpose of the hydroxy acid is to loosen the plugs and produce overall smoothness.  
 

After showering, a hydroxy acid lotion or cream is applied to the involved area twice daily.  Some studies have shown benefit with retinoic acid applied nightly as well. If the areas are red or itchy, a hydrocortisone cream or lotion can be added twice a day to this regimen.      

Remember, this is a condition that usually improves with time. Treatments are designed to improve but not cure the problem.