Some people have a troublesome inherited skin problem called keratosis pilaris. This is the technical name for a condition in which hundreds of hard, clogged pores cover a person’s shoulders, upper arms, buttocks, and upper thighs. It can seem to be a persistent case of acne, but these lesions rarely become inflamed and rarely become a pimple—though they will become inflamed if you pick at them. On darker skin the plugs can look like a sea of blackheads. What to do?
Gentle cleansing, exfoliating, and disinfecting can cause a huge reduction in the number of bumps. First, wash the skin gently with body wash (avoid soap, which can not only be too harsh but also may leave behind a film that can clog pores). If you like, you can use a clean washcloth gently over the bumpy areas. Do not overscrub. You can’t rip these bumps off, and inflaming the area will only make matters worse.
After bathing, dry the area gently. When the skin is dried, apply a BHA lotion, gel, or toner over the problem area. BHA (salicylic acid) is the perfect option because it is lipid soluble. Lipid soluble means it can exfoliate inside the pore where the plug exists, improving the shape of the pore to allow a normal flow of oil. That makes it the best choice for reducing and potentially even eliminating the problem. If the bumps you have tend to become pimples or are infected after the BHA, apply a topical disinfectant of either 2.5% or 5% benzoyl peroxide. Do not apply moisturizer to these areas unless they are dry. During the day it is best to keep the area covered by clothing to avoid the use of sunscreen, which can make the problem worse. However, if the skin is going to be exposed to sun then it is essential to apply a well-formulated sunscreen. It will take some experimenting until you find the sunscreen that works for you. (Source: Cutis, September 2008, pages 177-180.) If you are unable to use or do not get noticeable results from a BHA product, an AHA lotion or gel with glycolic acid is also worth considering.