Paleo Hacks – Keratosis Pillaris

I was browsing Paleo Hacks this morning and came across the following question:

My boyfriend and I are in very different places in the paleo journey. He has been following the lifestyle for years and I only started a few months ago. We have been fussing with macro nutrient ratios lately. He is always low carb but has more protein than fat where as I am low carb trying to do high fat mod protein.

He always seems to have a rash of sorts that is tons of little bumps on the back of his arms. I cant figure out what is causing it! He eats ground beef, raw kale, chicken soup (made the right way with TONS of minerals etc) and thats about it. I eat a much more varied diet. Now, I have only gotten the bumps a few times but I also get them on my legs! There doesnt seem to be any particular food that causes it.

Now I lets just say thanksgiving was an epic failure for me in all ways. I ate things that I cant even bring myself to write. Moving on, but I am really really breaking out into the “bump rash” right now. All over my body it seems! ARgggg

So here are my questions:

  1. What are these bumps?????
  2. Why does he have them and what does it mean? It seems like inflammation of some kind but from what?
  3. Am I having them right now because I am “detoxing” from my thanksgiving binge? It is the first time in months I had eaten such.. crap. Think store bought pie, fudge, stuffing made with fake butter ugh the list goes on.

Bf did not eat anything bad for the holiday- he was smartly at home and did not go to either of our mothers feasts. I am back on track – and pretty strict.


For more Paleo hacks:

This is my response to her question:

I had the same problem for a long time after spending a year traveling in Australia. Not only was I massively fat-soluble vitamin deficient, but I was getting a ton of sun, so I was probably having way too much vitamin D, which is known to result in a consequential vitamin A deficiency (see Chris Masterjohn’s work:

Hyperkeratosis pillaris is a common sign of vitamin A deficiency. It may be possible that the deficiency might be in vitamin K2 as well, since K2 is required for vitamins A and D to function correctly.

I only recently was able to heal my KP with a combination of diet and good exfoliation. But it can be done. It’s not a detox reaction, it’s a fundamental problem of disordered keratin production in the skin. The bumps are simply a buildup of keratin around the hair follicle.

I would add cod liver oil and high vitamin butter oil to your supplement routine if you have one. As far as products go, I like KP Duty by Dermadoctor for exfoliation in the shower, and Amlactin XL as a lotion.

Combining good diet, fat-soluble vitamins, and an aggressive exfoliation routine has completely cured my hyperkeratosis pillaris, so I really recommend that protocol for you and your boyfriend.

My Hyperkeratosis Pillaris at its WORST:

Hyperkeratosis Pillaris on my face, similar to that on my arms

I wanted to bring this question and answer session into my blog, since keratosis pillars (KP) is something I was dealing with for over a year after my trip in Australia. Having attended Chris Masterjohn’s talk, and reading the book “K2 and the Calcium Paradox”, I feel much more educated about the importance of the fat soluble vitamins, and what can happen when one is in excess. My experience in Australia was that my diet was very low quality, and the strong Australian sun was probably giving me way too much vitamin D, causing an imbalance in my fat-soluble vitamin ratios.

I have since cured this skin problem. YAY!

I hope that my experience with KP will give anyone else with problem skin not only hope for a cure, but also a functional protocol to take when looking to cure your skin ailments. I truly believe that a combination of improved diet, proper supplementation, and strategic topical treatment is the best way to deal with KP. I’ve read on some forums before that the condition is permanent. NOT TRUE! I encourage you to give this treatment regimen a try for a month or so and see how your skin reacts. For me, it was a miracle – I had been so self conscious about this skin problem that I was even somewhat depressed. I really felt unattractive when I was covering the redness up with makeup, and it really took a toll on my self confidence. This is why I’m so pleased that I discovered a way to treat the issue, and now my skin is essentially back to normal, with the exception of a bit of scarring.

If any of you are dealing with this skin problem, I really encourage you to try my treatment protocol. Feel free to ask me any questions if you want to know more information about my successful treatment!

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  1. I’ve always had KP on the backs of my arms and thighs, and suspect I may have it under my chin as well. The last few months it has been a lot better, but I hadn’t correlated it to my new primal diet. Maybe my diet has been clearing it up! I still suffer from chronically dry skin, and live at high altitude in the Rockies where it’s extremely dry and harsh all winter. I haven’t been able to find a lotion or oil that works sufficiently. I’m surprised to see the lotion you recommended, since it contains petroleum products. Do you have any other suggestions that have more natural ingredients? I myself have tried straight jojoba, sunflower, coconut oils, expensive body butters from Korres, Creme de Corps from Kiehl’s, etc. Nothing really cuts it but right now applying a body butter after I shower in the morning and straight coconut oil at night before I go to bed are keeping it at bay. Great blog, really excited to keep following and reading!

    1. Hi Jenny, thanks for the comment. KP is a very challenging problem to deal with, because not only do you have to fight the internal keratin regulation issues using nutrition, but you have to effectively exfoliate the top layer of your skin to break up the keratin bumps that have already been formed, since they don’t tend to just go away on their own.

      “I’m surprised to see the lotion you recommended, since it contains petroleum products.”

      I see your concern, and I’d like to point out that I only used the Amlactin XL as a serious, quick-acting treatment for the areas of my body that had KP on them (not my face though). I do try to avoid petroleum products as a habit, but at the end of the day, if I can get rid of a problem that much quicker by using a somewhat unnatural product, I’d rather just deal with the issue as quickly as possible and then be able to go back to my normal, natural product routine. But to each his/her own.

      The main point is to find a lotion with lactic acid in it, which helps break up the keratin and allows your skin to turnover more rapidly. One natural form of lactic acid is goat’s milk, which is found in Nubian Heritage’s Goat’s Milk & Chai lotion.

      You may prefer to use the naturally occurring lactic acid found in dairy products, but just be aware that your healing time will likely be somewhat more lengthy than if you opt to go the more powerful ‘pharmaceutical’ route. As I said before, I like to keep my beauty routine as natural as possible, but if I’m really struggling with a serious problem that I want to take care of in a minimal amount of time, I tend to give in and go with modern treatments.

      I will be reviewing a skin care cream from Green Pastures that I absolutely love for my face (since I don’t use Amlactin on my facial skin). It is a tad expensive (but reasonable) and comes in a small jar, so I save that product for my face and lips. Keep an eye on my blog for that product review, since I really feel it would be an excellent investment for you as a night cream to help with any KP on your face.

      Thanks again for your comment!

      1. Wow what a wealth of information, thank you Laura! Yes I’m okay with using something less natural or chemical-based short term too, if it really works and then I can move on to healthier long term options. I might give that stuff a try, my arms and legs are doing pretty good but under my chin is still really bumpy. Ultimately I need to drive a couple of hours down to Denver and find a really good dermatologist probably, but I will give lotion with lactic acid a shot first. And maybe even do a yogurt mask on it, I love the way that makes my skin feel. I’ve heard of the Beauty Balm and am very tempted but it is so pricey (when planning on using it all over the body). I would LOVE to see your review/feedback of it. I wonder if we could convince them to make a larger jar… ; ) thanks again!!

      2. No problem Jenny! Maybe if enough people start buying the Beauty Balm, they will make a “value” size jar. I personally ordered 5 jars for myself after the WAPF conference. I’ve been using it every night on my skin and I’m OBSESSED! Luckily it doesn’t take much (just a dab) to spread over your entire face. I really highly recommend it, especially for KP treatment.

        Yogurt is a great idea, as its full of lactic acid. The probiotics in yogurt will also help with any bacterial imbalance on your face.

        That said, I tried many different natural topical methods (like a yogurt mask) on my face, with no real noticeable benefits. Sometimes you need to just bite the bullet and use the pharmaceutical product to prevent scarring or permanent damage from trying to remove the bumps.

        I will say that the dermatologist did not help me at all with this issue. They just said it was ‘acne’ (even though I adamantly insisted I had never had acne before in my life), and threw a combination retinoid/antibiotic at me. It helped a bit, but the real difference has come from the diet and supplement changes. So my personal advice would be to try the protocol I outlined above for at least a month, as it takes that long for your skin to turn over completely. I think you’ll be happy with the results.

    1. Funny! I am only just realizing that the bumps on my cheeks !and chin are KP do and not acne (though i do battle with that sometimes too). I noticed it went away almost completely when I started taking CLO and washing with goat milk soap! I was supplementing for other reasons and the soap was just something that sounded nice at the store. But I seem to have stumbled upon this cure as well! Just received the beauty balm too. Luckily I don’t get much kp on my arms or thighs. Is that odd? That’s why I didn’t make the kp connection earlier.

  2. Wow lots of great information here. I’ve been Paleo for a couple of years now, a full year without dairy which I found dramatically helped my acne. Recently I’ve had what I thought was an acne flare up with little bumps, but I also had a flare of the little bumps on my arms – I’ve had these for years since 10 I think. Now that I think about it I think that my face and neck are breaking out with KP as well as my arms. I just started taking the fermented cod liver oil/butter oil combination 3-4 weeks ago and haven’t noticed a difference yet. I’m still taking 3,000 IU of Vitamin D a day, I live on the east coast, work indoors, but get outside when I can. My last blood test was low in vitamin D so I have been making sure to supplement with it. Sounds like I need to try Laura’s protocol by adding something topical (lotion, etc) with lactic acid in addition to the cod liver oil/butter oil combo. Laura would you also recommend reducing my vitamin D supplementation to restore balance?

    1. Do you take D2 or D3? A lot of what I heard about vitamin D supplementation at the WAPF conference this weekend suggested that vitamin D supplementation in general may not be such a ‘magic bullet’ for upping vitamin D levels. Dr. Stephanie Seneff writes that ingested vitamin D can actually block Vitamin D Receptor (VDR) activation, the opposite effect to that of sunshine, and that nominal doses of ingested vitamin D can suppress proper operation of the immune system ( So I’m not sure how great it is to take vitamin D supplements in large doses.

      Since I am just a student, I can’t really make any personal supplement recommendations for you at this time. I will say that adding the manual exfoliation with the scrub and the lotion helped immensely, so I would definitely try that. The Beauty Balm from Green Pastures is a great face cream to help with the bumps as well.

      I would try giving the FCLO/HVBO a few more weeks, it takes a long time to correct a nutritional deficiency. It’s always better to use a food-based supplement than one that has been man made. Good luck with the skin treatment!

      1. Interesting you bring that up, as winter is approaching and I’m watching my freckles fade (surest way to know how much sun one is getting) and I definitely am trying to sunbathe in the cold a bit. In the past I’ve supplemented with D3, and just got another bottle for this winter, but never felt better supplementing. I do it because I think I ought to. I only feel better when I get true sun exposure or even 5-7 minutes in a tanning bed. I’m fair skinned, Irish/Ukrainian heritage, so I am very careful because I can burn easily. Don’t want wrinkles either so will tend to protect my face regardless. Went skiing today and did wear a beeswax-based sunscreen on my face, but mid-day when I’m sure it was worn off had about 10 minutes of sun on my face and arms (and very seriously considered standing around in only my sports bra to get even more sun). I’ll look into your points above more, intuitively that makes sense, if you’re supplementing your body might stop working to make it/try.

  3. I have been supplementing with D3 – I live outside of Philadelphia so I know that at my latitude now I can’t make enough vitamin D with outside sun exposure and I’m still not sure on the tanning beds – I think that I would do it but its more a matter of fitting it into my schedule. @Jenny good idea on trying the “real thing” instead of the supplement

    @Laura I will try the exfoliation and keeping up the FCLO/HVBO – I’m halfway through the bottle that has 60 servings. I think I’ll try cutting my vitamin D back and see how that works as well – I’m all about the n=1 experimentation! Thanks for all of the great information, I’ll post back and let you know how things work out in a few more weeks.

      1. @Laura I’ve been doing the fermemted cod liver oil + butter oil for about 2 months now and added some of what you recommeded – the goat milk soap, KP Duty by Dermadoctor for exfoliation in the shower, and Amlactin XL as a lotion – which I think smells like maple syrup and waffles! Odd smell for a lotion 🙂 Following this protocol I’ve noticed a huge improvement in my skin quality on my upper arms and on my face. Sure enough the little bumps that I at first thought were acne (on my face) are keratosis and with the soap and lotion they are clearning up. Thanks so much for sharing your experience, you’ve helped me!

        1. Great to hear, Laura! Glad my advice has been helpful!

          What have you specifically been using on your face? I only had been treating my arms and legs with the scrub and lotion, since I thought it would be too intense for facial skin.

  4. Do you think it’s possible that I have way too much Vitamin D in my body? I thought KP was because of a Vitamin A and D deficiency, so I had been taking 50,000 units of Vit. D once per week, and 25,000 Vitamin A a day, and eating a ton of Vitamin A rich foods, but I just keep pooping out orange (LOLZ!), and I feel like my skin got a bit worse!

    1. Yeah, that sounds a bit overboard. I actually think my vitamin A deficiency was more due to an excess of vitamin D and an unbalanced A/D ratio. You probably only need at most 10,000 units of A and 2,000-4,000 units of vitamin D per day if you’re not getting any sun. I would cut back significantly from what you’re doing.

  5. I would like to try the protocol you suggest – but I have it on my face and the delicate skin of my neck and chest and need to be very careful with exfoliation. I know that I have caused premature aging by using things like Proactive in the past. I would appreciate any suggestions regarding this. Also, are there any ways to get this besides cod liver oil. As a lifeling vegetarian it is a difficult thing to take fish oil…Could Udo’s 3 6 9 DHA blend be substituted? Or could it be combined with another naturally occurring vitamin A? Or am I stuck with the cod liver oil?

    It is very frustrating to know that all the gross treatments I have been on through the years (before I knew better) and all the dermatologist visits were in vain – misdiagnosis. If I hadn’t finally gotten the “chicken skin” on my neck (which is super embarrassing and clearly wasn’t acne) I would have gone on believing my “little bumpies” were acne (my face skin looks just like your before picture)…Anyway – I suppose now that I am approaching 40 I may finally figure this out? I hope!