January 6, 2007

For the Health of It: Small, Itchy Bumps on Arms Common Among Adolescents


For the health of it

Question: I've had red bumps on my arms for a while, but now they feel itchy, especially at night. Are they going to get worse and worse? Is there anything to get rid of them?

Answer: Lots of things make their debut, with good or evil consequences, during the teen years. The X-Men comic books have clearly documented how mutant powers don't manifest themselves until adolescence, and then it's just too bad if the Brotherhood of Evil Mutants recruits you before the X-Men do. One day you're normal, and the next day you wake up having sprouted out with some wings that you have to bind down so no one will notice them under your clothes ... which may sound familiar, in a less feathery way, to teens who are not mutants.

Schizophrenia, scoliosis, the capacity to empathize with others and body odor also choose puberty as the time to make themselves known. And so does what you have (having looked at it myself): keratosis pilaris.

Lots of teens, maybe more than half, notice these rough bumps on the outer sides of their upper arms and maybe elsewhere, such as the fronts of their thighs. In many people, the bumps are tannish or reddish. For those whose skin is on the darker side, these bumps appear a bit darker than the rest of the skin. It's often regarded as a form of acne, just smaller and more evenly spaced, but that is not what it is, so acne medicines don't help get rid of it.

As with flying mutants, there seems to be a genetic basis for this. Keratin, the substance we admire when it's forming hair and fingernails, collects for some reason in the pores where our goosebumps occur.

Goosebumps result from tiny musclelike mechanisms in the skin that raise our hairs to a more vertical position. This came in handy during the olden days when we got scared or cold, but it's not so helpful now since we're less hairy (or less feathered, if Darwin was a little mixed up, after all). What this might have to do with keratosis pilaris, I don't know. As always, further research is called for. On werewolves, in this case.

In winter, this condition can seem itchier. And, to boot, everything that itches is itchier at night, just to drive us crazy. I wouldn't be surprised it if was just dry skin in that general area that was getting itchy, though, not the keratosis. Many folks with this problem also have dry skin or eczema, conditions that often are worse in winter.

A good treatment for keratosis pilaris is ammonium lactate solution or some other form of lactic acid. This is available without a prescription at some drugstores or by prescription for those needing a stronger concentration. First, though, you might try a steroid cream (like hydrocortisone, also sold over the counter) as you would for eczema, since that clears it up for some people in a month or two.

The last time I discussed this condition in this column a few years ago, the mother of a teen actually bowed down before me on behalf of her grateful offspring. It was kind of weird, since usually people just throw rose petals. So you can understand why I'd repeat the topic, since it's something that really bothers a lot of adolescents who don't know how to treat it. It's not that I'm looking for the adulation.

Robert Benon is a nurse practitioner with the health centers at Santa Fe and Capital high schools. Questions can be mailed to The New Mexican, For the Health of It, 202 E. Marcy St., Santa Fe, NM 87501; e-mailed to [email protected] or phone in to 986-3050.

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