• Many small, dark follicle-centered dots and rough bumps on the upper arms and lower legs. This pattern is most consistent with keratosis pilaris ("chicken skin") and/or blocked hair follicles.
• A few raised, healing bumps on the shins that could be ingrown hairs or mild folliculitis, especially if you shave, wax, sweat, or pick at them.
• Darker skin around the knees and leftover dark marks on the legs, likely from friction, dryness, and inflammation after previous bumps. This is common on deeper skin tones.

What you can do now

1. Do not scrub, squeeze, or pick the bumps or marks.
2. Shower with lukewarm water and a gentle, fragrance-free cleanser.
3. After every shower, while skin is still slightly damp, use a body moisturizer with urea 10%, lactic acid 10-12%, or salicylic acid 2%. Start once daily or every other day if your skin is sensitive.
4. Use a plain thick moisturizer on alternate times if the acid/urea cream stings.
5. Avoid dry shaving. If you remove hair, use shaving gel, a clean sharp razor, shave in the direction of hair growth, and moisturize afterward. Consider trimming instead if shaving repeatedly triggers bumps.
6. For the darker areas, avoid harsh bleaching creams, lemon, baking soda, or abrasive exfoliation. Improvement is slow and usually takes weeks to months after new inflammation stops.

Please arrange a dermatologist or primary-care visit

A simple routine for 8-12 weeks

• Moisturize legs and arms.
• On exposed skin, use broad-spectrum SPF 30+ sunscreen. A tinted sunscreen with iron oxides may help prevent dark marks from persisting or worsening.

• On rough, dotted areas: use a body lotion containing urea 10% or lactic acid 10-12%, 3-4 nights per week, then increase only if your skin tolerates it.
• On other nights, use a plain fragrance-free moisturizer.
• If a product burns, causes itching, or makes bumps worse, stop it.

• Scrubbing gloves, harsh body scrubs, lemon, toothpaste, baking soda, and unregulated "fairness" or bleaching creams.
• Picking or squeezing.
• Close dry shaving or waxing if that triggers bumps.

• What exact peel and strength? For darker skin tones, a superficial peel is generally safer than medium or deep peels. Common options include glycolic acid, salicylic acid, or selected low-strength TCA formulations.
• Are there active bumps, infection, or open sores? These should be treated first. Peeling over active folliculitis or irritated skin can worsen marks.
• Will you do a test area first? A small test patch is sensible, especially on the legs where marks can be stubborn.
• What is the pre- and post-peel plan? Your doctor may use a pigment-control topical treatment before/after the peel and will advise moisturiser and strict sun protection.
• How many sessions and what result is realistic? Improvement is usually gradual, not one-session removal. Leg marks often respond more slowly than facial marks.

Why salicylic acid may suit you

• It is helpful for clogged follicles, ingrown-hair type bumps, and post-inflammatory dark marks.
• It is generally considered usable across skin types and is often chosen when there is a higher tendency to develop dark marks after irritation.
• It may also reduce new bumps, which matters because treating pigmentation alone will not help if bumps continue to form.

Alternatives

• Glycolic acid peel: Can help rough texture and dark marks, but it may sting or irritate more. It can be a good option if your doctor feels your skin is stable and there are no active bumps.
• Salicylic plus mandelic acid peel: May be considered if you have persistent follicular bumps or ingrown hairs alongside the pigmentation. Your doctor should decide the formula and strength.
• Avoid medium/deep TCA or aggressive combination peels initially, especially on the legs. Your marks are 5 years old and your skin may pigment after inflammation, so safety is more important than fast peeling.

What I would ask your doctor

“Because I have long-standing PIH and still get small follicular bumps, would a superficial salicylic acid peel, possibly with mandelic acid, be safer than glycolic or TCA? Can we do a test patch on my leg first?”

• Will active bumps be treated first?
• What products should stop before the peel?
• What moisturizer and sunscreen plan should I follow afterward?
• How many sessions are expected, and how long should I wait between them?

1. Keratosis pilaris / follicular plugging on the upper arms and lower legs
   • The many tiny, rough, follicle-centered dots give a “strawberry skin” or “chicken skin” appearance.
   • Keratosis pilaris commonly affects the outer upper arms and legs.
2. Post-inflammatory hyperpigmentation (PIH)
   • The brown-black spots are likely marks left after prior inflammation, such as bumps, ingrown hairs, scratching, insect bites, or folliculitis.
   • PIH is more likely to persist in deeper skin tones and can remain for years.
3. Possible occasional folliculitis or ingrown hairs on the shins
   • A few more raised individual spots appear different from the flat old marks. These need an in-person examination to check whether follicles are still inflamed.
4. Knee darkening likely from friction/dryness plus PIH
   • This is common, but your doctor should assess it if similar velvety darkening is also present on the neck, underarms, or groin, as that can sometimes have other causes.

1. control new follicular bumps
2. smooth the rough plugged follicles
3. gradually fade the old dark marks
4. use a dermatologist-supervised superficial peel only after the skin is calm

Best treatment plan to discuss with your dermatologist

1. First, treat the rough bumps every day

• Urea 10-20% lotion/cream daily, or
• Lactic acid 10-12% / ammonium lactate 12% lotion daily

2. If you have active red bumps or ingrown hairs on legs

3. For the five-year-old dark marks

4. Chemical peel: what I would choose

• Treat active bumps and dryness for 4-6 weeks first
• Consider a test patch on the leg
• Start with a low-intensity superficial peel at a dermatology clinic
• Space sessions according to your dermatologist's assessment
• Stop exfoliating acids, scrubs, and retinoids for the period your doctor instructs before and after each peel

5. Prevent marks from returning

• No picking/squeezing
• No body scrubs, loofahs, or harsh friction on knees and legs
• Use SPF 30+ on exposed arms and legs every day. Sunlight can maintain or darken PIH. The AAD guidance on dark spots emphasizes consistent sun protection and stopping skin irritation.

Realistic timeline

• Texture/roughness: some improvement in 4-8 weeks
• New bumps: improvement over 6-12 weeks if triggers are controlled
• Five-year dark marks: visible fading often needs 3-6 months or longer, and may require a supervised treatment series

“I have likely keratosis pilaris with follicular dark marks and occasional active bumps. Can we first control the bumps with urea/lactic acid and assess azelaic acid, then do a test patch and conservative superficial salicylic peel rather than a deep peel?”