Scaling skin is the loss of the outer layer of the epidermis in large, scale-like flakes. The skin appears dry and cracked, though skin dryness isn’t always to blame. Scaling skin is also called:

  • desquamation
  • dropping of scales
  • flaking skin
  • peeling skin
  • scaly skin

Scaling skin may make a person self-conscious, particularly if it occurs on their hands, feet, face, or other visible areas. The scales can itch and redden, and the condition can affect their quality of life.

Many different conditions can cause scaling skin. Here are 16 possible causes.

Warning: Graphic images ahead.

Actinic keratosis

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  • Typically less than 2 cm, or about the size of a pencil eraser
  • Thick, scaly, or crusty skin patch
  • Appears on parts of the body that receive a lot of sun exposure (hands, arms, face, scalp, and neck)
  • Usually pink in color but can have a brown, tan, or gray base
Read full article on actinic keratosis.

Allergic reaction

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This condition is considered a medical emergency. Urgent care may be required.

  • Rashes occur when your immune system reacts to allergens on the skin
  • Itchy, raised welts that appear minutes to hours after skin contact with an allergen
  • Red, itchy, scaly rash that may appear hours to days after skin contact with an allergen
  • Severe and sudden allergic reactions may cause swelling and difficulty breathing that require emergency attention
Read full article on allergic reaction.

Athlete’s foot

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  • Itching, stinging, and burning between the toes or on the soles of feet
  • Blisters on the feet that itch
  • Discolored, thick, and crumbly toenails
  • Raw skin on the feet
Read full article on athlete’s foot.

Ringworm

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James Heilman/Wikimedia Commons
  • Circular-shaped scaly rashes with raised border
  • Skin in the middle of the ring appears clear and healthy, and the edges of the ring may spread outward
  • Itchy
Read full article on ringworm.

Contact dermatitis

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  • Appears hours to days after contact with an allergen
  • Rash has visible borders and appears where your skin touched the irritating substance
  • Skin is itchy, red, scaly, or raw
  • Blisters that weep, ooze, or become crusty
Read full article on contact dermatitis.

Allergic eczema

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  • May resemble a burn
  • Often found on hands and forearms
  • Skin is itchy, red, scaly, or raw
  • Blisters that weep, ooze, or become crusty
Read full article on allergic eczema.

Eczema

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  • Yellow or white scaly patches that flake off
  • Affected areas may be red, itchy, greasy, or oily
  • Hair loss may occur in the area with the rash
Read full article on eczema.

Psoriasis

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MediaJet/Wikimedia Commons
  • Scaly, silvery, sharply defined skin patches
  • Commonly located on the scalp, elbows, knees, and lower back
  • May be itchy or asymptomatic
Read full article on psoriasis.

Toxic shock syndrome

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Image by: Hoidkempuhtust/Wikimedia

This condition is considered a medical emergency. Urgent care may be required.

  • This rare but serious medical condition occurs when the bacterium Staphylococcus aureus gets into the bloodstream and produces toxins.
  • The bacterial toxins get recognized by the immune system as superantigens, causing the immune system to have a very strong reaction to them.
  • Sudden fever, low blood pressure, chills, muscle aches, headache, vomiting, diarrhea, abdominal pain, dizziness, and confusion may occur.
  • Another symptom is skin rash that resembles a sunburn and can be seen all over the body, including the palms of the hands and soles of the feet.
Read full article on toxic shock syndrome.

Ichthyosis vulgaris

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Image by: Skoch3 (Own work) [CC BY-SA 3.0 (creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
  • This inherited or acquired skin condition occurs when the skin doesn’t shed its dead skin cells.
  • Dry, dead skin cells accumulate in patches on the surface of the skin in a pattern similar to a fish’s scales.
  • Patches of dry skin typically appear on the elbows and lower legs.
  • Symptoms may include flaky scalp, itchy skin, polygon-shaped scales on the skin, scales that are brown, gray, or white, and severely dry skin.
Read full article on ichthyosis vulgaris.

Seborrheic eczema

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  • Yellow or white scaly patches that flake off
  • Affected areas may be red, itchy, greasy, or oily
  • Hair loss may occur in the area with the rash
Read full article on seborrheic eczema.

Drug allergy

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This condition is considered a medical emergency. Urgent care may be required.

  • Mild, itchy, red rash may occur days to weeks after taking a drug
  • Severe drug allergies can be life-threatening and symptoms include hives, racing heart, swelling, itching, and difficulty breathing
  • Other symptoms include fever, stomach upset, and tiny purple or red dots on the skin
Read full article on drug allergy.

Stasis dermatitis

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  • Stasis dermatitis develops in areas of the body that have poor blood flow, most commonly in the feet and lower legs
  • It causes swelling in the ankles and lower legs that gets better with elevation
  • Symptoms include a mottled, darkened appearance of the skin and varicose veins
  • It can cause dry, crusty, itchy skin that may become red and sore and have a shiny appearance
  • It may also cause open sores that weep fluid and crust over
Read full article on stasis dermatitis.

Stasis ulcer

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  • Symptom of advanced stasis dermatitis
  • Develop in areas of the body that have poor blood flow, most commonly in the feet and lower legs
  • Painful, irregularly shaped, shallow wounds with crusting and weeping
  • Poor healing
Read full article on stasis ulcer.

Hypoparathyroidism

  • This rare condition occurs when the parathyroid glands in the neck don’t produce enough parathyroid hormone (PTH).
  • Having too little PTH causes low levels of calcium and high levels of phosphorus in the body.
  • Symptoms include muscle aches or cramps, tingling, burning, or numbness in the fingertips, toes, and lips, and muscle spasms, especially around the mouth.
  • Other symptoms include patchy hair loss, dry skin, brittle nails, fatigue, anxiety or depression, and seizures.
Read full article on hypoparathyroidism.

Kawasaki disease

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This condition is considered a medical emergency. Urgent care may be required.

  • Usually affects children under age 5
  • Red, swollen tongue (strawberry tongue), high fever, swollen, red palms and soles of the feet, swollen lymph nodes, bloodshot eyes
  • Usually gets better on its own, but may cause severe heart problems
Read full article on Kawasaki disease.

Several skin disorders and physical conditions can lead to scaling skin. Scaling skin is usually a symptom of an underlying issue. Related conditions and diagnoses may include:

When you initially recognize scaling skin, you may simply apply lotion and not give it much thought. After all, it’s very common for skin to sometimes scale during periods of cold, dry weather or after prolonged sun exposure. However, if your scaling skin doesn’t improve, spreads, or worsens, you may want to see your healthcare provider.

Your healthcare provider will ask about your medical history and your symptoms. If you can pinpoint when the symptoms first appeared, it may help your healthcare provider determine a cause. Whether or not your skin itches or if anything provides relief could also help in diagnosing the problem.

The diagnosis is made based on the appearance of your skin, your history of exposure to any irritating or allergenic substances, and any accompanying symptoms.

Treatment depends on the severity of the symptoms and the cause of the scaling skin. In cases of allergic reactions, discontinuing use or contact with the allergen can solve your problem. You should still see an allergist to confirm what is triggering the scales.

Many times, skin conditions that lead to scaling can be treated with a simple topical cream. Oral medications are sometimes needed to address issues that are more than skin deep, however. Depending on the diagnosis, your healthcare provider may refer you to a dermatologist for specialized treatment.

Rarely is scaling skin a symptom of a medical emergency. However, sometimes it’s the sign of an allergic reaction, which can prove fatal if ignored. If scaling skin is accompanied by the following signs, seek medical attention immediately: