Scaling skin, or scaly skin, occurs when the outer layer of your skin peels away in large pieces that resemble fish scales. It can happen due to allergies, infections, or skin conditions like psoriasis.

Scaling skin is the loss of the outer layer of the epidermis in large, scale-like flakes. Scaling skin is also called:

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

Skin patches can occur on visible or covered areas. Depending on the underlying cause, the scales may:

  • itch
  • be painful
  • change color compared to the surrounding skin

Keep reading to learn the causes of scaling skin, what it looks like, and how to treat it.

When it’s an emergency

Some causes of scaling skin, like allergic reactions or toxic shock syndrome, can be a medical emergency.

If you experience a sudden, widespread rash or scaling skin that occurs with other concerning symptoms, contact 911 or your local emergency medical services.

Several skin disorders and physical conditions can lead to scaling on your top layer of skin. These may include:

  • skin reactions, including contact dermatitis, allergic eczema, drug allergies, and allergic reactions
  • infections, such as athlete’s foot and ringworm
  • skin conditions, such as eczema, psoriasis, seborrheic eczema, ichthyosis vulgaris, and actinic keratosis, or sun damage
  • health conditions, such as hyperparathyroidism, toxic shock syndrome, Kawasaki disease
  • complications of other health conditions, including stasis dermatitis and ulcers

Irritant contact dermatitis

contact dermatitis on the handsShare on Pinterest
Contact dermatitis tends to appear on the hands. Arora S. (2017). Aerospace Dermatology. Indian journal of dermatology, 62(1), 79–84 CC BY-NC-SA 3.0
scaly skin from irritant contact dermatitis on the handsShare on Pinterest
Irritant contact dermatitis can cause scaly skin. Reproduced with permission from DermNet NZ www.dermnetnz.org 2024

Contact dermatitis doesn’t necessarily involve an allergic reaction. It typically develops when skin cells become damaged or irritated due to contact with toxic or irritating substances, like solvents, scratchy fabrics, or hair dye. Symptoms can include:

  • rash with visible borders
  • itching
  • scaly or raw skin
  • blisters that may weep or become crusty

Allergic eczema

hives on the bodyShare on Pinterest
Allergic eczema typically occurs as a delayed reaction. Reproduced with permission from DermNet NZ www.dermnetnz.org 2024

Allergic eczema is a delayed allergic reaction that occurs about 24 to 48 hours after making direct contact with an allergen, such as jewelry, plants, or fragrances. Symptoms can include:

  • itching
  • burning or pain
  • blisters that may weep or become crusty
  • inflammation
  • warm skin

Allergic reaction

Hives on skin of color due to an allergic reactionShare on Pinterest
An allergic reaction can cause itchy hives. apiwut sookkasame/Shutterstock
Hives on a person's backShare on Pinterest
Hives may appear on any part of the body. Lovelyday Vandy/Shutterstock

An allergic reaction to food or airborne substances like mold or pollen can trigger a skin rash. Usually, the first time you experience an allergic reaction, the symptoms are more mild. However, if repeated exposure occurs, it can become severe or life threatening. Symptoms can include:

  • hives or rash that appears shortly after exposure to the allergen
  • itchy, raised welts
  • watery eyes
  • scratchy throat
  • nasal congestion or sneezing
When it’s an emergency

Severe and sudden allergic reactions may cause swelling and difficulty breathing that require emergency medical attention. Contact 911 or your local emergency services.

Drug allergy

drug allergy causing hives on the faceShare on Pinterest
A drug allergy can also cause a skin reaction. nymphoenix/Shutterstock

An allergic reaction to a drug may cause symptoms that can occur 1 day to 3 weeks after taking it for the first time. Symptoms can include:

  • rash
  • itching
  • fever
  • stomach upset

Chronic drug rashes, such as eczematous drug eruptions or lichenoid drug eruptions, can be scaly.

When it’s an emergency

A drug allergy can potentially cause a severe allergic reaction. Contact 911 or your local emergency services if you experience symptoms that include:

  • racing heart
  • swelling
  • difficulty breathing
  • a widespread rash covering the body

Athlete’s foot (tinea pedis)

athlete's foot on the toesShare on Pinterest
Athlete’s foot can cause flaking skin. Yopan90/Shuttertsock

Athlete’s foot is a fungal infection that usually affects the feet and toenails. It can be difficult to treat in people with weakened immune systems. Symptoms of athlete’s foot can include:

  • itching
  • burning or stinging between the toes
  • blisters or raw skin

Some people with athlete’s foot may also experience onychomycosis, which causes discolored, thick, or crumbling toenails.

Ringworm (tinea corporis)

ringworm infectionShare on Pinterest
Ringworm can cause a circular rash. frank60/Shutterstock

Ringworm is a fungal infection that can appear on the body or scalp. Symptoms may include:

  • itching
  • round scaly patches
  • patches with clearly defined edges
  • hair loss
  • overlapping rings

Eczema (atopic dermatitis)

Eczema flare up on the foreheadShare on Pinterest
Eczema can cause skin to peel and flake. Dermatology11/Shutterstock

Eczema tends to occur as a chronic condition. People may have flare-ups due to triggers that cause the immune system to overreact. Symptoms can include:

  • itching
  • sore skin
  • discolored scaly patches that flake off
  • thickened skin
  • raised bumps that may ooze fluid

Psoriasis

psoriasis scales on the armsShare on Pinterest
Psoriasis can cause silvery scales. Zay Nyi Nyi/Shutterstock

Psoriasis is a chronic skin condition that typically causes skin cells to build up faster than they should. It tends to affect the scalp, elbows, knees, and lower back. It can also affect the joints, which is known as psoriatic arthritis. The symptoms of psoriasis may include:

  • scaly or silvery skin patches
  • patches that are clearly defined
  • itching

Seborrheic dermatitis

Seborrheic eczema on the scalpShare on Pinterest
Seborrheic eczema typically affects the scalp but can affect other areas of the body. JuleDesign/Shutterstock

Seborrheic dermatitis may develop due to excess oil production that irritates the skin. It tends to affect the scalp but can also affect the body. Symptoms can include:

  • dandruff
  • scaly patches that flake off
  • skin discoloration

Actinic keratosis (sun spots)

actinic keratosisShare on Pinterest
Actinic keratosis typically occurs from long-term sun exposure. JodiJacobson/Getty Images

Actinic keratosis is a common precancerous skin condition that usually occurs due to long-term exposure to sunlight. Symptoms can include:

  • thick, scaly, or crusty skin patch
  • discoloration compared to surrounding skin
  • patches with a rough-feeling texture

Ichthyosis vulgaris

Ichthyosis vulgaris on the legsShare on Pinterest
Ichthyosis vulgaris can cause a rash with polygon-shaped scales. Gzzz, CC BY-SA 4.0, via Wikimedia Commons

Ichthyosis vulgaris is a skin condition in which the skin doesn’t shed dead skin cells. Symptoms can include:

  • patches of dry, dead skin cells
  • patches in a polygon shape or fish scale pattern
  • dry, flaking skin
  • itching
  • thickened skin

Hypoparathyroidism

Rash from hypoparathyroidism.Share on Pinterest
Hypoparathyroidism can cause a skin rash with other symptoms. Syriou V, Kolitsa A, Pantazi L, Pikazis D. Hypoparathyroidism in a patient presenting with severe myopathy and skin rash. Case report and review of the literature. Hormones (Athens). 2005

Hypoparathyroidism occurs when the parathyroid glands in the neck don’t produce enough parathyroid hormone, causing low levels of calcium and high levels of phosphorus in the body. Symptoms can include:

  • dry skin
  • patchy hair loss
  • muscle aches or cramps
  • tingling, burning, or numbness in the fingertips, toes, and lips
  • muscle spasms, often around the mouth
  • brittle nails
  • fatigue
  • anxiety and depression
  • seizures

Kawasaki disease (mucocutaneous lymph node syndrome)

Kawasaki diseaseShare on Pinterest
Kawasaki disease can cause a rash on the palms and soles of the feet. Dong Soo Kim derivative work: Natr, CC BY 2.0, via Wikimedia Commons

Kawasaki disease causes inflammation in the arteries, veins, and capillaries. It’s also the most common cause of acquired heart disease and tends to affect children under 5. Symptoms may include:

  • rash on the torso and groin
  • discoloration of the palms and soles of the feet that may peel off in sheets
  • fever that lasts for 4 to 5 days
  • swollen lymph nodes
  • bloodshot eyes
  • joint pain
  • diarrhea or vomiting
When to get medical attention

Kawasaki disease can cause serious heart problems. It’s best to get medical attention if you suspect your child has it.

Toxic shock syndrome

Rash due to toxic shock syndromeShare on Pinterest
Toxic shock syndrome can cause skin peeling. Mediscan / Alamy Stock Photo

Toxic shock syndrome occurs when a bacterial infection enters the bloodstream, where it produces toxins that the immune system reacts to strongly. Toxic shock syndrome is a medical emergency. Symptoms can include:

  • skin rash that feels like sandpaper and may resemble sunburn
  • sudden fever
  • muscle aches
  • dizziness
  • headache
  • abdominal pain, vomiting, or diarrhea
  • confusion
Toxic shock syndrome is a medical emergency

Toxic shock syndrome can lead to severe complications and be life threatening. If you suspect you or someone else has toxic shock syndrome, call 911 or your local emergency medical services.

Stasis dermatitis

Stasis dermatitis causing swelling on the legsShare on Pinterest
Stasis dermatitis can cause swelling and discoloration in the lower legs. James Heilman, MD, CC BY-SA 4.0, via Wikimedia Commons

Stasis dermatitis develops in areas of the body that have reduced blood flow, commonly in the feet and lower legs. While it can develop with aging, it may also indicate another health condition, such as heart or kidney disease. Symptoms can include:

  • swelling in the ankles and lower legs that improves when they’re elevated
  • varicose veins and skin discoloration
  • dry, crusty, itchy skin

Stasis ulcer

Venous stasis ulcer due to stasis dermatitisShare on Pinterest
Stasis dermatitis can cause painful ulcers to form on the skin. Photography by DermNet New Zealand 2022

A stasis ulcer is a symptom of advanced stasis dermatitis. It also develops in areas of the body with reduced blood flow, such as the feet and lower legs.

  • irregular shallow wounds that weep and crust
  • pain
  • slow healing

If you have scaling skin that lasts a long time, worsens, recurs, or occurs with bothersome symptoms, it’s best to talk with a doctor. They can perform necessary exams to determine the cause.

They may be able to diagnose some causes of scaly skin with a physical exam, but other causes may require additional testing, such as:

  • blood tests
  • skin tests or biopsy, where they remove part of the skin and send it to a lab for further testing
  • allergy tests

Treating scaling skin depends on the cause and severity of your symptoms. Treatment may involve:

  • avoiding allergens or irritants
  • applying topical medications
  • taking oral medications
  • additional treatments, depending on the cause

While not common, scaling skin can potentially be a medical emergency. Get emergency medical attention if you have scaling skin along with concerning symptoms, such as: