Why Do I Have Scaly Skin?

Does scaly skin have you itchy and uncomfortable? It may just be ordinary dry skin. But if over-the-counter products don’t help you heal, you could have a medical condition that requires a doctor's care.

There are several reasons for scaly skin. Whether you have a flaky scalp from time to time or scratchy patches all the time, a dermatologist can tell you if your symptoms are due to a lack of moisture or something more serious.

What Causes Scaly Skin?

Normally, your body sheds about 30,000 to 40,000 skin cells each day and replaces them with new ones. You don't feel the skin cells growing and shouldn't see any falling, or flaking, off.

The outer layer of your skin contains a mixture of dead skin cells and natural oils, which help it hold on to water. If this layer is damaged and moisture gets out, or if your skin cell renewal process goes off the rails, you could get flaky or scaly. Aging, exposure to sunlight and harsh chemicals, some medicines, and certain diseases could also be to blame.

Eczema (Atopic Dermatitis)

If you or your child has red, scaly patches that itch a lot, it might be eczema. This common condition is often mistaken for dry, sensitive skin. Babies and children usually get crusty spots on their chins and cheeks, but scaly skin can show up anywhere on the body. Hand eczema can cause the skin on your palms and fingers to get dry, thick, and cracked. The skin may burn or bleed.

Children often outgrow eczema. But adults who never had it can get it, too. Doctors don’t know what causes it. They think it’s a mix of genetics and things in your environment that your skin reacts to, like:

  • Wool
  • Soap
  • Perfume
  • Makeup
  • Chlorine
  • Cigarette smoke

You might notice these symptoms:

  • Red, irritated, or swollen skin
  • Crusting or oozing
  • Scaly patches that feel rough or leathery
  • Severe itching

Psoriasis

Silvery white scales that cover thick red, raised patches of skin are a telltale sign of plaque psoriasis. Doctors think it results from a faulty immune system. New skin cells grow faster than normal, but old skin cells fail to fall off. The new and old cells clump together, causing thick, itchy patches, sores, and scales

There are several different types of psoriasis. Scaly skin is most common with plaque psoriasis. It can show up on your knees, scalp, elbows, palms, lower back and the soles of your feet. The condition may also cause your nails to pit, crumble, or fall off. Psoriasis is passed down through families. It isn’t contagious.

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Diaper Dermatitis

Red, irritated, or scaly skin on your baby’s bottom is likely due to diaper dermatitis -- better known as diaper rash. This common condition is usually seen in infants ages 9 to 12 months. It shows up around the folds of the thighs and genitals -- places covered by a diaper

Diaper rash can result from an allergy or irritated skin. It could also be a yeast infection -- yeast thrives in warm, moist environments. Signs include a dark red skin rash that may have yellow fluid-filled blisters. At-home care may be fine for irritation rashes, but if your baby’s diaper rash won’t go away, see a doctor to figure out the cause and best treatment.

Seborrheic Dermatitis

This skin disorder is the most common cause of dandruff. White, oily flakes of dead skin in your hair and on your shoulders and, sometimes, an itchy scalp are signs of regular dandruff.

If you have seborrheic dermatitis, your scalp and nearby skin will feel greasy and be dotted with yellow or white crusty scales. You may even find flakes in your eyebrows. This type of dandruff can also affect the skin behind your ears and on the sides of your nose.

Actinic Keratosis

A flaky, scaly patch that comes and goes could be actinic keratosis (AK), a precancerous condition. You could get this scaly skin problem if you spend too much time in a tanning bed or unprotected in the sun. Without treatment, it can turn into squamous cell skin cancer. If you get one actinic keratosis, you usually will get another.

The main symptom is a thick, scaly, discolored patch of skin. Sometimes the area feels rough or like sandpaper but looks normal. It may be painful to touch. It can flake off, and your skin may feel normal again. However, the problem spot typically comes back when you’re exposed to sunlight.

Lichen Planus

This common condition begins as shiny, reddish-purple bumps. As more grow, they create thick clumps of rough, scaly skin, usually on your ankles and shins. The bumps may also show up on your wrists, lower back, and genitals. They often itch and might blister. Lichen planus can also affect the inside of your mouth and your nails.

Middle-aged adults are most likely to get it. Doctors aren’t sure what causes lichen planus. It may be an autoimmune disorder. It’s often seen in people who have hepatitis C. If you get it, ask your doctor about screening for hepatitis.

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Ichthyosis

This group of scaly skin diseases is most often passed down through families. The lifelong condition usually appears in childhood. A genetic problem causes skin cells to build up, creating thick, dry areas that look like fish scales. Certain medicines or diseases, including kidney failure, some cancers, and HIV, can trigger it. If this happens, it’s called acquired ichthyosis.

There are several forms. Ichthyosis vulgaris (fish scale disease) is common and may be mild. It can go undiagnosed if you keep your skin well-moisturized.

Pityriasis Rosea

Women or girls ages 10 to 35 are more likely to get this skin condition. The main sign is a single round, rose- or tan-colored spot in the middle of your body, arms, or legs. A cluster of scaly patches follows about a week or two later. The round spots have raised borders. There may be little or no scaly skin symptoms in children or pregnant women.

Doctors think a viral infection (like herpesvirus 6, 7, or 8) causes this scaly rash. It’s easy to mistake for ringworm. Other symptoms may include fatigue and headache.

Dermatomyositis

A reddish-purple, scaly rash followed by muscle weakness are the main symptoms of this inflammatory disorder. Women are most likely get it. It can occur at any age. It causes swelling in the blood vessels that feed your muscles and skin. You may notice a rash on your eyelids, nose, cheeks, elbows, knees, knuckles, upper chest, or back. Muscle weakness typically affects areas close to the middle of your body, like your hip, back, neck, and shoulders. Muscle pain isn��t a main symptom, although some people do report muscle aches.

When to See a Doctor

If you have dry, scaly skin that doesn't go away, jot down any other symptoms you have and when they happen. Make an appointment to see a dermatologist. Moisturizers can help soothe some types of scaly skin, but not all. Ask your doctor about treatments for your specific condition.

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on April 20, 2017

Sources

American Skin Association: “Dry Skin.”

American Academy of Dermatology: “Actinic Keratosis: Signs And Symptoms,” “Actinic Keratosis: Overview,” “Actinic Keratosis: Who Gets and Causes,” “Dry, scaly, and painful hands could be hand eczema,” “How Skin Grows,” “Ichthyosis Vulgaris: Overview,” “Lichen Planus: Overview,” “Lichen Planus: Signs And Symptoms.”

University of Iowa Hospitals & Clinics: “Winter Dry Skin.”

National Eczema Association: “Understanding your eczema.”

National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Ichthyosis Overview,” “What Is Atopic Dermatitis?”

Mayo Clinic: “Dandruff: Symptoms and Causes,” “Psoriasis: Causes,” “Psoriasis: Definition,” “Psoriasis: Symptoms.”

UpToDate: “Patient education: Diaper rash in infants and children (Beyond the Basics).”

Merck Manual Professional Version: “Pityriasis Rosea.”

The Myositis Association: “Dermatomyositis.”

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