Scaling Skin

By Claudia Shannon / Research Scientist / Honayst

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.

Conditions that cause scaling skin, with pictures

Many different conditions can cause scaling skin. Here are 16 possible causes. Warning: Graphic images ahead.

Allergic reaction

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
Toxic shock syndrome

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.
Drug allergy

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
Kawasaki disease

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

Causes of scaling skin

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:

  • actinic keratosis (a condition that starts with scaling skin but can progress to growths and skin cancer)
  • allergic
  • eczema
  • athlete’s foot
  • contact dermatitis
  • hypoparathyroidism
  • ichthyosis vulgaris
  • ringworm
  • psoriasis
  • eczema
  • Kawasaki disease
  • seborrheic
  • eczema
  • allergic reaction
  • drug allergy
  • stasis dermatitis and ulcers
  • toxic shock syndrome

Diagnosing the underlying cause of scaling skin

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 options for scaling skin

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.

When to seek emergency medical attention

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:

  • severe allergic reaction (hives, swelling, difficulty breathing, itching)
  • nausea and vomiting
  • severe weakness
  • high fever
  • sudden and severe blistering