Your skin may be flaky because it is too dry. This is a particular problem as we get older (MIMS Dermatology 2007;3:40–42). Skin produces its own grease to moisturize the skin, but as we get older less grease is produced. Add to this the effects of soaps, hot water dehydration and central heating, and your skin can become dry, rough, itchy and scaly. Our legs have the fewest grease glands and so are particularly affected, producing a ‘crazy-paving’ appearance. The problem is most common in the winter (‘winter itch’), because of indoor heating.
There are some common-sense ways of improving dry skin.
- Ask your pharmacist about ‘emollients’. These are moisturizers that replace water lost from the skin (although this is only slightly possible) and prevent further loss of moisture. There are many types – creams, lotions, ointments, bath oils and shower gels – so you should be able to find one that suits you.
- You do not have to bathe every day to be clean. Bathing strips natural protective grease from your skin. If you think your skin is dry, bath or shower only twice a week – you can easily wash the smelly parts of your body separately. Use warm, not hot, water. And it is often a good idea to apply the moisturiser prior to the bath or shower and use it as a soap substitute, then pat your skin dry when you come out of the bath/shower – but be careful: It may be slippery.
- Avoid perfumed or drying soap. Choose an unperfumed ‘cream bar’ type or use aqueous cream (from pharmacies) instead of soap. Never use aqueous cream that contains sodium laurel sulphate (SLS). Always use SLS-free products as this has now been found to strip the natural moisturising factor from your skin and make it more dry. (SLS is one of the main ingredients in detergents.)
- Do not put any disinfectant in the bath or, worse, directly onto your skin. This can start a dermatitis reaction and make the problem even worse. An unperfumed emollient bath oil is a good idea, because it will help to prevent dry skin. You can buy suitable oils from pharmacies – ask the pharmacist for advice. But remember that bath oils can make the bath or shower very slippery!
- Do not scrub your skin.
- Take warm, not hot, baths or showers.
- Moisturize your skin after bathing, when the skin is still slightly damp, as this seals in the moisture. So after washing, towel-dry your skin gently, then apply an emollient. You can always use the emollient as a soap substitute and grease yourself up prior to the shower and use the emollient to wash in.
Eczema / Dermatitis
Eczema and dermatitis are two names for the same thing. If you have eczema your skin will be dry, flaky, red and itchy. It will also be sensitive to irritant substances such as some soaps and chemicals. Areas of eczema can become infected by bacteria, in which case they become weeping and crusted. The itching is particularly annoying and can be enough to disturb your sleep. It almost always starts in childhood, and often gets better in teenagers (however, this may not always be the case depending on family history). In adults, the armpits, backs of knees, neck, face and upper chest are the commonest sites. Sometimes eczema is a reaction to an irritant substance, such as a cosmetic or a chemical or even a plant; hairdressers are particularly at risk of eczema on their hands. Even if you have grown out of your eczema, your skin will remain sensitive. This type of eczema is termed irritant or allergic contact dermatitis.
If you think you might have eczema talk to your doctor, as many treatments are available. Emollients are particularly important. They are the mainstay treatment for any type of eczema, so look at the above advice for dry skin. In eczema, there is a deficiency of the protective fatty substances that we all have in our skin, which waterproofs it. Emollients help to put this right. In general, the more oily the emollient, the more effective it will be, but of course a very greasy emollient might be too messy so you need to find a compromise. Eczema can flare up from time to time, and when this happens your doctor will probably prescribe a steroid cream and will explain how to use it. Other treatments are available for more severe eczema.
It is important to minimize scratching, as this can lead to infection. Look at our section on itching.
If your skin is very itchy as well as flaky, and this has happened recently, you might have picked up scabies. Scabies is an infection caused by a tiny mite that lives on the skin. For more information, look at our page on itching: questions to ask yourself.
If you are finding visible flakes of skin shed from your scalp, look at our section on dandruff.
First published on: embarrassingproblems.com
Reviewed and edited by: Fiona Elliott
Last updated: December 2020