There are lots of possible reasons why your skin might look scaly. This is definitely a problem to see your doctor about, because all the causes can be treated.
Look carefully at the scaly part of your skin. Is it a patch, with a definite edge? Perhaps there is just one patch, or there might be several. There are three common causes of scaly patches – psoriasis, fungal infection and pityriasis rosea – but you need to see your doctor who will also consider other, less common, possibilities.
Psoriasis (‘sor-eye-a-sis’) is one of the commonest causes. The patches have a definite edge, and their surface is covered with small, silvery scales. Psoriasis often occurs on the elbows, knees and on the scalp. It is usually itchy and always mirrors itself on each side of the body. Many people with psoriasis notice that the surface of their nails has tiny pits, as if someone has hit the nail with a tiny ice-pick.
Psoriasis can start at any age, but age 35 years is average. No-one knows what causes it. It runs in the family in about a third of cases, and it is more likely and more severe in smokers. The severity of psoriasis varies greatly from person to person. For some it is just a minor irritation, but for others it can majorly affect their quality of life. Some medications such as lithium (for bipolar disorder) and beta-blockers (for blood pressure) can make it worse. It can also be triggered by injury to the skin and by throat infections. The condition is not contagious, so it cannot be spread from person to person. There are many different treatments. If the psoriasis is not severe, your doctor will probably prescribe a steroid cream or a vitamin D cream.
A fungal infection is another common cause of scaly patches of skin. There may be just one patch, or several. Often the patch gradually enlarges, while the centre seems to clear. The culprits can be various types of fungi, and your doctor can prescribe a cream that is appropriate for the type that you have. Some fungi can cause toenail infection.
Pityriasis rosea is the third most common cause of scaly patches. (Pityriasis means bran-like scale, and rosea means pink.) Older children and young adults are most commonly affected. It seems to be a harmless condition that clears up on its own within a few weeks. Some people feel unwell for a few days before they get the rash, with symptoms such as a headache, high temperature and joint pain. There will be lots of small scaly patches on the trunk and neck, and each patch has a delicate scaly surface. After the rash has gone, you may have some darker or lighter areas of skin. These should return to normal within a few months and will not leave permanent scarring.
The name ‘icthyosis’ (‘ik-thee-oh-sis’) comes from a Greek word meaning fish (‘icthys’), because it causes scaliness of the skin over most of the body. The scales are small, flaky and white or grey, and often curl up at the edges, making the skin feel rough. Icthyosis is uncommon, and usually runs in families. It usually shows up by the age of 5 years, and then begins to lessen. It is not particularly itchy. Emollients are an important part of treatment (see our advice for dry skin), and your doctor may suggest a special cream to remove some of the scales so they are less obvious.
An itchy, scaly rash may be an allergic reaction to the saliva and faeces of scabies mites. For more information on scabies see our page on itching: questions to ask yourself.
If the scaly skin is on your scalp, look at our dandruff section.
First published on: embarrassingproblems.com
Reviewed and edited by: Fiona Elliott
Last updated: December 2020