Scaly Skin

What is scaly skin? – scaly skin is when the skin appears dry and flaky, like the scales of a fish. It can be caused by some conditions, such as:

• Psoriasis – a skin condition where the body’s own immune system starts to attack the skin. It can cause ‘plaques’ on the skin which look red or silvery, dry, and scaly. Common areas where the plaques are found are the scalp, elbows, knees, and lower back. These plaques may also be itchy, although this is not always the case
• Eczema – this is another condition where the body’s own immune system starts to attack the skin. The skin is normally a barrier between the body and the outside environment. In eczema, this barrier becomes porous and less effective at keeping the environment out. The skin becomes very itchy, dry, red, and scaly. In very severe cases, the skin can also weep, ooze, and start to crust. The skin is also very sensitive to substances such as foods, soaps, pollution, or humidity
• Contact dermatitis – this is a reaction of the skin to touching a substance that a person reacts to. This normally occurs a few days after a person comes into contact with the allergen. The skin becomes itchy, red, and scaly. In severe cases, blisters can also develop on the skin
• Athlete’s foot – this is caused by a fungal infection. The skin between the toes or on the soles of the feet become itchy, white, and scaly. This condition can also affect the toenails and cause them to become discoloured and thickened
• Allergic reaction – an allergic reaction can cause a rash on the skin which may appear scaly. More often, the rashes are red, raised, and itchy. It can occur any time from minutes to days after the skin comes into contact with an allergen

What causes the scaliness? – scaly skin in all of these conditions is caused by the outer layer of the skin (called the epidermis) falling away in flakes. It can be triggered by a lot of different things, such as allergens, changes in the environment (such as dryness or humidity), or an infection (for example, by a fungus).

Pre-existing skin conditions can lead to scaly skin – a person could be susceptible to developing scaly skin if they have certain skin conditions like psoriasis or eczema. You can also develop scaly skin if your skin is sensitive to a particular substance and you come into contact with it.

Skin conditions like these are often genetic – many skin conditions are partly influenced by genetics, so you are more likely to develop conditions that cause scaly skin if a close relative also has the condition. These conditions are also quite common, with up to one in ten people affected by psoriasis and up to one in five affected by eczema.

Report symptoms to a doctor – you may have scaly skin if your skin looks very dry and flaky. It’s often quite difficult to tell the difference between scaly skin and other skin complaints. So, if you’re concerned about having scaly skin, it’s important to make an appointment with your usual GP.

In your consultation, your GP can:

• Confirm whether you have scaly skin
• Diagnose the cause of your scaly skin
• Come up with a suitable management plan to care for your scaly skin
• Prescribe any medications you may need
• Answer any questions you may have about your skin

Often, the treatment for scaly skin depends on the cause – if your scaly skin is caused by specific allergens or triggers, avoiding them may be enough to stop scaly skin from reoccurring. Some common triggers are:

• Lifestyle – stress, smoking, or itching scaly skin can make symptoms worse
• Skincare – using fragrance free detergents for your clothes, soaps, and moisturisers can improve your symptoms
• Prescription treatments – you can get treatments for specific skin conditions, like Dovonex for psoriasis

How to improve appearance of scaly skin – to improve the appearance of scaly skin or reduce symptoms such as itch or pain, you can use topical ointments. Sometimes these are simply fragrance-free moisturisers which keep your skin from becoming too dry. Some ointments contain medicines that can help to heal the skin and reduce the inflammation.

Scaly skin is not a medical emergency – a rash however can appear if you have a severe allergic reaction. Call 999 immediately if you notice these symptoms:

• Difficulty in breathing, swelling to the lips or tongue, a choking sensation, and coughing
• Feeling dizzy, feeling faint, or collapsing
• Crampy abdominal pain, feeling sick (nausea), being sick (vomiting), and diarrhoea
• A widespread rash across your skin (with any of the above symptoms)

Getting scaly skin can have some health implications – some health conditions are related to each other, which means that getting diagnosed with one increases the chances of being diagnosed with the others.

Psoriasis:

• Psoriatic arthritis – a condition which causes inflammation and pain of joints. One in five people who have been diagnosed with psoriasis develop psoriatic arthritis too
• Cardiovascular conditions – such as heart attacks or stroke
• Diabetes – this is a condition where your body struggles to control blood sugar levels

Eczema:

• Asthma – asthma is a condition that affects the airways, or tubes that carry air into the lungs
• Hayfever – an allergy caused by pollen

Some conditions that cause scaly skin can affect people for life – however, knowing your triggers and with the right care, you can drastically reduce the effect that the conditions can have in your life.

Having scaly skin can increase the chances of getting a skin infection – this is because the barrier layer between the skin and the environment is compromised. However, keeping your skin moisturised and clean reduces the chance of getting an infection.

Itching skin that is scaly can also cause scarring – you can reduce the chances of scarring by:

• Ensuring that skin is well moisturised, which can reduce itch
• Regularly using any ointments that you have been prescribed with
• Avoiding itching your skin during the day
• Wearing protective mittens at night to avoid itching during sleep