Got Scaly Skin Patches? Here's How to Get Rid of Them for Soft, Smooth Skin

Close-up of woman's leg with cream applied

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Distinct from run-of-the-mill dry skin, scaly skin can be an unsightly, uncomfortable issue. Not to mention the laundry list of potential causes: You could fill a textbook with the causes of scaly skin, which range from common conditions (such as psoriasis and eczema, AKA atopic dermatitis) to rare genetic disorders, cutaneous lymphoma, or allergic reactions, says board-certified dermatologist Hayley Goldbach, MD. And, depending on the exact cause, the treatment for scaly skin can also vary. (This is one symptom where you'll most likely want to see a dermatologist—more on that to come.) That said, while the causes can range widely, "by and large, the scaling you see is due to the shedding of the very top layer of the skin known as the stratum corneum," she explains. Ahead, Goldbach and board-certified dermatologist Melanie Palm, MD, MBA, share more on what to know if you're dealing with scaly skin patches, plus some initial treatments to try.

Meet the Expert

  • Hayley Goldbach, MD, is a board-certified dermatologist at Brown Dermatology in Providence, Rhode Island. Prior to her medical career, she was a reporter for NPR, and she now shares her expertise with various outlets in addition to her patient-facing work.
  • Melanie Palm, MD, MBA, is a board-certified dermatologist, cosmetic surgeon, and the founder of Art of Skin MD in Solana Beach, California. She takes a personalized, balanced approach to patient care, and contributes to media outlets regularly to share her insights with the public.

Causes of Scaly Skin Patches

As mentioned, there's no shortage of potential causes for scaly skin patches, so you're best off seeing a dermatologist to nail down the right one—especially if you aren't sure what it might be. But here's some more info on five of the more common ones:

  • Dry skin: While scaly patches can be different than just straight-up dryness (i.e. your skin could be dry but not actually flaking), there is a good amount of overlap. "In most cases, scaly skin is caused by dryness or a lack of moisture," Palm explains. "Scaly skin is often the result of a compromised skin barrier. When the skin barrier is damaged, its ability to retain moisture is compromised, leading to a scaly or flaky appearance."
  • Eczema or atopic dermatitis: "This is an inflammatory condition in which inflammation in the top layer of the skin causes it to appear scaly and red," Goldbach says. It can also manifest as crusty spots, and, left untreated, can cause the skin to crack and bleed, Palm adds. With eczema, there are often external factors—like soaps and irritating fragrances—that can be triggers, she notes.
  • Psoriasis: "Psoriasis is another inflammatory condition," Goldbach explains. "In this disorder, the top layer of skin is actually thicker. It grows so rapidly that it doesn't have time to shed normally and it creates pink or red plaques of skin with a 'silvery' scale."
  • Seborrheic dermatitis: Colloquially known as dandruff, this can cause scaly skin on the scalp that shows up as flakes that you may notice falling off of your head. Inflammation is also at play here (the root cause of the issue is a reaction to naturally-occurring yeast on our body), and it's often centered around the hair follicle, leading to scaly patches that can also appear a bit greasy, Goldbach says.
  • Actinic keratosis:  Often referred to as AK, this precancerous lesion is a precursor to squamous cell carcinoma. It's caused by UV exposure and damage and can appear as thick, scaly, or patchy skin that may be slightly pink, Palm says. Actinic keratoses can often lead to skin cancer, so it's especially important to get checked by a board-certified dermatologist ASAP. It can also often peel off and come back, so see a doctor if you're noticing a recurring patch of scaly skin, Palm adds.

What Scaly Skin Patches Look Like

It can vary a bit based on the underlying cause, but overall, scaly skin patches tend to have a white and flaky appearance, Goldbach says. "Sometimes, depending on what is driving the scaliness, the skin underneath can be irritated and red," she adds.

How to Treat Scaly Skin Patches

Overall, the first step in getting rid of scaly skin patches is to lock moisture back into the skin. Goldbach suggests using thick, fragrance-free creams or ointments, and notes that this is an especially good starting point if you suspect that your scaly skin patches are due to dry skin or very mild atopic dermatitis. Palm agrees, adding that gentle exfoliation may be helpful as well.

While some scaly skin patches are treatable at home, know that many require specific regimens in order to address the specific cause. For example, in the case of seborrheic dermatitis, moisturizing isn't going to help much, as you need to address the yeast that's causing the inflammation, Goldbach tells us. Eczema often requires prescribed topical or oral steroids, while actinic keratosis definitely requires the evaluation of a board-certified dermatologist, says Palm.

In general, unless you're sure your scaly skin patches are due to dryness, seeing a professional is absolutely key to determining the cause and correct treatment. "Because there are so many causes of scaly skin, it is important to see a board-certified dermatologist, especially if your scaly skin isn't going away with a simple moisturizer," Goldbach advises.

The Final Takeaway

While scaly skin patches can be uncomfortable and alarming, board-certified dermatologists have the most common causes nailed down, as well as effective treatments for each. If you're experiencing scaly skin for the first time, aren't sure what's causing it, or find it isn't getting better with moisturizing and gentle exfoliation, don't hesitate to book an appointment with a professional who can help. Once you have a diagnosis and a treatment plan, you'll be well on your way to the relief of returning to soft, smooth skin.

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