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. 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. Some medications such as lithium (for bipolar disorder) and beta-blockers (for blood pressure) can make it worse. There are many different treatments. If the psoriasis is not severe, your doctor will probably prescribe a steroid 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. There will be lots of small scaly patches on the trunk and neck, and each patch has a delicate scaly surface.
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.
Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, March 18th 2011
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