Monday, March 16, 2020
Of all the possible weird skin symptoms you could experience, skin peeling might be one of the most disconcerting—and uncomfortable. So what’s actually causing that peeling? And what kind of skin-peeling treatments are out there?
“When the top layer of your skin flakes off or peels off, that’s usually a result of some type of inflammation underneath the skin or something that the skin has come into contact with,” Isha Tiernan, M.D., a dermatologist at Tufts Medical Center, tells SELF. More specifically, topical allergies or sensitivities, as well as chronic conditions like eczema or psoriasis, are common causes of peeling skin.
That said, peeling skin can be one of several alarming symptoms of infections or life-threatening illnesses—although these instances are much rarer.
In other words, there’s a wide range of conditions that can potentially cause skin peeling on your face and body. Effectively managing your peeling skin is just a matter of figuring out which one’s to blame. Here’s what you need to know about some of the most common causes of peeling and flaking skin, from how to identify them to how to treat them.
1. Sunburn
Anyone who’s come home from the beach with fiery red shoulders knows that a period of peeling isn’t far behind. After the initial stages of a sunburn, in which the skin is red, tender, and sometimes hot to the touch, peeling will occur because the skin is trying to repair its topmost layer, Erin Boh, M.D., Ph.D., a professor of dermatology at Tulane University, tells SELF.
“Those sunburnt [skin] cells are basically going to die, then that causes the barrier to get disrupted,” she explains. “The cells normally would be ‘glued’ together, but these dead or dying cells start losing their ‘glue,’ so to speak.” And it’s when these damaged skin cells come “unglued” that you’ll start to notice some peeling.
For milder cases, cool compresses, gentle and soothing skin protectants like aloe vera, and pain relievers can help reduce the discomfort of a sunburn, Dr. Tiernan says.
But if your sunburn is more severe, meaning it’s a deeper shade of red and much more painful, it’s likely that the lower levels of your skin are also affected and inflamed. In these cases your skin will probably blister before it sloughs off, Dr. Boh says, adding that your first step toward treating a severe sunburn should be taking an anti-inflammatory pain reliever, like ibuprofen, within 24 hours of getting burned.
Your dermatologist can also prescribe a topical steroid to help mitigate the inflammation in the first few days. Whether your sunburn is moderate or intense, do not pick at it.
2. Dry skin
Some people’s skin naturally tends toward dryness. But the reality is that “dry skin can happen to anyone,” Dr. Tiernan says, cautioning against low-humidity environments (like an apartment heated by forced air), harsh soaps, and scalding-hot showers. Whether or not you naturally have drier skin, these factors can easily strip the skin of its natural moisture, which, Dr. Boh explains, leads to a damaged skin barrier.
“When the skin is not intact, that barrier that keeps everything bad out and allows things like water and other nutrients in is disrupted,” Dr. Boh says. “As a consequence of the disruption, the body then will lose water to the environment and then get more dry.” That causes symptoms like a feeling of tightness in the skin, itchiness, cracks in the skin, and a propensity for the skin to start to flake and peel off.
So treating dry skin boils down to trying to repair the skin’s barrier and replenish its moisture. First, Dr. Tiernan recommends using a thick cream-based moisturizer for wherever your skin is dry (like your hands or face)—and to use it after every time you wash that part of your body. “Otherwise, you’re just stripping your hands of its natural oils, which leads to irritation, little breaks in the skin, and inflammation,” she says.
You can make your moisturizer more effective by using it directly after showering or washing, Dr. Boh says. “The key is to put moisturizers to wet skin and then dry off,” she says. “The moisturizer will pull in that water and rehydrate the skin.”
You can also use a humidifier, take lukewarm showers (rather than hot ones), and stick to mild cleansers to keep dry skin at bay. Even something as simple as wearing gloves during the winter can protect your skin against drying environmental elements, Dr. Tiernan says.
3. Eczema
When a patch of peeling skin is itchy, extremely dry, red, and inflamed, it could very well be due to eczema, a chronic condition in which the skin’s barrier doesn’t sufficiently protect against bacteria and irritants. Eczema can easily be mistaken for regular old dry skin because it gives the skin a similar appearance and tends to occur more frequently in the winter. But eczema usually has specific triggers (like allergens) and will likely require further treatment.
As with dry skin, moisturizing is a very important preventive step when you have eczema, Dr. Tiernan says. But she adds that eczema patients should also make extra sure to keep their skin clean, avoid irritants (like harsh cleansers and fragrances), and steer clear of any known allergens.
They should also get in touch with their dermatologist when they notice a flare. “Once the eczema happens, it’s really important to try to see a provider as soon as possible, because we can prescribe steroid creams or ointments that can help calm down the inflammation,” she says.
4. Contact dermatitis
Contact dermatitis occurs when the skin has a negative reaction to something in the environment. And, according to the Mayo Clinic, there are two types of contact dermatitis you should be aware of. Allergic contact dermatitis is triggered when you come into contact with something you’re allergic to (like poison ivy, nickel, or certain ingredients in your skin-care products) and your skin breaks out in a rash as an immune response. Irritant contact dermatitis, on the other hand, isn’t due to contact with an allergen but to something that damages your skin’s protective barrier to the point that it causes a rash. Dr. Tiernan says rubbing alcohol, fertilizers, or drying hand washes can often set off a case of irritant contact dermatitis.
It can be tricky to differentiate between contact dermatitis and eczema, as they both cause similar symptoms and those with eczema are prone to developing contact dermatitis. “Anytime the skin is dry and prone to inflammation, you’re more likely to develop contact dermatitis,” Dr. Tiernan says.
The key difference is that contact dermatitis usually won’t get better with the usual first-line eczema treatments, like moisturizing. “Typically, I’ll think about contact dermatitis when a patient has something that looks like regular eczema but it’s not seeming to get better with our current treatments,” Dr. Tiernan says. “It makes me think that something they’re coming into contact with is making it worse.”
With that in mind, the best way to prevent contact dermatitis is to identify and avoid your specific set of triggers (which can include things like weather, irritants, and allergens). That may take some trial and error, but talking to your dermatologist will help.
If you’re in the middle of a flare, your dermatologist can prescribe a topical steroid to help mitigate the inflammation that comes with contact dermatitis. In the meantime, Dr. Tiernan says it’s important to keep your skin hydrated and use hypoallergenic products as often as possible.
5. Psoriasis
The most common form of psoriasis presents as red, dry, itchy patches of thickened skin called plaques. Because this skin is thicker than patches of eczema, for instance, it’s technically more likely to flake than peel.
“Psoriasis is a condition where our body starts attacking its own skin cells, and that causes skin renewal to really speed up,” Dr. Tiernan explains. “Rather than taking a traditional 28 days for the skin cells to shed, it’ll be a four-day turnaround. These skin cells are shedding much more easily due to the underlying disease and that’s why patients with psoriasis develop a lot of flaking of the skin.”
Psoriasis can be a complex condition to understand and manage, and the right treatment depends on the type and severity of your symptoms. Your dermatologist may recommend using topical medications, light therapy, or a combination of treatment options, as SELF previously reported. But it’s just as important to avoid things that could cause a flare-up in the first place, which may include trauma or injury to the skin, infections, and stress.
Psoriasis is also yet another condition that can sometimes appear as dry skin, but if your skin doesn’t improve with an increased moisturizing regimen, that’s a sign that you’re dealing with an underlying issue like psoriasis. If your skin isn’t getting better or starting to flake and peel more, get in touch with your dermatologist.
6. Seborrheic dermatitis
Seborrheic dermatitis is a scaly, flaky rash, Dr. Boh explains. It tends to crop up in areas with a high concentration of oil glands, like the scalp (where it looks like a very severe case of dandruff), face, and groin, or in high-friction areas like the armpits or between the fingers.
“The hallmarks of seborrheic dermatitis are going to be redness, scaliness, oil, and itchiness,” she says, adding that it often occurs due to an overproduction of oil and yeast, which leads to inflammation that subsequently makes the skin’s top layer flake away.
Sometimes seborrheic dermatitis resolves on its own, the Mayo Clinic says. But other cases can be stubborn enough to require repeated treatment and maintenance to prevent yeast and oil from accumulating again.
Unlike many of the other conditions on our list, seborrheic dermatitis isn’t associated with dry skin. So moisturizing won’t do much to treat it—instead, you’re better off addressing the yeast buildup with an antifungal cream or shampoo, Dr. Boh says. These are available with a prescription, but over-the-counter dandruff shampoos containing ingredients like selenium sulfide, tar, salicylic acid, or pyrithione zinc, can also help treat seborrheic dermatitis on the scalp specifically. According to Dr. Tiernan, alternating between two or three products that contain different active ingredients will likely deliver the most effective results.
7. Athlete’s foot
This fungal infection occurs when fungus “creates a home” in the top layers of your skin, as Dr. Tiernan puts it, and proceeds to secrete enzymes that break down that layer. The result is a red, scaly, peeling rash. Moist, warm areas tend to attract fungus, Dr. Tiernan explains, so your feet after a workout make an ideal environment.
It’s important to treat athlete’s foot relatively quickly because, if you leave it alone, the skin could break down to the point that it becomes secondarily infected. Dr. Tiernan recommends using an over-the-counter antifungal cream or powder. And changing your socks regularly won’t hurt either, she says.
8. A serious underlying condition
Finally, there are some (very rare) situations in which peeling skin is a symptom of a much more severe condition—one that may require immediate medical care. In particular, Dr. Boh points to Steven Johnson syndrome, a severe reaction to a new medication whereby the skin breaks out into a painful, red rash and blisters before shedding. And Dr. Tiernan notes that toxic shock syndrome often comes with peeling skin as well as fever, vomiting, diarrhea, body aches, and confusion.
Again, it’s unlikely that one of these conditions will sneak up on you, but if your skin is peeling off in large sheets or if the peeling skin is accompanied by extremely tender skin or a fever, see a doctor right away.