ConditionSkin, hair & nails
Rough Skin Texture: Causes and Treatment
Rough skin texture means skin that feels dry, scaly, bumpy or uneven instead of smooth. The most common causes are dry skin (xerosis), keratosis pilaris (tiny rough bumps on the arms and thighs), sun damage, and a build-up of dead skin cells. Eczema, psoriasis, an underactive thyroid and some genetic conditions can also cause it. Gentle cleansing, daily moisturizers with urea or lactic acid, sun protection and retinoids improve most rough skin within weeks.
Also called: Rough skin, uneven skin texture, bumpy skin, coarse skin, scaly skin
At a glance
- What it is
- Skin that feels dry, scaly, bumpy, thickened or uneven.
- Common causes
- Dry skin, keratosis pilaris, sun damage, aging, harsh soaps, cold dry weather.
- Less common causes
- Eczema, psoriasis, ichthyosis, underactive thyroid, actinic keratoses.
- Home care
- Gentle cleanser, thick moisturizer, urea or lactic acid creams, sun protection.
- See a doctor
- Rough patches that bleed, persist or grow, or widespread scaling.
When to get help
See a doctor within a day or two
- Rough skin with widespread redness, peeling and feeling unwell, or blisters after a new medicine
Book a routine appointment
- A rough, scaly spot on sun-exposed skin that does not heal, bleeds or keeps coming back (possible actinic keratosis or skin cancer)
- A crusted or growing lump within a rough patch
- Rough, dry skin with tiredness, weight gain, feeling cold and constipation (possible underactive thyroid)
- Thick, scaly skin over much of the body since childhood
- Itchy rough patches that do not improve after 2 to 3 weeks of moisturizing
Usually safe to manage at home
- Rough, dry skin in winter or after frequent washing
- Small rough bumps on the backs of the upper arms or thighs
Common causes of rough skin
| Cause | What it looks and feels like | Where |
|---|---|---|
| Xerosis (dry skin) | Dull, flaky, tight, sometimes cracked | Shins, hands, arms; worse in winter and with age |
| Keratosis pilaris | Tiny rough bumps around hair follicles, like goosebumps or sandpaper | Backs of upper arms, thighs, buttocks, cheeks |
| Photoaging (sun damage) | Leathery, coarse, uneven texture, wrinkles, spots | Face, neck, hands, forearms |
| Actinic keratosis | Rough, sandpaper-like scaly spots, often easier to feel than see | Sun-exposed areas, usually over 40 |
| Dead skin buildup | Dull, slightly rough surface | Elbows, knees, heels |
| Calluses and corns | Thick, hard skin from friction | Feet, hands |
| Acne and enlarged pores | Bumpy, uneven surface | Face |
Less common causes
- Eczema: itchy, dry, rough patches, often in skin creases; long-term scratching thickens the skin
- Psoriasis: thick, well-defined, scaly plaques
- Ichthyosis: inherited dry, fish-scale-like skin, often on the shins
- Hypothyroidism: dry, coarse, pale skin along with tiredness and feeling cold
- diabetes, kidney disease and nutritional deficiencies
- medicines: retinoid tablets, some cholesterol and cancer drugs
- contact dermatitis from soaps and detergents
How doctors assess rough skin
Most rough skin is diagnosed by appearance. A doctor will ask about skin care, bathing habits, sun exposure, itch, family history and other symptoms. Tests are used when needed:
- blood tests for thyroid function, blood sugar or kidney function
- a skin scraping for fungal infection
- a biopsy of a persistent rough spot to rule out skin cancer
How to smooth rough skin
Daily skin care
- Wash gently: use lukewarm water and a fragrance-free, soap-free cleanser. Keep showers under 10 minutes.
- Moisturize right after bathing, while skin is still damp, and at least twice a day. Thick creams and ointments work better than lotions.
- Use exfoliating moisturizers: creams containing urea (10% to 20%), lactic acid or ammonium lactate, or salicylic acid soften scale and smooth bumps. They may sting on cracked skin.
- Avoid scrubbing hard: harsh scrubs and loofahs can irritate skin and make keratosis pilaris worse.
- Humidify indoor air in winter.
Retinoids
Topical retinoids (adapalene over the counter, tretinoin or tazarotene by prescription) increase skin cell turnover, smoothing texture and reducing sun damage and keratosis pilaris. Start slowly, as they can cause dryness and irritation. Avoid in pregnancy.
Sun protection
Daily broad-spectrum SPF 30 or higher sunscreen, hats and clothing prevent further sun damage and allow photoaging to improve.
In-office treatments
- chemical peels
- microdermabrasion
- laser resurfacing
- cryotherapy or prescription creams (such as fluorouracil) for actinic keratoses
Treat underlying conditions
Thyroid hormone for hypothyroidism, prescription creams for eczema or psoriasis, and moisturizing regimens for ichthyosis.
Frequently asked questions
What causes rough skin texture?
The most common causes are dry skin, keratosis pilaris, sun damage and buildup of dead skin cells. Harsh soaps, hot showers and cold, dry weather make it worse. Eczema, psoriasis, ichthyosis and an underactive thyroid are other causes.
How do I get rid of rough bumps on my arms?
These are usually keratosis pilaris. Use a gentle cleanser and a daily moisturizer containing urea, lactic acid or salicylic acid. Topical retinoids can help. It is harmless, and it often improves with age, though it may return in winter.
What is the best moisturizer for rough skin?
Thick, fragrance-free creams or ointments applied after bathing work best. For very rough or scaly skin, moisturizers with urea, lactic acid or ammonium lactate also exfoliate and smooth the surface.
When should I see a doctor about rough skin?
See a doctor for a rough, scaly spot on sun-exposed skin that persists, bleeds or grows, which could be precancerous or cancer. Also seek advice for widespread thick scaling, rough skin with other symptoms such as tiredness and weight gain, or itch that does not improve.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Dry skin: Diagnosis and treatment
- American Academy of Dermatology: Keratosis pilaris
- DermNet: Xerosis; Actinic keratosis
- MedlinePlus: Dry skin
- Skin Cancer Foundation: Actinic keratosis