SymptomSkin, hair & nails
Skin Peeling: Causes and Treatment
Skin peeling is the shedding of the outer layer of skin, as flakes, scales or sheets. Most peeling follows damage or dryness: sunburn, dry skin, eczema, psoriasis, athlete's foot or skin products such as retinoids. Peeling on the hands and feet after a fever can follow scarlet fever or Kawasaki disease in children. Widespread peeling with blisters, painful skin, fever or sores in the mouth is a medical emergency.
Also called: Peeling skin, desquamation, skin shedding, flaking skin, scaly skin
At a glance
- What it is
- Loss of the outer skin layer as flakes, scales or sheets.
- Common causes
- Sunburn, dry skin, eczema, psoriasis, fungal infections, contact dermatitis, acne or anti-aging products.
- Serious causes
- Stevens-Johnson syndrome, staphylococcal scalded skin syndrome, toxic shock syndrome, Kawasaki disease.
- Diagnosis
- Usually by appearance; skin scrapings or biopsy if unclear.
- Treatment
- Moisturizers, avoiding triggers, treating the cause (steroid creams, antifungals).
When to get help
Call 911 or go to the ER
- Widespread red, painful skin that blisters or peels in sheets, especially with fever, sore mouth, eyes or genitals, or after starting a new medicine
- Peeling skin with high fever, low blood pressure, dizziness or confusion (possible toxic shock syndrome)
- A baby or young child with fever and red, tender skin that wrinkles and peels when touched
See a doctor within a day or two
- Severe sunburn with blisters over a large area, fever, chills or vomiting
- A child with fever for 5 days or more, red eyes, red cracked lips, rash and swollen hands or feet, or peeling fingertips afterwards (possible Kawasaki disease)
- Peeling skin with spreading redness, warmth, pus or fever (possible infection)
Book a routine appointment
- Peeling that lasts more than 2 weeks despite moisturizing
- Thick, scaly, well-defined patches that keep coming back
- Peeling between the toes or on the soles that does not clear
- Peeling of the palms or soles that keeps recurring
Usually safe to manage at home
- Peeling a few days after mild sunburn
- Dry, flaky skin in winter or after frequent hand washing
- Mild peeling after starting retinoid, acid or acne products
Why skin peels
The outer layer of skin (the epidermis) constantly renews itself, normally shedding invisibly. When the skin is damaged, inflamed or very dry, cells are shed faster and in visible flakes or sheets. Peeling is part of healing in many cases, for example a few days after sunburn.
Common causes of peeling skin
Sunburn
Peeling starts about 3 to 8 days after a sunburn as damaged skin cells are shed. It is itchy but harmless. Blistering sunburn means a deeper burn.
Dry skin
Cold weather, low humidity, hot showers, harsh soaps and aging all dry the skin, causing flaking, tightness and fine cracks, especially on the shins, hands and arms.
Eczema
Eczema (atopic dermatitis) causes itchy, dry, red, scaly patches, often in skin creases. Dyshidrotic eczema causes tiny itchy blisters on the palms and fingers that then peel.
Psoriasis
Psoriasis causes thick, well-defined, red patches with silvery scale on the elbows, knees, scalp and lower back. Scale builds up and sheds. People sometimes describe the skin as so scaly it peels constantly.
Contact dermatitis
Contact with an irritant (detergents, solvents, frequent hand washing) or an allergen (nickel, fragrance, preservatives, poison ivy) causes red, itchy skin that then peels. See contact dermatitis.
Fungal infections
- Athlete's foot: peeling, itchy, cracked skin between the toes or a dry "moccasin" scaling on the soles.
- Ringworm: ring-shaped, scaly patches with a clearer center.
- Fungal infection of the hand: dry scaling, often on one palm only.
Skin care products and medicines
Retinoids (tretinoin, adapalene), benzoyl peroxide, alpha-hydroxy acids, chemical peels and some chemotherapy drugs cause peeling, especially in the first weeks.
Peeling hands and feet
- Exfoliative keratolysis: harmless peeling of small air-filled patches on the palms, often in warm weather.
- Hand-foot-and-mouth disease: peeling palms and soles, and sometimes nail shedding, weeks later.
- Scarlet fever: peeling fingertips and toes 1 to 2 weeks after the rash.
- Kawasaki disease: peeling around the fingertips and toes in the recovery phase, after a prolonged fever in a young child.
Serious causes
| Condition | Key features |
|---|---|
| Stevens-Johnson syndrome and toxic epidermal necrolysis | Painful red skin and blisters peeling in sheets, sores in the mouth, eyes and genitals, usually 1 to 3 weeks after starting a new medicine |
| Staphylococcal scalded skin syndrome | Mostly in babies and young children: fever, tender red skin, then wrinkling and peeling like a scald |
| Toxic shock syndrome | Sudden high fever, low blood pressure, rash like sunburn, then peeling of palms and soles a week or two later |
| Kawasaki disease | Fever 5 days or more in a young child with red eyes, lips and rash; peeling fingertips later; risk to heart arteries |
| Exfoliative dermatitis (erythroderma) | Red, peeling skin over most of the body from severe eczema, psoriasis or a drug reaction |
How doctors find the cause
A doctor or dermatologist looks at where the peeling is, its pattern, and asks about sun exposure, products, medicines, work, fever and other illness. Tests may include skin scrapings for fungus, swabs for bacteria, patch testing for allergies, and occasionally a skin biopsy.
How to treat peeling skin
General care
- Do not pull or pick at peeling skin; trim loose edges with clean scissors.
- Moisturize with a fragrance-free cream or ointment while the skin is still damp after washing, at least twice daily. Petroleum jelly or creams containing ceramides, glycerin or urea work well.
- Use lukewarm, not hot, water and gentle, soap-free cleansers.
- Use a humidifier in dry indoor air.
- Protect from the sun while skin is healing.
Treating specific causes
- Sunburn: cool compresses, aloe vera or moisturizer, fluids, and acetaminophen (paracetamol) or ibuprofen for pain (follow the label dose).
- Eczema: emollients and topical steroids or other anti-inflammatory creams.
- Psoriasis: topical steroids, vitamin D creams, light therapy or systemic medicines.
- Fungal infections: antifungal creams such as terbinafine or clotrimazole, continued for 1 to 2 weeks after the skin looks clear.
- Contact dermatitis: avoid the trigger; a steroid cream for flare-ups.
- Product irritation: use the product less often, apply moisturizer first, then build up gradually.
- Drug reactions: stop the suspected medicine only on medical advice, and seek urgent care if skin blisters or the mouth is affected.
Frequently asked questions
What causes skin to peel?
Most peeling is caused by sunburn, dry skin, eczema, psoriasis, contact dermatitis, fungal infections or skin care products such as retinoids. Peeling after a fever can follow scarlet fever or Kawasaki disease. Widespread peeling with blisters, pain or mouth sores can be a dangerous drug reaction.
Why is my skin peeling so badly it feels scaly?
Very scaly, peeling skin often comes from psoriasis, severe dry skin, eczema or a fungal infection. Thick, well-defined scaly patches suggest psoriasis. If moisturizing twice daily for 2 weeks does not help, see a doctor or dermatologist for a diagnosis.
Why is the skin on my hands peeling?
Common reasons include frequent hand washing, dry weather, contact dermatitis from soaps or chemicals, dyshidrotic eczema and harmless exfoliative keratolysis. Fungal infection and psoriasis are other causes. Peeling fingertips in a child after a fever should be mentioned to a doctor.
Should I peel off peeling skin?
No. Pulling peeling skin can tear healthy skin underneath, cause pain and increase infection risk. Let it shed naturally, keep it moisturized, and trim loose pieces with clean scissors if they catch on clothing.
When is peeling skin an emergency?
Peeling skin is an emergency when it comes with widespread painful redness or blistering, sores in the mouth, eyes or genitals, high fever, low blood pressure, or in a baby with red tender skin. These can signal Stevens-Johnson syndrome, scalded skin syndrome or toxic shock.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Sunburn, how to treat; Dry skin, tips for managing
- MedlinePlus: Skin, peeling
- NHS: Athlete's foot; Psoriasis
- American Heart Association: Kawasaki disease
- National Organization for Rare Disorders: Stevens-Johnson syndrome / toxic epidermal necrolysis