What Causes Desquamation (Skin Peeling)?

Your skin cells go through a regular cycle of death and regrowth, which is called desquamation, to keep your skin healthy. This is a normal shedding process that you typically don’t even realize is happening. However, sometimes cells die more quickly than usual and slough off in large amounts, which causes flaking or peeling on the outer layer of your skin.

The most common reason this happens is because of damage, such as after a bad sunburn, but underlying skin conditions can also trigger skin peeling.

What Does Desquamation Look Like?

When your skin is peeling, the epidermis (top layer) of your skin starts to dry out, crack, and break away from the rest of your skin. This usually isn’t painful because this layer is made of dead skin cells. In fact, this is why your skin peels in the first place—the skin cells in the affected area are damaged, and your body is trying to get rid of them. 

The peeling skin may look lighter or darker (or a combination of both) than your intact skin. As it breaks away, it may look scaly and peel or flake off in small or large pieces. In some cases, you may notice that it appears crumbly, as if you have dandruff on your skin.  

Causes of Skin Peeling

The most common cause of desquamation is damage to the outer layer of your skin, but underlying skin conditions and medical treatments can also contribute to symptoms.

Environmental Exposure

Exposure to harsh elements or substances in your environment can damage the epidermis or cause moisture loss, eventually resulting in dry skin and dead skin cells that fall off in large amounts. Some common environmental exposures that may cause skin peeling include:

• Ultraviolet (UV) rays: Spending too much time outside without wearing UV protection can damage your skin and cause a sunburn, which often peels your skin as it heals. UV damage can also occur if you use tanning beds.
• Exposure to extreme heat or cold: Very cold temperatures, especially when it’s windy, can damage the outer layer of the skin enough to cause shedding. Similarly, very dry air can dry out your skin, making it more prone to cracking and peeling.
• Allergens: Contact dermatitis can be caused by something you’re allergic to or something that’s simply irritating to your skin. The allergen can leave you with itchy, scaly skin that may go through the desquamation process as it repairs itself.

Skin Conditions

Some acute (short-term) or chronic (long-term) skin conditions can damage the outer layer of your skin through dryness, infection, or weakening of the skin barrier. The most common causes of desquamation as a result of skin conditions include:

• Eczema: People with eczema often have dry skin, and when eczema occurs on the hands, it’s even more likely that this dry skin will become so dry that it peels or flakes.
• Psoriasis: Psoriasis is a chronic skin disease that causes the formation of red, raised patches on the skin. Sometimes, the skin becomes dry, cracked, and itchy—all of which can damage skin cells and cause flaking or shedding. There are several types of psoriasis, but erythrodermic psoriasis is the type of psoriasis that most often causes excessive skin peeling.
• Athlete’s foot: This common infection caused by the fungus tinea pedis often results in red, itchy, and flaky skin under and between the toes.
• Seborrheic dermatitis: This chronic skin condition causes itchy, oily, scaly, and flaky patches on your scalp, face, neck, and upper chest.
• Other severe skin conditions: Some serious conditions cause extreme skin shedding, including exfoliative dermatitis, toxic epidermal necrolysis/Steven-Johnson Syndrome, and staphylococcal scalded skin syndrome. All three conditions are potentially life-threatening but rare and are usually accompanied by a fever and rash.

Other Health Conditions

Even though they aren’t directly related to the skin, a few systemic health conditions (which can affect your whole body) can cause extensive skin peeling. These include:

• Kawasaki disease: This acute illness is rare and occurs primarily in young children. It causes inflammation of the blood vessels (also known as vasculitis). Common symptoms include fever, swelling, and rash. After a few weeks of illness, most children experience skin peeling on their hands and feet.   
• Toxic shock syndrome: This bacterial infection causes fever and flu-like symptoms, along with a red rash that looks similar to a sunburn. Like Kawasaki disease, the skin on the hands and feet typically peels a few weeks after the illness begins.

Certain Treatments

Some treatments can weaken the skin barrier and cause flaking or peeling, such as:

• Skincare products: Topical products that reduce symptoms of acne or signs of aging can dry and irritate the skin, encouraging your skin to peel. In fact, some people use products like retinoids and salicylic acid for this exact purpose, applying them as a chemical exfoliator to trigger a higher amount of skin cell turnover.
• Cancer treatments: Radiation and chemotherapy are commonly associated with symptoms like dry skin, itching, rashes, and skin peeling. 

When to Contact a Healthcare Provider

Peeling skin caused by environmental exposure or allergens doesn’t usually need professional treatment, as it usually resolves on its own with skincare and moisturization. However, if you’ve been taking care of your peeling skin at home and it isn’t getting better, you should contact a healthcare provider for next steps.

If your skin suddenly peels and you don’t know why, an acute or chronic skin condition like psoriasis or eczema could be the cause, especially if your symptoms are worsening, spreading, or affecting your quality of life. It helps to see a dermatologist (a doctor who specializes in skin, hair, and nail conditions) about your symptoms so they can help you make a treatment and management plan.

If your skin peeling is accompanied by any signs of illness, like fever or rash, or if your skin is broken, blistered, oozing, or bleeding, it’s important to seek prompt medical attention. This could be a sign of infection or a serious health condition.

Treatment Options

For the most part, you can treat peeling skin the same way you would repair dry skin or skin that’s healing from a minor injury. This often includes protecting it from further damage, keeping it clean and hydrated, and making a plan to prevent it from peeling again.

If the peeling is temporary (e.g., caused by sunburn, contact dermatitis, or Athlete’s foot), you can:

• Bathe or shower in warm water for shorter periods and pat your skin dry
• Protect your skin by being mindful of the UV index, cold temperatures, and dry air
• Moisturize with an occlusive ointment or cream to hydrate the skin and lock in moisture
• Use hypoallergenic or fragrance-free soaps, detergents, and beauty products
• Apply over-the-counter medications like aloe vera, topical hydrocortisone, or antifungal creams as needed

If a chronic health condition like eczema, seborrheic dermatitis, or psoriasis is causing peeling, you can follow these same recommendations, but you should also work closely with a dermatologist to be sure you’re managing your condition under the guidance of a healthcare provider. They can also help you identify your triggers and create a treatment plan that reduces the amount of flares you have. 

If your skin is peeling may be due to a more serious health condition like toxic shock syndrome, Kawasaki disease, or exfoliative dermatitis, it’s important to seek medical care instead of trying to treat your symptoms at home. In these cases, skin peeling is a relatively minor symptom in the scope of a potentially life-threatening illness.    

How To Prevent Your Skin From Peeling

You can’t prevent all causes of skin peeling, but if your desquamation is a result of environmental factors or dry skin, there are several things you can do to keep your skin healthy. Consider these tips:

• Wear sunscreen, sunglasses, and a hat when you're outside
• Use gentle skincare and cleansing products
• Moisturize your skin regularly
• Try using a humidifier in your home if you're living in a dry or cold climate

Because peeling is sometimes triggered by fungal or bacterial infection, you may also be able to prevent some of the underlying causes by practicing basic hygiene, like washing your hands often, regularly sanitizing commonly used items, not sharing personal care items, and wearing waterproof shoes on wet public surfaces like communal showers and the areas surrounding public pools.

Complications

Peeling skin isn’t usually harmful, as it’s just an accelerated version of the normal shedding process your skin goes through all the time. When it’s caused by a health condition rather than environmental exposure, it’s important not to ignore it. Skin peeling could indicate a more serious condition that can cause complications without treatment.

In the short term, peeling skin can leave your epidermis vulnerable to infection from germs and bacteria, especially if you pick at it or the skin becomes excessively dry and itchy (leading to scratching). Skin infections usually require treatment with prescription medications, and people with compromised immune systems and chronic health conditions are more likely to get a skin infection.

A Quick Review

Desquamation, or skin peeling, is your body's way of shedding dead skin cells and generating new ones. However, some things can cause skin cells to die and slough off faster than normal, resulting in skin that peels or flakes. Sun exposure, allergens, extreme climates, underlying skin conditions, and medical treatments can all cause skin peeling.

Practicing good sun protection habits and cleaning and moisturizing your skin can help keep symptoms at bay. If your symptoms occur alongside signs of an infection, it's important to see a healthcare provider for proper care.