QUESTION: Hello Doctor, my skin keeps peeling off, especially when the weather is hot. What causes it and what should I do? Julia.
ANSWER: Dear Julia,
We need to first appreciate the difference between skin peeling and shedding, the terms used in explaining them and the factors that influence each.
Desquamation: The medical term for skin peeling (Generally speaking).
Epidermis: The part of peeling skin that you see which is the outermost and the thinnest layer of your skin that plays an important role in protecting your body against bacteria and germs.
Epidermal desquamation: The normal, invisible and continuous but insensible bodily activity that is largely ignored unless the rate or amount of scale production becomes abnormal.
Shedding: The epidermis makes new skin cells to replace the thousands of cells that die off every day.
Skin peeling: Refers to the exaggerated visible superficial desquamation and can occur in inherited and acquired conditions.
Shedding skin
According to research, humans normally shed between 100 and 200 million cells per day.
Women are said to shed larger squames than men, suggesting slower desquamation in women.
Yet rates of desquamation in men and women are the same.
Factors causing it
– Location: Limb, trunk, face, genital.
– Race: Inexplicably, Africans desquamate at a greater rate than Caucasians or Orientals.
– Season: It is reported that desquamation is greater in sunny than cold days, though there is great individual variability in those data.
– Age: faster in younger than the older individuals.
– Sex: No difference in amount, the only difference is in squame size, female or male.
Mechanism: Shedding is spontaneous such that neither friction nor grooming is required for shedding.
Peeling skin
If you have peeling skin, it is a sign that your skin is healing from some type of damage. Sunburns, allergies and skin diseases.
Treatment for cancer, acne and aging can also cause peeling skin. Picking at peeling skin can lead to infection.
Peeling skin may be flaky or scaly (dry Skin), irritated or inflamed, itchy (pruritus).
Causes of skin peeling
Skin Damage
– Burns: tissue damage brought on by heat, chemicals, electricity, radiation or the sun.
– Sunburns: occur from exposure to the sun’s ultraviolet (UV) rays or UV light from artificial sources. Immunosuppressed patients (HIV, Malnourished, cancer and organ transplant recipients) are more vulnerable to the damaging effects of high-intensity ultraviolet (UV) light than immunocompetent ones. Multiple burns can lead to premature skin aging and skin cancer.
– Irritation from friction.
- Genetic or inflammatory diseases
– Kawasaki disease: inflammation of the blood vessels in which peeling of the skin usually beginning around the nails is often a later finding.
– Peeling skin syndrome - Infectious diseases
– Group A streptococcal infections like scarlet fever.
– Staph infections like impetigo.
– Toxic shock syndrome. - Skin conditions
– Allergic reactions, include contact dermatitis, skin rashes and Steven Johnson syndrome.
– Athlete’s foot (tinea Pedis) and Jock itch (tinea cruris).
– Dry Skin
– Edema (fluid retention and swelling)
– Pemphigus
– Seborrheic Dermatitis.
– Skin deaseas like Eczema, psoariasis and erythrodermic psoriasis.
Management
Treatment will depend on the cause.
– Photo protection: To prevent UV-induced damage, Clothing and glasses(dark colors protect more efficiently), Hats (particularly useful to protect the scalp, forehead, and neck), gloves (useful in preventing the appearance of photoaging signs on the hands), Sunglasses (note their UVA screening capability), Sunscreens which scatter UV light (contain carotenoids, Vitamin C&E and seresis among others).
– Allergic medications, Antibiotics, Antifungals and Corticosteroids for inflammatory causes.
