Flaky skin on legs: causes and what to do

What causes dry flaky skin on legs?

Dry skin, also called xerosis, can feel rough, tight or itchy and develop scales or fine cracks. The arms and legs are often worse affected. Cold outdoor air, dry indoor air from heating or cooling, frequent bathing and some soaps or detergents can all contribute. Long, hot showers also strip away protective oils. Winter can make dryness worse, but flaky legs are not exclusively a winter problem.124

Not every flaky patch is straightforward dryness. Contact dermatitis is inflammation caused by something touching your skin, such as a detergent or cosmetic that irritates it or triggers an allergic reaction. Eczema can cause dry, bumpy, itchy patches; psoriasis can also cause excessive dryness and scaling. Peeling after sunburn or friction has a different starting point: damage to the skin's outer layer. The appearance alone is not enough to choose the right treatment.23

How to care for flaky legs

1. 1Wash with lukewarm water rather than hot water, and avoid bathing longer or more often than needed.
2. 2Use a gentle cleanser without dyes or perfume. For very dry or itchy skin, an emollient soap substitute is another option.
3. 3Pat your legs dry rather than rubbing them, leaving the skin slightly damp.
4. 4Apply moisturizer immediately after washing. Smooth it gently in the direction your hair grows.
5. 5Apply moisturizer again in the morning and before bed, and whenever your legs feel dry or tight. Very dry skin can need several applications daily.

A cleanser does not need foam to clean skin, despite the visual appeal of turning a shower into a product demonstration. Emollient soap substitutes do not foam like ordinary soap but still clean effectively.5

Which moisturizer should you use?

Choose a fragrance free body moisturizer. Petroleum jelly and mineral oils help retain moisture, while glycerin attracts moisture to the skin. For excessively dry legs, a dermatologist can select a formula containing ingredients such as urea, ceramides, lactic acid or glycerol to hydrate skin and restore its outer layer. Some people need a prescription moisturizer. There is no single ingredient strength that suits every case; the formula should match the severity and cause of the dryness.26

What improvement should you expect?

Moisturizers soften rough skin and help prevent cracking by restoring moisture and supporting the skin's protective barrier. Many people can manage ordinary dry skin with daily moisturizing and less exposure to drying conditions. Moisturizer belongs on the legs, not just on the bathroom shelf, where it has an excellent record of doing nothing. There is no fixed recovery time for every cause of flaking. If eczema, psoriasis or another condition is driving the dryness, that condition also needs treatment.26

What causes flaky skin on legs and feet?

Dry skin can affect both the legs and feet, but flaky soles can also be athlete's foot, a fungal infection that resembles dryness. Moisturizer alone does not address a fungal cause; treatment for peeling skin depends on the diagnosis and can include antifungal medicine. If the feet keep peeling despite moisturizing, have them assessed rather than assuming the legs and feet have the same problem. Let peeling skin shed naturally. Pulling it off can create openings for bacteria and increase infection risk.23

What causes dry flaky skin on legs in older adults?

Skin produces less natural oil with age, and nearly everyone has dry skin by age 60. Oil production drops markedly during the 40s and continues declining afterward. Medicines can add to the problem: statins and diuretics are among those associated with extreme dryness. Diabetes, thyroid disease and kidney disease are other possible contributors, and dialysis or cancer treatment increases the risk. Tell your clinician about new dryness and your medicines rather than changing a prescription yourself.4

What causes extremely dry flaky skin on lower legs?

Asteatotic eczema is inflammation caused by very dry skin, most commonly on the shins. It often affects older adults and can produce a network of red cracks between plates of skin. It can start on one shin and spread around both lower legs. Low humidity, excessive bathing and soaps contribute by damaging the skin barrier. Severe cases can develop widespread redness, swelling or surface blisters.7

This type of eczema usually responds rapidly to treatment. Thick moisturizers such as petroleum jelly or an oily cream are used several times daily; a thinner cream can be adequate after a few days. Inflamed areas sometimes need a clinician directed topical steroid. Avoid direct heat and continue moisturizing after improvement, because the eczema is likely to return if the skin dries out again.7

What should make you stop or seek help?

If an emollient wash stings and rinsing does not settle it, ask a pharmacist for an alternative. Persistent burning or inflamed hair follicles also need advice. Leave 20 to 30 minutes between emollients and prescribed skin treatments; ask which goes first. Keep emollient soaked clothing and bedding away from flames and cigarettes. Use a clean spoon for tubs, and watch for slippery bathroom surfaces.5

See a clinician if dryness does not go away, keeps returning, becomes severe or leaves painful cracks or open sores. Call promptly for unexplained peeling or fever or chills. New, excessive scaling accompanied by weight loss, fever or feeling generally unwell needs investigation. Mention dry thinning hair, weight gain and unusual sluggishness too, because these can help identify an underlying thyroid problem.237

Before an appointment, note when the flaking began, what worsens it and which treatments you have tried. Bring the names and doses of medicines, vitamins and supplements. A dermatologist can often assess dry skin by examination, with tests when an underlying cause needs checking. If reaching your lower legs or applying moisturizer often enough is difficult, say so: the treatment plan needs to be one you can actually follow.136