Dry, flaky patches on your face: causes and care

A dry patch is an area of skin that feels rough, looks dull or flaky, and may itch or sting. On the face, patches often show up beside the nose, on the cheeks, around the mouth, or in and between the eyebrows. Most are harmless and improve with gentle care. Some are a rash that needs a doctor to name it. This guide helps you work out which is likely, what to do first, and when to get help. For the general causes of dryness, see what causes dry skin.

The four common causes

Cause	What it looks like	Where it shows	What the source says
Ordinary dry skin	Tight, rough, flaky skin, sometimes itchy	Cheeks and anywhere exposed to cold air	MedlinePlus says dry skin can be dry, scaly, itchy and red, with fine cracks
Reaction to a product	Itchy, dry, cracked skin, sometimes blisters	Where the product went on	The NHS says contact dermatitis most often affects the hands and face
Acne treatment	Dry, peeling, red skin in the first weeks	Where the treatment goes	The AAD says acne treatments tend to dry and irritate the skin
Seborrheic dermatitis	A scaly rash with dry scales, greasy scales or both	Sides of the nose, eyebrows, forehead, eyelids, around the mouth, beard area, behind the ears	The AAD says it appears on oily areas of the body

Two or more causes can happen at once. A person using a new acne cream in winter may have treatment dryness and weather dryness together.

Ordinary dry skin

The American Academy of Dermatology (AAD) says dry skin happens when skin loses too much water. Its sign list includes flakes, rough texture, itch, peeling and, when dryness is severe, cracks that may bleed. MedlinePlus lists common causes: cold, dry winter air, dry indoor air from heating or cooling, bathing too often or too long, some soaps and detergents, and aging.

It often gets worse in winter and after long, hot showers. It improves when you change the cause. The AAD says that with the right self-care, you tend to see improvement within 2 weeks.

The AAD puts it directly: dry skin is damaged skin. It also says that effective treatment for dry skin strengthens the outer layer of your skin. How to treat dry skin on your face gives the full routine.

A reaction to something on your skin

If the patch started within days of a new cleanser, moisturizer, makeup, sunscreen or hair product, suspect a reaction. The NHS calls this contact dermatitis, a type of eczema triggered by contact with a particular substance. It says the skin becomes itchy, blistered, dry and cracked, that lighter skin can turn red and darker skin can turn dark brown, purple or grey, and that it most commonly affects the hands and face.

The NHS lists two kinds:

• Irritant reactions, which it says are most commonly caused by soaps and detergents, solvents or regular contact with water. Perfumes and preservatives in toiletries or cosmetics are on its list of irritants. Symptoms range from mild dryness, redness, burning or stinging to painful blisters.
• Allergic reactions, in which the immune system reacts to a substance. The NHS lists cosmetic ingredients such as preservatives and fragrances among common allergens.

The NHS says contact dermatitis usually improves or clears up completely if the substance causing the problem is identified and avoided. Stop the new product, go back to a plain fragrance-free cleanser and moisturizer, and watch the patch. The NHS says to see a GP if symptoms are persistent, keep coming back or are severe. The NHS says a GP may refer you to a dermatologist for more tests if the cause cannot be found. Before your next new product, patch test it on a small area first.

Dry patches from acne treatment

Acne treatments often cause dry, flaky patches where they go on, especially around the mouth and nose. The AAD says benzoyl peroxide, salicylic acid, retinoids such as adapalene and tretinoin, and isotretinoin tend to dry and irritate the skin, and that a daily moisturizer helps skin tolerate them. The NHS lists dry or peeling skin as a common side effect of benzoyl peroxide.

This dryness is expected and usually settles. Skinli's plans say dry, red or peeling skin in weeks 2 to 4 is normal with the treatment gels. For an over-the-counter product, use it less often and add more moisturizer. For a prescribed treatment, keep using it and ask your doctor before changing anything. Retinoid dryness and peeling covers the steps in detail.

Seborrheic dermatitis

Seborrheic dermatitis is a common rash that many people mistake for dry skin. The AAD says it causes a scaly rash that appears on oily areas of the body. On the face, the AAD lists the forehead, eyebrows (between and underneath), eyelids, the sides of the nose, around the mouth and the beard area, and the ears. It also appears on the scalp, the back of the head and neck, and the chest.

Signs the AAD describes:

• dry, flaky skin that is more noticeable where there is a rash or hair
• a rash that can be dry, have greasy scales, or both
• skin that tends to be oily in some areas and dry in others, which can look like combination skin
• on darker skin, a rash that is darker than your natural skin tone, or light spots; on lighter skin, a red rash
• an itch that is usually mild

The clue is location and pattern. Flakes that keep coming back beside the nose and in the eyebrows, point to this rash more than to ordinary dryness, especially with flakes on the scalp too. A doctor can confirm it and recommend treatment, and the AAD says the itch and burning go away with effective treatment.

Dry patches on darker skin

Dry patches can look different on brown and black skin, which makes them easy to misread. The AAD's page on dry skin in darker skin tones says flaking, discoloration and rough texture are more noticeable than in lighter skin, and dry skin can look whitish or grayish-white. A dermatologist quoted there says a moisturizer with ceramides can reduce that whitish look.

Rashes change color by skin tone too. The NHS says contact dermatitis can turn darker skin dark brown, purple or grey, where lighter skin turns red. The AAD says seborrheic dermatitis on the face often looks darker than your natural skin tone, or shows as light spots, on darker skin. That same AAD page on dry skin in darker skin tones warns that some people live for years with an undiagnosed skin condition, thinking their skin is just too dry for moisturizer to work.

Other conditions a doctor should check

Some dry, flaky patches come from skin conditions that need a diagnosis:

• Eczema. The NHS says atopic eczema can make the skin dry, cracked, crusty, scaly or thickened, and red, white, purple or grey, or lighter or darker than the skin around it depending on skin tone. It says to see a GP if you have symptoms of it or treatments are not helping.
• Psoriasis. The AAD lists psoriasis among conditions that can cause excessively dry skin.
• Rosacea. The NHS lists dry skin among its possible symptoms, along with redness that comes and goes and a burning or stinging feeling when using water or skincare products.
• A spot that changes. The AAD says new spots or moles that itch, bleed or change color are often early warning signs of skin cancer, and to see a dermatologist about any spot that seems suspicious.

What to do first, for any dry patch

These first steps come from the AAD, NHS and MedlinePlus advice above:

1. Stop anything new. Any product started in the last few weeks goes on hold.
2. Stop scrubbing and exfoliating. A dermatologist in the AAD's moisturizer guide says people often make the mistake of exfoliating dry, peeling skin, which removes more moisture.
3. Wash gently. Lukewarm water and a mild, fragrance-free cleanser. The AAD says products with alcohol or fragrance can irritate dry skin.
4. Moisturize damp skin. Apply a fragrance-free cream or ointment right after washing and whenever the patch feels tight. MedlinePlus says moisturizers work best on damp skin.
5. Wait two weeks and look again. Take a photo on day one and day 14 in the same light, so you can compare.

When to see a doctor

See a doctor or dermatologist if a patch:

• has not improved after two weeks of the steps above
• keeps coming back in the same place, especially beside the nose, in the eyebrows or along the hairline
• is cracked, bleeding, oozing, crusted or painful
• itches so much that it keeps you awake, which MedlinePlus lists as a reason to contact a provider
• is a single spot that is new, growing, bleeding or changing color

Dry, cracked or itchy skin that does not improve can be eczema or another condition, and a doctor can tell which one and prescribe treatment. To check your overall skin type once the patches have settled, see how to find your skin type.