Recognizing the Symptoms of Malnutrition in Adults' Skin

October 21, 2025 •

4 min read

According to a 2025 study in the journal Nutrients, deficiency is widespread among hospitalized adults, manifesting as slow wound healing and other complications. Recognizing the subtle symptoms of malnutrition in adults' skin is crucial for early intervention and better health outcomes.

Quick Summary

This article details the various skin manifestations of malnutrition in adults, including dryness, rashes, pigmentation changes, and impaired wound healing. It explains how deficiencies in specific nutrients, such as vitamins, minerals, and protein, impact skin health and presents a comparative guide to recognizing these signs. Timely intervention is emphasized for managing and reversing these skin issues.

Key Points

Dry, Flaky Skin: A common symptom often caused by deficiencies in essential fatty acids, vitamin A, or zinc, resulting from a compromised skin barrier.
Distinctive Rashes: Specific deficiencies, like niacin (pellagra) or zinc (acrodermatitis enteropathica), produce characteristic rashes on exposed or specific areas of the body.
Skin Color Changes: Malnutrition can cause a pale, sallow complexion (due to iron or B vitamin deficiency) or hyperpigmentation in certain areas (linked to vitamin B12 deficiency).
Impaired Healing: Slow wound healing, easy bruising, petechiae, and purpura often indicate a lack of vitamin C, essential for collagen synthesis and vascular strength.
Protein-Energy Manifestations: Severe protein deficiencies can present with significant edema (kwashiorkor) or thin, wrinkled skin from muscle and fat wasting (marasmus).
Correcting Deficiencies: The primary treatment for these skin issues involves restoring nutrient levels through diet, fortified foods, or supplements, often resolving the dermatological symptoms.

Malnutrition can profoundly affect the body, with many of the earliest and most visible signs appearing on the skin. In adults, these symptoms can range from subtle changes in texture and color to more severe rashes and delayed healing. Identifying these dermatological markers is a vital step toward diagnosis and treatment, as correcting the underlying nutritional deficiencies can often reverse these skin problems.

Common Skin Symptoms of Malnutrition

Dry, Flaky, or Scaly Skin

One of the most frequent signs of malnutrition is the development of dry, rough, or scaly skin, a condition known as xerosis. This can be a result of insufficient essential fatty acids, which are critical for maintaining the skin's lipid barrier and moisture retention. In severe cases, particularly with protein-energy malnutrition (PEM), the skin can take on a classic "flaky paint" appearance where patches peel away.

Vitamin A deficiency: Can lead to dry, scaly skin and a condition called phrynoderma, or "toad skin," characterized by firm, follicular, hyperkeratotic papules.
Zinc deficiency: Often causes dry, rough patches, especially around the mouth, hands, and feet.

Skin Rashes and Lesions

Nutrient deficiencies can trigger distinctive rashes and skin lesions. These can be easily mistaken for other skin conditions, making a nutritional assessment crucial for proper diagnosis.

Niacin (B3) deficiency (Pellagra): Results in a characteristic dermatitis, particularly on sun-exposed areas. The rash resembles a sunburn, progressing to rough, scaly, hyper-pigmented plaques and a telltale "Casal's collar" around the neck.
Zinc deficiency: Can cause a specific type of dermatitis, often around the mouth, hands, and feet, featuring erythematous and pustular lesions.
Riboflavin (B2) deficiency: May lead to a seborrheic dermatitis-like facial rash, primarily affecting the nasolabial folds and forehead.

Changes in Skin Color and Bruising

Malnutrition can significantly affect skin pigmentation and vascular integrity, leading to a variety of color changes and easy bruising.

Pale or Sallow Complexion: Iron and certain B vitamin deficiencies can cause anemia, leading to a pale or sallow skin tone due to reduced hemoglobin and oxygen supply.
Hyperpigmentation: Deficiencies in vitamins B12 and folate can result in patches of dark, brownish pigmentation, often accentuated in the creases of the palms and on the knuckles.
Easy Bruising (Petechiae and Purpura): A lack of Vitamin C, which is vital for collagen synthesis, weakens blood vessels, causing them to rupture easily. This leads to small red or purple spots (petechiae) or larger areas of bruising (purpura).

Slow or Impaired Wound Healing

The skin’s ability to repair itself is highly dependent on an adequate supply of nutrients. Deficiencies can significantly delay the healing process.

Vitamin C deficiency: Crucial for collagen production, a lack of vitamin C slows the healing of cuts, scrapes, and bruises.
Zinc deficiency: Essential for cell growth and repair, low zinc levels can impair wound healing.

Protein-Energy Malnutrition Manifestations

In severe cases of protein-energy malnutrition, different patterns of skin changes can be observed, particularly in the forms of kwashiorkor and marasmus.

Kwashiorkor: This severe protein deficiency is characterized by edema (swelling) and a shiny, "varnished" look to the skin. Areas of pressure and friction may show erythematous or violaceous patches that later peel.
Marasmus: In contrast, severe calorie and protein deficiency leads to significant fat and muscle loss, causing the skin to become thin, lax, and wrinkled.

Comparison of Key Nutritional Deficiencies and Their Skin Symptoms


Nutrient Deficiency	Typical Skin Symptoms	Associated Systemic Symptoms
Vitamin A	Dry, scaly skin (xerosis), phrynoderma ("toad skin"), impaired wound healing.	Night blindness, frequent infections, weakened immune system.
Vitamin C	Easy bruising (petechiae/purpura), slow wound healing, dry/rough skin, bumpy skin.	Bleeding gums, joint pain, fatigue, weakened immunity.
Iron	Pallor (pale skin), dry skin, pruritus (itching), angular cheilitis (cracks at mouth corners).	Fatigue, shortness of breath, cold hands and feet.
Zinc	Perioral/acral dermatitis (rash around mouth, hands, feet), slow wound healing, hair loss.	Diarrhea, loss of appetite, mood changes.
Niacin (B3)	Photosensitive dermatitis (sunburn-like rash on exposed skin), hyperpigmented plaques, Casal's collar.	Diarrhea, dementia (the 3 D's of Pellagra).
Protein	Dull, dry skin, weakened skin barrier, thin/wrinkled skin, edema (kwashiorkor).	Muscle wasting, fatigue, apathy.

Seeking Diagnosis and Treatment

If you or a loved one notice these skin symptoms, especially in conjunction with other signs like fatigue, weight loss, or weakness, it is important to consult a healthcare professional. A thorough evaluation, including a nutritional assessment, can determine the cause of the deficiencies.

The Path to Recovery

Diagnosis: Blood tests can confirm specific vitamin and mineral deficiencies. A doctor can also evaluate the underlying cause of malnutrition, which can range from poor diet to medical conditions affecting absorption.
Nutritional Support: Treatment involves correcting the identified deficiencies through dietary adjustments, fortified foods, or targeted supplements.
Addressing Underlying Issues: If malnutrition is a secondary effect of another illness, such as an eating disorder or chronic disease, addressing that primary condition is essential for long-term recovery.
Skin Care: While nutritional correction is the main focus, topical treatments may be used to soothe skin symptoms and prevent secondary infections.

Conclusion

Skin symptoms of malnutrition in adults serve as important indicators of a deeper health issue. While easily confused with other dermatological problems, their specific appearance—from dry, flaky patches to bruising and rashes—often points towards specific nutritional gaps. Prompt medical evaluation and nutritional rehabilitation are key to restoring both skin health and overall well-being. By understanding these signs, individuals can take proactive steps toward recovery and improved quality of life. The skin's journey back to health is a reflection of the body's internal healing process once adequate nutrition is restored.

A Guide to Malnutrition Care

Source: National Center for Biotechnology Information (NCBI)

Frequently Asked Questions

Yes, while acne has many causes, studies have linked low vitamin A levels to its presence. Vitamin A promotes skin development and fights inflammation, and topical or oral vitamin A can help reduce acne lesions.

Malnutrition impairs wound healing because key nutrients essential for tissue repair are lacking. For instance, Vitamin C is crucial for producing collagen, a primary component of healthy skin, and its deficiency slows down healing significantly.

Pale skin can be a sign of anemia, which is often caused by a deficiency in iron or certain B vitamins. These nutrients are necessary for producing hemoglobin, which carries oxygen in the blood. A lack of oxygen reaching the skin can cause it to appear pale.

The 'flag sign' is a distinctive pattern of light and dark bands in the hair, which reflects alternating periods of malnutrition and adequate nutrition. It is particularly associated with severe protein deficiencies like kwashiorkor.

Yes, malnutrition can lead to dry, itchy skin (pruritus). This can be caused by deficiencies in nutrients like iron or vitamin E. Scratching the itchy skin can sometimes cause a rash-like appearance.

Zinc deficiency can cause a specific dermatitis, often seen in a periorificial (around body openings) and acral (hands, feet) distribution. The rash may appear as erythematous, pustular, or erosive plaques and is sometimes mistaken for other skin irritations.

Yes, it is possible to be malnourished even if you are not underweight. This can happen due to specific micronutrient deficiencies (like vitamins or minerals) or in cases of overnutrition, where an individual consumes excess calories but lacks essential nutrients.