Asteatotic eczema is a dry, itchy skin condition that typically affects older adults who live in cold, dry areas. It is also known as “eczema craquele.” People with asteatotic eczema usually have patches of dry skin on their shins, but they may also have them on their back, thighs, arms, and belly.

People with asteatotic eczema often experience the condition during colder months, when their skin may be dehydrated. A 2022 paper published by the National Center for Biotechnology Information (NCBI) explains that central heating reduces air humidity, which can cause dry skin.

Most people can treat their asteatotic eczema with moisturizers, but doctors may prescribe topical steroid creams if the symptoms are severe.

This article looks at asteatotic eczema and how to treat it. It also describes potential complications and ways of preventing flares.

People with asteatotic eczema usually have patches of dry, itchy, inflamed skin on their shins. They may notice cracks in their skin that form irregular polygonal patterns similar in appearance to a dried-up riverbed.

The American Osteopathic College of Dermatology (AOCD) notes that although people with asteatotic eczema usually have a rash on their shins, they may also have patches on their thighs, arms, and belly or back.

Sometimes, the cracks in a person’s skin split open and bleed or ooze a watery liquid. Other symptoms include rough, scaly patches and swelling.

According to the NCBI, central heating is a major cause of asteatotic eczema, with more people developing symptoms during winter. Central heating dries the air in a person’s home, and the lack of humidity can dry out their skin.

Age also plays a part. The National Institute on Aging (NIA) explains that as people grow older, they lose sweat and oil glands, which makes their skin drier.

Some lifestyle factors can also affect a person’s skin. Prolonged soaking in a hot bath, washing with some soaps, smoking, and not drinking enough water all contribute to drier skin.

Read more about dry skin in winter here.

The biggest risk factor for asteatotic eczema is age. According to the NCBI, the median age at which doctors diagnose people is 69 years, although people can develop the condition at any age.

People who sit close to their radiators or fireplaces increase their risk of getting dry skin. The National Eczema Association (NEA) explains that dry skin can become brittle, leading to an eczema flare.

If a person scratches their skin or has open cracks or fissures, it can increase the risk of infections, as bacteria and allergens can get in.

Learn more about infected eczema here.

Most doctors diagnose people with asteatotic eczema during a physical exam, especially if the rash has the distinctive fissuring pattern. The AOCD says they may also ask how often the person bathes and what types of soaps or cleansers they use.

The NCBI adds that when people have fissures, they may also have darker patches of skin or little blisters. These are more likely if the person has scratched their skin.

Doctors may recommend a skin biopsy, where they collect a small skin sample and send it to a laboratory for analysis.

Learn about different types of eczema here.

Doctors usually recommend that people with asteatotic eczema use moisturizers at least twice daily to keep their skin hydrated. The NCBI advises using moisturizers with high oil content, as water-based lotions can dry the skin.

Sometimes, doctors prescribe topical steroid creams for people to use alongside their moisturizers. This helps reduce swelling and itching. The NEA recommends applying the steroid cream first and then covering the area with moisturizer.

The NCBI says people can take steps to help prevent flares and promote skin healing. These include:

  • applying moisturizer immediately after bathing
  • reducing the frequency and temperature of baths
  • switching to a milder soap
  • taking additional care when using towels to avoid scratching the skin
  • avoiding sitting too close to a heat source
  • using a humidifier in centrally heated rooms
  • drinking plenty of fluids
  • not wearing wool or other itchy fabrics close to the skin

Learn about treatments for eczema (atopic dermatitis) here.

Asteatotic eczema can be very itchy, and most people scratch their skin at some point. The NCBI warns that this can lead to infections, including lichen planus.

If the crack or fissures in the skin are deep, they may bleed or become infected and seep pus. Other skin sores may also leak a watery liquid. All of these can be very painful and may need extra treatment.

Learn about 16 natural remedies for eczema here.

Most people with asteatotic eczema recover well with treatment and can help prevent flares by keeping their skin well moisturized. However, the NCBI warns that it can recur, and people may need to take preventive steps, such as those above, in winter.

Find 10 tips for preventing eczema flares in winter here.

Below are answers to some commonly asked questions about asteatotic eczema.

Should a person cover eczema or let it breathe?

Most people with asteatotic eczema do not need to cover the rash, but if the itching is intense and the person is scratching it, the NEA recommends wet wrap therapy. This can be particularly helpful if the itch interrupts the person’s sleep or they scratch more at night. People can wet wrap their legs at home.

After applying topical medication and moisturizer, the person wraps the affected area with damp, white cotton gauze. They then cover this with a soft, dry layer before putting on pajamas.

The NEA says the wrapping can stay in place overnight, but people need to ensure it does not dry out.

Learn more about wet wraps for eczema here.

Is sunshine good for eczema?

The sun can dry the skin, which can aggravate an eczema flare. However, some people find that being in the sun improves their symptoms. Some sunscreens contain chemicals that can irritate the skin, but there are many different types, so people can usually find one that works for them.

People may wish to apply sunscreen roughly half an hour after applying moisturizer. The NIA also suggests putting sunscreen on at least 15 minutes before going outside and reapplying it regularly.

Learn more about the sun and eczema here.

Asteatotic eczema typically affects older people who live in colder climates. It causes dry, itchy, inflamed patches of skin, usually on a person’s shins.

Some people develop fissures, or cracks in their skin, which can be painful, and increase the risk of infections.

Doctors recommend people with asteatotic eczema moisturize their skin with an oily emollient to keep it hydrated. They may prescribe topical steroids to reduce the itch.

Most people respond well to treatment, although they may experience flares each winter.