Asteatotic Eczema: Causes, Symptoms, Treatments, and More

Asteatotic eczema is characterized by dry, cracked, and itchy skin. It occurs when the skin loses water, often due to reduced humidity in the air. To manage the symptoms, doctors may recommend gentle skin products, using a humidifier, or applying topical steroids. Asteatotic eczema may also be called eczema craquelé or xerotic eczema. While it often affects the lower legs, it may also develop on other parts of the body like the thighs or arms.

Read on to learn more about asteatotic eczema, including its causes, symptoms, treatment, and prevention.

Asteatotic eczema develops when the skin loses water. This can occur due to environmental factors, such as living in a dry climate like the desert or at high altitudes.

The winter months can also cause a flare-up due to reduced humidity. Bathing excessively and using harsh products that compromise the skin barrier may also play a role.

Some less common causes include:

• medications like diuretics, which increase the excretion of salt and water from the body
• nutritional deficiencies
• hypothyroidism
• some types of cancer or cancer treatments

Learn more about 7 common eczema triggers.

Asteatotic eczema symptoms include skin that is:

• dry
• cracked
• itchy
• flaky
• inflamed

Though it frequently develops on the lower legs, other parts of the body may also be affected. For example, some people may experience patches of asteatotic eczema on their thighs, arms, or chest.

Learn more about what eczema looks and feels like on skin of color.

Dermatologists typically diagnose asteatotic eczema by performing a physical exam, asking about your symptoms, and evaluating your medical history. Though a skin biopsy is usually unnecessary, a microscopic examination can allow the dermatologist to identify signs of inflammation and disruptions to the skin barrier.

Your doctor may perform additional tests if they suspect an underlying condition like hypothyroidism.

Treatment for asteatotic eczema typically involves rehydrating the skin.

You may be able to manage asteatotic eczema at home with over-the-counter (OTC) products like lotions containing a high oil content. The American Osteopathic College of Dermatology also recommends applying an emollient like Vaseline within 3 minutes of bathing or showering and applying a gentle moisturizer throughout your day.

If you bathe frequently, it may help to reduce the frequency to allow your skin to heal. Keeping showers short and using gentle, fragrance-free soaps can also be beneficial.

If you live in a dry environment, using a humidifier in your home can help decrease water loss from your skin. It may also help to wear loose clothing to avoid irritating your skin.

This condition can be very itchy. For mild asteatotic eczema, low-potency topical steroids like hydrocortisone cream and emollients can relieve itching and protect the skin barrier. Topical steroids can cause side effects like skin thinning. Talk with your doctor about how long you should use them.

For people with severe asteatotic eczema, prescription topical steroids may be needed. These may include:

• triamcinolone (Cinolar)
• fluocinolone (Synalar)
• betamethasone (Betamethacot)

Other treatments may be required if you have an underlying condition contributing to asteatotic eczema. Talk with a dermatologist about a treatment plan.

Learn more about managing advanced eczema.

With treatment, the outlook for people with asteatotic eczema is favorable. The condition generally responds well to treatment, and removing factors like harsh soaps can further contribute to healing.

There may be an increased potential for the skin to become infected due to the deep skin fissures associated with severe asteatotic eczema. Follow your dermatologist’s treatment plan as closely as possible.

People who live in dry climates or at high altitudes may be more likely to develop asteatotic eczema due to the reduced humidity in these environments. In addition, people who bathe frequently or use harsh skin products may be more susceptible.

Asteatotic eczema is more common in older adults. The condition, though, can occur as well in younger people.

The National Eczema Society provides several recommendations for preventing asteatotic eczema:

• Avoid prolonged exposure to sources of high heat, such as fires or radiators, which can dry out your skin.
• Limit your time in the shower or bath to 10–15 minutes.
• Use warm water instead of hot when bathing.
• Use gentle skin products and moisturize frequently.
• Try to raise the humidity of the air in your home. You can place a bowl of water in each room or use a humidifier.

Joan Paul, M.D., M.P.H., DTMH, reviewed the answers to these common questions about asteatotic eczema.

Yes, asteatotic eczema can be very itchy. To relieve itching, your dermatologist may recommend topical steroids in addition to emollients.

Asteatotic eczema is more common in older adults but can occur in younger people as well.

Asteatotic eczema occurs when the skin loses water. Contributing factors include dry environments, excessive bathing, and harsh skin products.

You may be able to manage the condition at home with OTC lotions, emollients, and steroid creams. Limiting your time in the shower and using warm water instead of hot may also be beneficial.

A dermatologist may need to prescribe a more potent topical steroid treatment for severe cases.

Talk with your dermatologist about ways to manage and prevent asteatotic eczema.