Understanding Asteatotic Eczema

Asteatotic eczema, also known as eczema craquelé or xerotic eczema, is a type of eczema triggered by dry skin. The first signs of dry skin, or xerosis, may include skin that is:

• scaly
• cracked
• red
• inflamed

Over time, as your epidermis continues to lose water, asteatotic eczema can develop. This water loss leads to the development of “fissures” in your skin, which appear as red, patterned lines.

Asteatotic eczema can appear anywhere on the body, but the most common locations are on your arms, legs, and torso. It may also appear on smaller patches of skin, such as on your ears, fingers, or toes.

People can develop asteatotic eczema from:

• environmental causes
• underlying conditions
• nutrient deficiencies
• medications

These are discussed in more detail below.

Environmental causes

Cold weather and dry atmospheres can lead to a decrease in humidity and an increase in dry skin and the risk of asteatotic eczema. In addition, soaps, detergents, and other harsh products that dry out your skin can increase the risk of developing asteatotic eczema.

Underlying conditions

Certain health conditions have been linked to asteatotic eczema, including:

• hypothyroidism
• lymphoma
• nephrotic syndrome

Asteatotic eczema may develop as a rare side effect of these conditions or as a result of untreated dry skin caused by these conditions.

Nutrient deficiencies

Dietary imbalances, malabsorption, and other underlying gastrointestinal conditions can lead to nutrient deficiencies.

Research from 2019 has suggested that deficiencies in certain nutrients, such as vitamin D, selenium, and zinc, may have an impact on conditions like eczema.

For asteatotic eczema specifically, zinc and essential fatty acid deficiencies have been reported.

Medications

According to the American Academy of Dermatology (AAD), certain medications, such as statins and diuretics, can cause dry skin. If left untreated, this dry skin may develop into asteatotic eczema.

Although there are many potential causes of asteatotic eczema, certain risk factors make this condition more likely to develop.

Age

Skin conditions become more common as we age due to underlying changes in the integrity of the skin cells. Older adults who struggle with dry skin are more at risk of developing asteatotic eczema, according to a 2019 review.

Dry skin

Dry skin can appear at any age and is often caused by environmental factors, such as cold weather or frequent bathing. People who struggle with dry skin because of these factors are more likely to develop asteatotic eczema.

Lower humidity

Low levels of humidity occur when the weather is cold, dry, or both. Over time, low humidity levels can cause dry skin, which may become asteatotic eczema if not treated.

Frequent bathing

While bathing helps restore moisture to your skin, doing it too often can produce the opposite effect — especially if the water is extremely hot. Research from 2020 has suggested that frequent bathing is a risk factor for asteatotic eczema.

Harsh chemicals

Many of the bath and shower products on the market contain chemicals and fragrances that can cause dry skin. These harsh chemicals increase the risk of asteatotic eczema if they dry out your skin too much.

Symptoms of asteatotic eczema generally start with the classic symptoms of dry skin. When your skin is dry, you may notice that it is:

• white
• flaky
• tight
• itchy
• scaly
• cracked
• inflamed

As asteatotic eczema develops, your skin may begin to look as if it’s been marked or scratched. Thin, red lines called fissures can appear on the skin in a geometric-like pattern. These fissures often surround large, dry patches of skin.

Without treatment, asteatotic eczema can cause your skin to become swollen and inflamed. Untreated asteatotic eczema can also lead to a condition called nummular dermatitis, which is characterized by coin-shaped skin lesions.

Like many other types of eczema, asteatotic eczema is treated with topical and oral medications and lifestyle changes.

Generally, treatment for eczema begins with daily use of moisturizers and other emollient-containing products. This helps restore moisture to your skin barrier and reduce inflammation and other symptoms.

Medicated ointments and creams can also help speed up recovery during a flare-up. Topical treatment options for asteatotic eczema may include:

• Corticosteroids. Topical steroids are often the first treatment prescribed for atopic dermatitis.
• Calcineurin inhibitors. Calcineurin inhibitors help reduce inflammation and are often prescribed with corticosteroids. Pimecrolimus and tacrolimus are two commonly prescribed calcineurin inhibitors.
• Lipids. Lipids play an important role in maintaining the protective barrier of the skin. One 2014 study found that topical application of two endogenous lipids, N-palmitoylethanolamine (PEA) and N-acetylethanolamine (AEA), greatly improved skin function and hydration.

In some cases, oral antihistamines can help prevent the itching associated with an asteatotic eczema flare-up.

For more severe asteatotic eczema, stronger medications may be prescribed, such as oral steroids or other anti-inflammatory medications. However, these are prescribed only in rare cases for asteatotic eczema.

In most cases, asteatotic eczema can be prevented with a few simple lifestyle changes.

If you live in an area that’s frequently cold or dry, make sure to keep your skin moisturized year-round and consider investing in a humidifier.

If you take frequent baths or showers, consider bathing less, turning down the heat, and using natural products instead.

If you’re at risk of developing asteatotic eczema as a symptom of another condition or as a side effect of a medication, speak with your doctor about how to prevent flare-ups.

Here are some home remedies that may help reduce the symptoms and severity of an asteatotic eczema flare-up at home:

• Oatmeal. Colloidal oatmeal is beneficial for a variety of skin conditions, including xerosis and atopic dermatitis. It can be used in the bath to create a soothing mixture for inflamed skin.
• Plant oils. One 2012 study found that sunflower oil can help improve the stratum corneum — or outermost layer — of your skin. Similar benefits have been observed with coconut oil, which has a host of positive benefits for people with eczema.
• Botanicals. Herbal preparations and essential oils have been used for thousands of years as alternative medicine. Some people report that certain essential oils, such as tea tree and calendula, may help reduce the symptoms of severe eczema. However, herbal preparations and essential oils can be common causes of allergic contact dermatitis. Always speak with your doctor or healthcare professional before using them.

Reach out to a healthcare professional or dermatologist for more suggestions on easing your asteatotic eczema symptoms at home.

Asteatotic eczema generally responds well to treatment and tends to resolve in a matter of days or weeks, depending on severity and treatment.

For asteatotic eczema caused by other underlying conditions, those conditions may need to be treated before treatment for the asteatotic eczema becomes effective.

For asteatotic eczema caused by medications, your doctor may want to discontinue or change these medications to treat the eczema.

Although asteatotic eczema isn’t permanent, it can persist and recur unless special care is taken to reduce the underlying triggers.

Asteatotic eczema develops from dry skin, most commonly as a result of environmental factors.

This type of eczema is characterized by dry, itchy skin that develops into scaly patches surrounded by thin, red fissures.

Treatment for asteatotic eczema is very similar to standard treatments for eczema and includes topical medications and lifestyle changes.

If you’re experiencing the symptoms of asteatotic eczema, schedule a visit with your doctor or dermatologist for proper diagnosis and treatment.