What Is Asteatotic Eczema?

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Asteatotic eczema occurs when your skin gets too dry, causing itchy, cracked skin. This condition is also called xerotic eczema or eczema craquelé. While this condition is most common in people who are older, it can affect adults at any age.

Learn more about the symptoms, causes, diagnosis, treatment, and how to cope with asteatotic eczema.

Tips for Coping With Asteatotic Eczema

Verywell / Jessica Olah

Asteatotic Eczema Symptoms

Asteatotic eczema causes symptoms that are common with a variety of skin disorders. However, asteatotic eczema most often affects the shins, thighs, chest, or arms. Symptoms can include:

  • Redness
  • Dry, scaly skin
  • Pain
  • Cracked skin
  • Itching
  • Weeping/leaking of fluid
  • Crusted skin
  • Bleeding
Asteatotic Eczema ( Craquel)

Reproduced with permission from ©DermNet NZ www.dermnetnz.org 2022

Collectively, these symptoms are called xerosis. But because they most often occur in the winter months, this condition is sometimes called winter itch.

Cracked Pavement Appearance

Asteatotic eczema creates distinct-looking cracks in the outermost layer of the skin, which are sometimes described as "cracked pavement" or a "dried-up river bed."


Asteatotic eczema develops when your epidermis, or top layer of skin, becomes excessively dry. Although your skin might appear to be rather thin, the epidermis is actually made up of five layers.

When skin is properly hydrated, skin cells plump up with water and form a barrier to help protect against injury and keep bacteria from entering your body. Your skin also produces oil (sebum) from sebaceous glands, which forms a barrier to help keep water in your skin.

When the top layer of your skin loses water, it becomes dehydrated, making you more prone to asteatotic eczema. This commonly occurs during the winter months, when humidity is lower. Soaps or other hygiene products can also remove oil from the skin, causing it to dry out.

Asteatotic eczema is common in the older population. As a person gets older, their sebaceous glands often don't produce as much oil as they used to. This makes the person's skin more likely to dry out.

This condition is also more likely to occur in skin that has decreased sensation or scar tissue that has formed as a result of injury.


Asteatotic eczema is diagnosed by a doctor during a physical exam. The doctor will ask questions about how your symptoms started and what makes them worse.

Asteatotic eczema produces fissures or patterned lines in the affected area, which makes it easier to identify. However, additional testing might be performed to rule out other possible causes of your symptoms, such as allergies.

Allergy testing is performed in a few different ways. Patch testing involves placing a small amount of a variety of possible allergens, or substances that could trigger your symptoms, on patches that are then placed on the skin of your back. This type of testing takes several days.

The prick test is the most common type of allergy testing performed. This is not usually needed in the evaluation of rashes like eczema. Instead, skin prick testing is often used to diagnose other types of allergies like environmental allergies that cause itchy eyes and a runny nose.

The doctor will scratch a small amount of the suspected allergen into your skin and observe for a response. This test is much quicker and provides results within about 30 minutes.

Blood tests can also be performed to look for other causes of skin itching. It could be caused by liver disease, kidney disease, and certain types of cancer.


Moisturizing your skin is a key part of treatment. Using a cream or petroleum-based emollient within three minutes of showering helps lock in water before it can evaporate. Moisturizing throughout the day is also recommended.

Choose a product with a high oil content, such as an ointment or a cream, to help seal in the moisture. Your skin will feel "greasy" after applying these products. While lotions might absorb more easily, they have a high water content and evaporate quickly from your skin.

Topical medications (applied directly to the skin) are also often used to treat severe cases of asteatotic eczema. Your doctor might prescribe a steroid cream to decrease inflammation and itching of your skin.

Topical calcineurin inhibitors and topical phosphodiesterase-4 inhibitors are also sometimes prescribed to counteract cells in your immune system that are causing your skin to be inflamed. If your symptoms are severe, you might need oral steroid medications as well.

The prognosis of asteatotic eczema is different for everyone. This condition typically develops later in life and can be chronic, meaning you'll deal with flare-ups for the long haul. Maintaining a consistent skin care routine and avoiding triggers whenever possible can reduce your chances of chronic symptoms of eczema.


In addition to moisturizing and medications, there are many things you can do at home to help treat and prevent further flare-ups of asteatotic eczema. These include:

  • Avoid common irritants: Even if you're not allergic to the ingredients in your personal care products, things like fragrances or dyes can further irritate skin that is affected by eczema. Choose products made for "sensitive skin" that are free from scents, dyes, and preservatives.
  • Take short showers or baths: Avoid excessive time in the shower or tub.
  • Pat, don't rub: Use a soft towel to pat your skin dry after your shower or bath. Rubbing can cause further damage to your skin.
  • Stay comfortable: Wear loose-fitting clothing over the parts of your body affected by asteatotic eczema. Choose materials that "breathe," such as 100% cotton. Avoid fabrics that can irritate the skin further, like wool.
  • Use a humidifier: Add moisture to the air in your home with a humidifier. This can be particularly helpful during the winter months, when humidity is lower.
  • Keep a constant temperature: Avoid sudden, drastic changes in temperature, which can trigger an eczema flare-up. Keep your thermostat at a consistent setting and avoid the temptation of sitting right next to a fire or heater.


Asteatotic eczema is caused by your skin becoming dry. It's common in older people, who have reduced oil production in their skin. The skin can have itchy, dry fissures. It is treated with moisturizer, lifestyle measures, and sometimes with steroid ointment or prescription medications.

A Word From Verywell

Although asteatotic eczema is uncomfortable, you can take steps to improve your quality of life during a flare-up. Be proactive: Follow a good skin care routine and avoid triggers whenever possible.

Frequently Asked Questions

  • What is asteatotic vs. atopic eczema?

    Asteatotic eczema occurs when your skin gets too dry. Atopic eczema is another skin condition with skin dryness that can lead to redness and itching. Some people with asteatotic eczema can also have atopic eczema. In atopic eczema, people usually develop symptoms early in life. They may have additional atopic disorders like asthma, life-threatening food allergy, or environmental allergies with symptoms like those seen in hay fever.

  • How do you treat asteatotic eczema?

    Asteatotic eczema is treated with topical medications and a good skin care routine.

  • Will eczema go away?

    Eczema is typically a chronic condition, but symptoms can come and go. When your symptoms are worse, you're experiencing a flare-up.

  • What happens if eczema is left untreated?

    Ignoring your eczema won't make it go away. Skin that becomes more irritated can eventually bleed, increasing your risk of infection.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Osteopathic College of Dermatology. Asteatotic eczema.

  2. National Cancer Institute. Layers of the skin.

  3. National Eczema Society. Our skin and eczema.

  4. Cassler NM, Burris AM, Nguyen JC. Asteatotic eczema in hypoesthetic skin: a case seriesJAMA Dermatol. 2014;150(10):1088.  doi:10.1001/jamadermatol.2014.394

  5. American College of Allergy, Asmthma, & Immunology. Testing & diagnosis.

  6. National Eczema Association. Controlling eczema by moisturizing.

  7. National Eczema Association. Prescription topicals.

  8. American Academy of Dermatology Association. Eczema types: Atopic dermatitis: Tips for coping.

By Aubrey Bailey, PT, DPT, CHT
Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living.