Asteatotic eczema – Complete guide

Asteatotic eczema is also known as eczema craquelé. It is another form of eczema that is more common in older people. It usually affects the shins, but can also affect other areas such as the thighs, tummy, arms, and back. If your home is warm and dry during the winter, you will be prone to develop this type of eczema. In asteatotic eczema, the skin becomes very dry, scaly, and rough.

What causes asteatotic eczema?

Drying of the skin (more common during the winter season) can cause epidermal water loss and this will lead to asteatotic eczema. Medications such as diuretics can increase the drying effect. Other factors include decreased sebaceous and sweat glands in the elderly, friction, and prolonged baths.

How to treat asteatotic eczema?

  • Emollients: emollients can help to keep the skin smooth and moisturized. It can brought over the counter in pharmacies, supermarkets, or can also be obtained on prescription. There are a wide range of emollients you can choose from (depends on the greasiness). the more drier the skin, the more greasier an emollient is needed. you can also look for emollients containing N-palmitoylethanolamine (PEA) and N-acetylethanolamine (AEA). These are phospholipids that can help with the itching and improve skin barrier.
  • Emollients for washing and bathing: soaps, bubbles, and shower gels can dry out the skin. It’s best to use a leave-on emollient/emollient wash product as a soap substitute. Emollient bath oils can make the bath more slippery, so make sure to use non-slip bath mats to help reduce the risk of falling (or you can use support bars fixed to the wall in the shower).
  • Topical steroids: can help reduce inflammation and reduce red, sore, and cracked skin. It can also make the skin dry so do use emollients. Low potency steroids include desonide and hydrocortisone and are useful for mild disease.
  • Corticosteroids: patients with moderate disease should receive medium or high potency corticosteroids (fluocinolone, triamcinolone, and betamethasone). Emollients should continue to be used with corticosteroids.
  • Antihistamins: if itchiness does intefere with sleep, then antihistamins can help.
  • Humidifier: using a humidifier can also help.

How to reduce the risk of developing asteatotic eczema?

  • Avoid sitting right next to a fire, radiator, or another heat source.
  • Don’t spend too long in the bath (10-15 mins is ideal). Make sure to bath in cold water or lukewarm as bathing on hot water can make the skin very dry.
  • Avoid soap when bathing or showering and vigorous toweling. Make sure to use plenty of emollient to keep the skin moisturized and also for washing/bathing.
  • Try to keep the air in the room moist (a bowl of water in each room should help).