Asteatotic Eczema

By Dr. Eddie Valenzuela

Asteatotic eczema is an inflammatory skin condition that’s caused by very dry skin. Sometimes called xerotic (dry) eczema or craquelé (French for cracked) eczema, asteatotic eczema is characterized by a red, dry, and itchy rash that resembles cracked paving stones.

The most common symptoms of asteatotic eczema include diamond-shaped patches or plates of skin separated by red bands and dry, flakey patches of skin on the shins, lower legs, thighs, chest, and arms. In some cases, severe asteatotic eczema can cause swelling and surface blistering.

Causes of Asteatotic Eczema

Asteatotic eczema is mostly caused by water loss of the stratum corneum, otherwise known as extreme skin dryness.

The outer layers of our skin need 10-20% water concentration in order to stay healthy, and the free fatty acids that live in our skin help hold onto that necessary moisture. Most people that suffer from asteatotic eczema have a large decrease in free fatty acids, and when there is a loss of those fatty acids, our skin can lose moisture 75% times more than healthy skin.

This moisture loss causes skin cells to shrink and lose elasticity, creating the characteristic asteatotic eczema cracks or fissures on the skin’s surface. Sometimes these fissures are so deep that they injure the small blood vessels in the skin, which causes superficial bleeding and redness. The moisture loss can also cause itchy skin, sometimes called pruritis, which is another common symptom of asteatotic eczema.

The skin barrier and its important fatty acids can be damaged or lost in a variety of ways, including:

  • Genetic predisposition
  • Old age
  • Low humidity
  • Medication and steroid use
  • Neurologic disorders
  • Use of harsh products
  • Excessive bathing
  • Lack of moisturizing

Who Can Get Asteatotic Eczema?

Anyone with very dry skin is at risk for asteatotic eczema, but it most often affects people that are:

  • Elderly
  • Suffering from underactive thyroids or have malnutrition
  • Undergoing antiandrogen therapy
  • Using retinoids, protein kinase inhibitors, or diuretics
  • Bathing without moisturizing
  • Scarred or have hypoesthetic skin

Treating Asteatotic Eczema

Though asteatotic eczema can be very uncomfortable and looks very serious, it generally responds well to treatment and clears up quickly. The best ways to treat asteatotic eczema are:

  • Avoiding environmental factors that cause dry skin like hot baths and direct heat or extreme cold
  • Stopping use of harsh products like soaps, detergents, or other household items with irritating ingredients and fragrances
  • Cleansing skin with a gentle body wash for eczema
  • Applying an over-the-counter topical steroid cream, such as a hydrocortisone cream
  • Applying a more potent, prescription cream for severe cases

The best way to treat asteatotic eczema is to make sure the skin stays moisturized, as dry skin can cause a future flare-up of the rash. Use a cream, lotion, or emollient with a high oil content at least twice a day, but especially after bathing or showering. A baby eczema cream, like Dr. Eddie’s Happy Cappy Moisturizing Cream for Eczema, can offer the necessary hydration without irritating ingredients. Not a baby? This cream while made for children of all ages is entirely appropriate for adults of all ages too.

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Dr. Eddie Valenzuela is an award winning pediatrician and the founder and CEO of Pediatric Solutions, LLC.

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