Nicknamed eczema craquele for its dry, cracked appearance that resembles crazy paving, asteatotic eczema can be itchy, painful, and can even cause bleeding when it becomes severe. It usually affects older folks, but it can still occur in much younger people.
No one welcomes the kind of scaly fissures that asteatotic eczema causes. So we’ve outlined some critical deets about what exactly it is, what causes it, and how you can send it packing.
What is asteatotic eczema?
Asteatotic eczema is a type of itchy atopic dermatitis that causes dry, scaling, and inflamed skin. Docs also call it eczema craquele or cracked skin.
Typically, it first shows up as dry skin. As it gets worse, your skin might crack and scale in particular patterns.
The symptoms break out on the lower legs, back, trunk, and arms. Asteatotic eczema most commonly shows up in the winter, when skin is at its driest. Though it can affect anyone, older adults most commonly receive diagnoses of asteatotic eczema due to the effects of aging and dehydrated skin.
Recognizing the patterns of asteatotic eczema and how they look can help you link up with the right treatment. Here’s a picture slideshow that might help.
The most widely recognized cause of asteatotic eczema is the loss of water from the top layer of skin called the stratum corneum. This happens when genetic, environmental, or physical factors trigger an oopsie in the skin’s protective barrier.
We rounded up the most common causes, outlined in research from 2020 (ugh, that year) and 2016 (OMG that sucked, too).
If you live in areas or climates with lower humidity, asteatotic eczema might become a thing for you. It most often pops up during winter months when the air is dryer and you’re running that heater indoors. Using a dehumidifier or heating fan in your home may also lead to asteatotic eczema.
Location also plays a role, as living in typically dry and desert-like areas or high-altitude zones may mean you develop asteatotic eczema more readily.
Folks over 60 years young are at a higher risk of experiencing asteatotic eczema. Their sweat glands are less active. Upside: Less sweaty. Downside: Drier skin.
Infants and toddlers also commonly experience different types of eczema. Their skin dries quickly and is extremely sensitive.
No, malnutrition is not the same as starving. Believe it or not, it’s totes possible to be malnourished and eat three decent meals a day. Malnutrition actually means an imbalance or deficiencies in specific nutrients, vitamins, minerals, fatty acids, or energy.
So if you fill up on nothing but Sour Patch Kids three times daily, you’re probably not going to get a wide enough nutrient profile.
You could develop asteatotic eczema if:
- Your diet doesn’t provide everything you need.
- You’ve got gastrointestinal issues, like malabsorption, that stop you getting enough nutrients from the food you eat.
- You experience weight loss due to an underlying health condition or an eating disorder.
Some meds can trigger asteatotic eczema. Oral retinoids and diuretics, in particular, can dry out your skin, and summon the eczema demon.
Retinoids are chemically related to vitamin A and regulate skin growth. Diuretics make you pee out more water, which can dry out your skin.
Drugs used in hormone replacement therapy may also cause asteatotic eczema.
Excessive bathing and use of soaps
If you like nothing more than a long, relaxing soak in a scalding hot bath, beware. Frequent baths in hot water draw moisture out of the skin and could lead to asteatotic eczema. Some soaps and detergents also have this effect, as many of them contain degreasing agents.
Additionally, overly fragrant soaps and lotions (think Old Spice) may also irritate your skin if it’s already dry and cracked.
Occasionally, asteatotic eczema has links to conditions like lymphoma, leukemia, and solid organ tumors.
Researchers don’t know whether the conditions themselves cause asteatotic eczema or if their treatments contribute to the cause. Nevertheless, there have been cases linking one to the other.
In many cases, docs treat hypothyroidism with diuretics, protein inhibitors, and hormone replacement drugs. Both underactive thyroid and its treatments could trigger a bout of asteatotic eczema.
Symptoms and clinical features
Asteatotic eczema first rears its itchy head as plain ol’ dry skin. As the dermatitis gets worse, your skin becomes itchy, flaky, scaly, and inflamed. If your skin is pale, it may appear red or deeper in color. People with darker skin might find that it appears ashy. Cracks can appear and open up as the skin loses more water.
When this happens, the affected skin develops a pattern that looks like crazy paving or a cracked river bed. These cracks and patches appear sore and irritated, and your skin may crack so severely that it seeps or bleeds.
In some cases, the skin may itch so badly that you can’t stop yourself scratching until it bleeds, leading to yet more skin breaks and — oh, joy of joys — scabs.
Asteatotic eczema typically affects the lower legs, back, tummy, and sometimes the arms. However, it can show up anywhere, like that ex you never wanted to see again.
On your toes
If your toes or fingers are dry and cracked, it could be asteatotic eczema or pompholyx eczema.
This type of eczema begins with a burning sensation then forms painful, inflamed, water-filled blisters. They may even become infected if you’ve been scratchin’ more than a 90s Hip-Hop DJ. So watch out for ouchies on your tootsies.
When the blisters pop, the skin dries out excessively, leading to the appearance of the fissures you can see in asteatotic eczema.
Asteatotic eczema may affect the entire ear or specific areas. The National Eczema Society describes it as “an extremely irritating, and, at times, painful condition.”
In more severe cases, you could lose skin, your ears can become very sore, or you may find that your outer ear becomes infected. This can then spread to the inner ear, which… yeah. Ow.
A doctor or dermatologist needs to examine your skin and diagnose you before they can prescribe treatment for asteatotic eczema. In some cases, they may need to take a biopsy. You’ll need to keep in regular contact with your healthcare professionals to see how your treatment is going, and so they can make any adjustments to your regimen.
The main goal of treatment is to provide ample hydration to the skin. Healthcare professionals may suggest the following treatments:
- lotions and creams with high oil content (to be applied twice a day and always directly after bathing to lock in moisture)
- emollients containing phospholipids and ceramides
- topical steroids and corticosteroids, depending on the severity and response to previous treatment
- other topical agents like pimecrolimus cream
You can usually use a combo of topical emollients and steroids. You can also take other measures to reduce the risk and severity of asteatotic eczema, like taking fewer baths, minimizing your use of harsh or super fragrant soaps and detergents, and using a humidifier during dryer months.
Slathering on moisturizers right after a bath while skin is still damp can also be helpful.
Aside from prescription creams and steroids, you’ve got some options to ease your uncomfortable asteatotic eczema symptoms at home.
- Colloidal oatmeal. You’ll need to get your hands on some whole oats that still have their bran coat. Grind up some uncooked oats in a food processor, then use the powder in a bath, not too hot! You can also find creams and other products containing colloidal oatmeal.
- Natural oils. You can use plant oils like sunflower seed, olive, and coconut oil to apply to your sore skin after a shower to lock in that precious moisture.
- Fatty acids. Taking a supplement containing evening primrose, borage, or blackcurrant seed oil might ease eczema symptoms.
- Acupuncture. Some people find that acupuncture can help with the itchiness associated with asteatotic eczema. But it won’t treat the condition itself, just how it feels.
Asteatotic eczema is an itchy and potentially painful skin condition that leads to cracks, fissures, and bleeding.
This type of eczema most often affects older people and happens as a direct result of water loss in the skin. Various things, like dry air, certain meds, and some medical conditions can trigger asteatotic eczema.
Thankfully, there’s a ton of treatments available for asteatotic eczema. You can find both prescription and natural options that’ll combat the scratchiness, and help your skin to chill the f*ck out.
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