What Is Asteatotic Eczema? Symptoms, Causes, and Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is asteatotic eczema?
Asteatotic eczema is a common form of eczema in which water loss from the outer skin layer causes dry, scaly, itchy and cracked patches, peaking in winter and after age 60. It is not contagious and has no cure, but it responds well to greasy, high-oil moisturizers applied daily on damp skin, with prescription creams when needed. [1]
Key Takeaways
Asteatotic eczema is a type of eczema causing dry, itchy, cracked skin — also known as xerotic eczema or eczema craquelé. [1]
It is caused by water loss from the epidermis; the classic "dried mud" pattern comes from the skin cracking through lack of moisture. [1]
Most common in winter and in people over 60, when skin glands produce less sweat and oil to keep the protective barrier hydrated. [1]
Greasy, high-oil "healing" ointments work best; avoid watery or scented lotions, which can dry the skin further. [1]
Not contagious, chronic with flare-ups — consistent daily moisturizing and prevention habits keep symptoms at bay. [1]
What the research says
Asteatotic eczema is common in older adults. In a Finnish study of 552 adults aged 70 to 93 who had a whole-body skin examination by dermatologists, nearly 80% had at least one skin disease that needed treatment or follow-up, and asteatotic eczema was found in 20.8%. (Sinikumpu et al., J Am Geriatr Soc, 2020) [6]
Moisturizer improves skin hydration and barrier function in asteatotic eczema. In a randomized, double-blind trial of 40 adults with mild, symmetric asteatotic eczema of the lower legs, a ceramide-containing moisturizer met the primary goal of changing water loss through the skin (transepidermal water loss) by day 15 and improved skin hydration; a comparison cream base performed similarly after day 1. The authors noted the small sample size. (Draelos et al., J Drugs Dermatol, 2024) [7]
What Is Asteatotic Eczema?
Asteatotic eczema (pronounced "uh-stee-toh-tick" "eg-zuh-muh") is a type of eczema that causes patches of dry, itchy, and cracked skin. This condition is most common in the winter, when the air is dry and you use heat to warm your body. [1]
Asteatotic eczema causes patches of your skin to dry out. Similar to how a mud puddle dries out when exposed to heat and sunlight, your skin cracks from a lack of moisture. Cracks in your skin can turn into sores, especially if you scratch them, which puts you at risk of developing an infection. Moisturizing your skin with ointments or skin creams helps treat asteatotic eczema. [1]
Asteatotic eczema is also known as xerotic eczema or eczema craquelé. It is one of the most common types of eczema, and it is the most frequent type among people 60 years of age or older — though it can affect anyone at any age. [1]
What Are the Symptoms of Asteatotic Eczema?
Symptoms of asteatotic eczema include dry, scaly, bumpy patches of skin; itchy skin; skin discoloration (red to purple tones or darker than your natural tone); and cracked skin (fissures). [1]
Symptom | Medical Term | What It Looks Like |
Dry, scaly, bumpy patches | Dry skin (xerosis) | Rough, flaky patches on the skin surface |
Itchy skin | Pruritus | Persistent urge to scratch |
Skin discoloration | Discoloration | Red to purple tones, or darker than your natural skin tone |
Cracked skin | Fissures | Cracks across the skin, often in a dried-mud pattern |
Severe asteatotic eczema happens when deep cracks turn into sores on your skin. Your skin may swell, hurt, and drain pus. Contact a healthcare provider right away if you notice these symptoms, as they are a sign of an infection. [1]
Where Does Asteatotic Eczema Affect the Body?
Asteatotic eczema flare-ups can affect any part of the skin on your body. The most common locations include the ears, face, hands and arms, legs and shins, and torso. [1]
What Causes Asteatotic Eczema?
Dehydration, or water loss from the outermost layer of your skin (the epidermis), causes asteatotic eczema. [1]
The condition most often affects people after age 60 because glands in your skin produce less sweat and oil as you age. Sweat and oil form a protective barrier that keeps your skin hydrated. When that barrier weakens, moisture escapes and the skin dries and cracks. [1]
What Are the Risk Factors?
You may be more at risk of developing a flare of asteatotic eczema depending on your environment, habits, and health:
Risk Factor | Why It Dries the Skin |
Cold, dry climate | Dry outdoor air strips moisture from the skin. |
Direct heat exposure | Sitting close to a fireplace or heater accelerates water loss. |
Long, hot baths or showers | Hot water and long exposure dissolve the skin's natural oils. |
Harsh soaps | Strong cleansers strip the protective lipid barrier. |
Clothing friction | Rough or tight clothing rubs and irritates the skin. |
Medical conditions | Hypothyroidism increases the skin's tendency to dry out. |
Certain medications | Diuretics increase fluid loss, which can dry the skin. |
Family history | The condition can run in your biological family. |
Is Asteatotic Eczema Contagious?
No. Asteatotic eczema is not contagious — the condition does not spread through person-to-person contact. [1]
How Is Asteatotic Eczema Diagnosed?
Your provider will diagnose asteatotic eczema after a physical examination. They will learn more about your medical history and symptoms during this exam. [1]
The physical appearance of your symptoms usually leads to a diagnosis, and additional tests are not necessary. If your provider offers a test, it could diagnose the underlying cause of your symptoms. For example, if they suspect your symptoms are the result of hypothyroidism, your provider will offer a thyroid function blood test. [1]
How Is Asteatotic Eczema Treated?
Treatment for asteatotic eczema focuses on rehydrating your skin. The first line of treatment is using a moisturizer — a skin cream or ointment. You can apply moisturizer to your skin daily, after taking a shower or bath (when your skin is still damp), or as needed throughout the day. [1]
Depending on the severity of your condition, your provider might recommend prescription creams or ointments to soothe your skin and help it heal:
Treatment Category | Examples | What They Do |
Over-the-counter moisturizers | Greasy, high-oil "healing" creams and ointments | Rehydrate and repair the skin barrier; first-line treatment |
Topical steroids | Hydrocortisone, desonide | Soothe inflammation and help skin heal |
Topical corticosteroids | Fluocinolone, triamcinolone, betamethasone | Stronger anti-inflammatory options for stubborn flares |
Topical anti-itch creams | Pimecrolimus | Reduce itch without steroid side effects |
You should use moisturizers and topical creams or ointments prescribed by your provider at the same time. Talk to your provider about when to apply each type — some creams work best if you apply them to your skin first. [1]
What Is the Best Cream for Asteatotic Eczema?
The best at-home creams or ointments are greasy moisturizers with high oil content. You can purchase these over the counter at most retailers — look for "healing" creams or ointments. [1]
Avoid lotions that have water as their main ingredient or are scented. These types of moisturizers can dry out your skin rather than help it. [1]
How Soon After Treatment Will I Feel Better?
It can take a couple of weeks for your skin to rehydrate and heal. During this time, make sure you follow your healthcare provider's instructions so you are healing as expected. [1]
What Can I Expect Long-Term?
Asteatotic eczema is a chronic condition that can go away and come back unexpectedly. There is no cure, but treatment helps your skin heal. You can prevent flare-ups (the return of symptoms) by keeping your skin hydrated and using moisturizer daily. [1]
Eczema prevents your skin's protective barrier from working as expected, which can make you more at risk of developing an infection in the cracks of your skin. While you have a flare, try to avoid scratching — scratching can break open the cracks and create a wound. Resisting the urge can be very difficult, but you can use an over-the-counter anti-itch cream to help. [1]
How Can I Prevent Asteatotic Eczema Flare-Ups?
You can reduce your risk of a flare-up with a few consistent habits:
Prevention Habit | How It Helps |
Shorter baths or showers (no more than 15 minutes) with warm, not hot, water | Limits the time hot water strips the skin's oils. |
Keep distance from heating sources in winter (fireplace, radiator) | Reduces direct drying heat on the skin. |
Moisturize after every bath or shower and throughout the day | Traps water in the skin while it is still damp. |
Use gentle cleansers instead of harsh soaps | Preserves the skin's natural lipid barrier. |
Use a humidifier at home | Adds moisture to dry indoor air. |
When Should I See a Healthcare Provider?
Visit your healthcare provider if you have symptoms of asteatotic eczema that do not improve using at-home moisturizers. [1]
Contact your provider immediately if your cracked skin becomes infected. Signs of infection include pain, swelling, fluid or pus leaking out of skin bumps or sores, and fever with chills. [1]
What Questions Should I Ask My Provider?
Helpful questions to bring to your appointment include: What type of moisturizer do you recommend? How often should I apply prescription creams to my skin? Should I apply moisturizer or a prescription treatment first? Are there side effects to the treatment? [1]
Conclusion: The Cracked-Winter-Skin Problem Has a Simple Solution — Hydrate, Daily
Asteatotic eczema is a treatable form of eczema that can show up when you least expect it — like during a winter holiday or a dry summer. The pattern on the skin looks dramatic, but the problem is straightforward: your skin has lost water, and it needs it back.
The routine that works is simple once it becomes habit. Try over-the-counter greasy ointments first — applying one might feel weird, but they rehydrate your skin better than other types of lotions. Moisturize right after bathing on damp skin, keep showers short and warm, switch to gentle cleansers, run a humidifier, and step back from the fireplace. If that is not enough, a provider can recommend prescription creams to soothe your skin. Since the condition tends to return seasonally and more often with age, regular moisturizing is your best long-term defense.
If your cracked skin is not improving, or if it becomes painful, swollen, or starts draining pus, see a healthcare provider promptly. For more clear, verified health information, explore the rest of Rinnit.com — start with our guides on dry skin and eczema types.
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Frequently Asked Questions
What is asteatotic eczema?
Asteatotic eczema is a type of eczema that causes patches of dry, itchy, and cracked skin. Also called xerotic eczema or eczema craquelé, it results from water loss in the outermost layer of skin (the epidermis). It is one of the most common forms of eczema, peaking in winter and among people 60 and older, though it can affect anyone at any age. [1]
What does asteatotic eczema look like?
Asteatotic eczema appears as dry, scaly, bumpy patches that may be red to purple or darker than your natural skin tone, with fine cracks forming a pattern similar to dried mud. The most common locations are the ears, face, hands, arms, legs, shins, and torso. [1]
What causes the cracking pattern?
The epidermis loses water and dries out — similar to how a mud puddle cracks when exposed to heat and sunlight. With age, the skin's glands produce less sweat and oil, weakening the protective barrier that normally holds moisture in. [1]
Is asteatotic eczema contagious?
No. It does not spread through person-to-person contact. [1]
What are the risk factors?
Living in a cold, dry climate; sitting close to heat sources like fireplaces; long, hot baths or showers; harsh soaps; friction from clothing; conditions like hypothyroidism; medications such as diuretics; and a family history of the condition.
What is the best treatment?
Rehydrating the skin is the first line of treatment. Apply a greasy, high-oil moisturizer daily — ideally right after bathing while skin is still damp. Avoid watery or scented lotions. For more severe flares, providers may prescribe topical steroids (hydrocortisone, desonide, fluocinolone, triamcinolone, betamethasone) or anti-itch creams (pimecrolimus). [1]
How long does it take to heal?
It can take a couple of weeks for the skin to rehydrate and heal. Follow your provider's instructions during this time, including the correct order for applying moisturizer and prescription creams. [1]
Can asteatotic eczema be cured?
There is no cure, as it is a chronic condition that can go away and come back unexpectedly. But consistent daily moisturizing and prevention habits effectively stop flare-ups and help the skin heal. [1]
How do I prevent flare-ups?
Take showers of no more than 15 minutes with warm (not hot) water, keep a distance from fireplaces and radiators in winter, moisturize after bathing and throughout the day, use gentle cleansers instead of harsh soaps, and run a humidifier at home.
Should I scratch the itchy skin?
Try to avoid it. Scratching can break open the cracks and create a wound, which raises the risk of infection. An over-the-counter anti-itch cream can help manage the urge. [1]
When should I seek medical care right away?
Contact a provider immediately if cracked skin becomes infected — watch for pain, swelling, fluid or pus leaking from bumps or sores, and fever with chills. Also see a provider if symptoms do not improve with at-home moisturizers. [1]
Related Reading
References
Cleveland Clinic. Asteatotic eczema (eczema craquelé or xerotic eczema). Cleveland Clinic. Last updated August 7, 2024. https://my.clevelandclinic.org/health/diseases/asteatotic-eczema
Srivastava D, Sathe NC, Persaud Y. Asteatotic eczema. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan 10. PMID 31747214. https://www.ncbi.nlm.nih.gov/books/NBK549807/
American Osteopathic College of Dermatology. Asteatotic eczema. AOCD. Archived July 11, 2025. https://web.archive.org/web/20250711164308/https://www.aocd.org/page/AsteatoticEczema
DermNet New Zealand Trust. Asteatotic eczema (eczema craquelé). Oakley A. DermNet. Updated July 2014. https://dermnetnz.org/topics/asteatotic-eczema
National Eczema Society (U.K.). Asteatotic eczema. National Eczema Society (now Eczema UK). Last reviewed February 26, 2020. https://www.eczema.org.uk/support/asteatotic-eczema
Sinikumpu SP, Jokelainen J, Haarala AK, et al. The high prevalence of skin diseases in adults aged 70 and older. J Am Geriatr Soc. 2020;68(11):2565-2571. PMID 32754902. https://doi.org/10.1111/jgs.16706
Draelos ZD, Higham RC, Osborne DW, et al. Assessment of the vehicle for roflumilast cream compared to a ceramide-containing moisturizing cream in mild eczema. J Drugs Dermatol. 2024;23(10):834-840. PMID 39361692. https://doi.org/10.36849/JDD.2024.7958
Medical disclaimer
This article is for informational purposes only and is not medical advice. Always consult a qualified healthcare provider for diagnosis and treatment decisions.
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