What it looks like
The hallmark is distinctive enough to be worth describing carefully: diamond-shaped plates of skin, separated from one another by red bands that form a network. Hence its other name, eczema craquelé — cracked eczema. The shins are by far the most common site, though it can spread to the rest of the lower legs, the upper limbs, and the trunk.
Who gets it, and why
It is mainly a condition of older skin, though anyone with very dry skin can get it. Underneath, it is water loss from the outermost layer of skin after the barrier breaks down. The things that push it along are ordinary and mostly modifiable:
- Low humidity — dry indoor air in winter is a classic setting.
- Over-washing, and soap. Frequent hot showers with soap strip exactly what this skin can't spare.
- Medications and conditions — it is associated with ichthyosis, hypothyroidism, malnutrition, and medicines including retinoids and diuretics.
Why that last line matters. Asteatotic eczema is one of the skin problems that occasionally points somewhere else — a thyroid that needs checking, a medication worth reviewing, nutrition worth a look. That is not a reason to worry; it is a reason to have it seen rather than just creamed, especially if it has appeared suddenly or is not settling.
What helps
Management is aimed squarely at the dryness: bathing less often, using a cream cleanser instead of soap, and applying thick emollients and moisturizers regularly rather than occasionally. Where areas are inflamed, a mild topical steroid may be used — which one, and for how long, is your doctor's decision. It usually responds quickly, but it needs the skin care to continue afterward, or it returns.
Our guides on choosing a moisturizer, choosing a cleanser and winter eczema cover the daily side in more detail.
Where it fits with everything else
Older skin is drier skin, and dryness is the soil that most eczema grows in — which is why this one becomes more common with age even in people who never had a skin problem before. Our guide on eczema in later life covers the wider picture of skin that changes as you get older.
Catch the season before it catches you
This is the most seasonal eczema there is — it arrives with the dry air and leaves with it. A year of Ollowen check-ins shows you your own curve, so next winter you can start the heavier routine before the cracks appear rather than after.
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Sources
- DermNet. Asteatotic eczema.
- National Eczema Society. Eczema in later life.
- American Academy of Dermatology. Dermatologists’ tips for relieving dry skin.
More Ollowen guides: see all →