Asteatotic Eczema (Eczema Craquelé) - Symptoms, Causes & Treatment
Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026
A form of eczema caused by extreme skin dryness, producing a distinctive cracked pattern like crazy paving or a dry riverbed, most often on the shins of older adults in winter. Central heating, over-washing, low humidity and age-related loss of skin lipids are the main drivers.
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Quick Answer
Asteatotic eczema, or eczema craquelé, is dry, itchy, cracked skin with a crazy-paving pattern, typically on the shins of older adults during winter. It is caused by loss of skin lipids, over-washing and dry indoor air. Treatment is intensive greasy emollients several times daily, a soap substitute, shorter cooler showers, and a short course of topical steroid ointment for inflamed areas.
Symptoms
- Dry, scaly skin with a cracked crazy-paving pattern
- Red fissures between the scale plates
- Itch, sometimes intense
- Most often shins, also forearms and flanks
- Worse in winter and after hot showers
Causes & Risk Factors
- Age-related decline in skin surface lipids
- Central heating and low indoor humidity
- Frequent hot showers and soap use
- Diuretics, statins and some other medications
- Hypothyroidism and zinc deficiency in some cases
Treatment & Management
- Greasy emollient ointments applied three or more times daily
- Soap substitutes and bath oils in place of detergents
- Shorter, cooler showers
- Topical corticosteroid ointment for inflamed cracked areas
- Humidifying the home in winter
When to See a Doctor
See a doctor if the cracks are weeping, crusted or spreading with redness and warmth (possible infection or cellulitis), or if the eczema is not improving after two weeks of intensive emollients.
Frequently Asked Questions
Why is it worse in winter?
Cold outdoor air holds little moisture and indoor heating dries it further, stripping water from an already lipid-poor skin barrier. Symptoms usually improve in humid summer conditions.
Which moisturiser works best?
Thicker is better. Ointments and greasy creams outperform light lotions for asteatotic eczema. Apply within minutes of washing, while skin is still damp.
Medical References
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Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. The content on this page should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional for proper medical evaluation, diagnosis, and treatment of your condition.