Asteatotic eczema, also known as ‘eczema craquelé’ or ‘xerosis,’ is a common skin condition affecting many people around the world. In essence, it’s a type of eczema that causes dry, scaly, and itchy skin. It’s often linked with aging, as it tends to affect older individuals, particularly during the colder, drier months. However, don’t worry! Our guide will help you understand this condition in a simple, easy-to-understand manner.

Asteatotic eczema is a skin disorder marked by extremely dry, cracked, and itchy skin. Imagine your skin as a well-hydrated plant; when it has sufficient water, it’s supple and robust. But, when it lacks moisture, just like a plant, it can become dry and brittle. That’s exactly what happens in asteatotic eczema. The term ‘asteatotic’ is derived from ‘steat,’ which means fat – implying a lack of oils on the skin surface, leading to excessive dryness.

Types

Types of asteatotic eczema and give you a clear, easy-to-understand guide.

Type 1: Winter Xerosis

Winter xerosis is the most common type of asteatotic eczema. As the name suggests, it is mainly prevalent during winter when the air is dry and harsh. Cold, dry air depletes the skin’s natural moisture, leading to dry, itchy, and scaly skin. If untreated, these skin changes can advance into a full-blown case of winter xerosis.

Type 2: Senile Xerosis

Senile xerosis predominantly affects older adults. As we age, our skin’s ability to retain moisture diminishes. This leads to the development of dry, itchy skin, commonly known as senile xerosis. Senile xerosis often intensifies during winter, just like winter xerosis, but can persist year-round.

Type 3: Drug-induced Xerosis

Certain medications can cause your skin to become dry and itchy, leading to drug-induced xerosis. Drugs that can cause this type of asteatotic eczema include diuretics, retinoids, and certain cholesterol medications. If you notice dry, itchy skin after starting a new medication, it’s important to consult your doctor.

Type 4: Eczema Craquele

Eczema craquele, or ‘cracked skin’ eczema, is a severe form of asteatotic eczema. The skin becomes so dry and tight that it starts to crack, resembling porcelain or glass that’s been shattered. This type of eczema can be very painful and is often associated with severe itchiness.

Regardless of the type, it’s important to seek professional help if you believe you’re dealing with asteatotic eczema. By getting an accurate diagnosis and starting treatment early, you can help alleviate your symptoms and prevent further skin damage.

Causes

Understanding its causes can help prevent or manage this condition. Here’s a comprehensive, easy-to-understand list of the major causes:

1. Age: As we age, our skin naturally becomes drier. This lack of moisture can lead to asteatotic eczema.
2. Winter Weather: Cold, dry air can dehydrate your skin, creating conditions perfect for asteatotic eczema to thrive.
3. Low Humidity: Living in areas with low humidity, or using air conditioning and heating systems that dry out the air, can lead to this skin issue.
4. Over-Washing: Frequent bathing or hand-washing can strip your skin of its natural oils, leading to dryness and potential eczema.
5. Harsh Soaps and Detergents: These products can remove the protective oils from your skin, causing it to become dry and cracked.
6. Dehydration: Not drinking enough water can dehydrate your skin, which might exacerbate asteatotic eczema.
7. Certain Medications: Some drugs, like diuretics or antihistamines, can dry out the skin.
8. Alcohol and Caffeine: These substances can dehydrate the body and, consequently, the skin.
9. Smoking: It can reduce blood flow to the skin, leading to dryness.
10. Diet: Lack of certain nutrients, like essential fatty acids, can negatively impact skin health.
11. Health Conditions: Diseases like hypothyroidism, kidney disease, or diabetes can cause dry skin.
12. Radiation Therapy: This cancer treatment can lead to dry and cracked skin.
13. Menopause: Hormonal changes can cause skin dryness and asteatotic eczema.
14. Psoriasis: This skin condition can increase your likelihood of developing asteatotic eczema.
15. Genetic Predisposition: Your genetics might make you more susceptible to eczema.
16. Stress: It can trigger or worsen asteatotic eczema.
17. Skin Injuries: Damage to the skin can sometimes lead to dryness and eczema.
18. Sun Exposure: Overexposure to the sun can dry out and damage your skin.
19. Frequent Swimming: Chlorine in swimming pools can be harsh on the skin, causing dryness.
20. Poor Hydration of Skin: Lack of adequate skin moisturization can cause eczema.
21. Occupational Hazards: Jobs involving exposure to chemicals or frequent hand-washing can trigger eczema.
22. Allergies: Certain allergies can make the skin more sensitive and prone to dryness and eczema.
23. Physical Irritants: Materials like wool or synthetic fibers can irritate the skin, leading to dryness and eczema.
24. Hard Water: Water with high mineral content can leave a residue on the skin, causing dryness.
25. Lack of Sleep: It can negatively affect your overall health, including your skin condition.
26. Skin Infections: Certain infections can lead to dry, flaky skin and exacerbate eczema.
27. Malnutrition: Lack of proper nutrition can contribute to poor skin health and eczema.
28. Obesity: It can make the skin folds prone to dryness and eczema.
29. Hormonal Imbalances: Conditions causing hormonal imbalances, like thyroid disorders, can contribute to eczema.
30. Excessive Scratching: It can further irritate and dry out your skin, worsening eczema.

Understanding these causes can help you manage your skin condition better. Remember to stay hydrated, moisturize regularly, avoid known triggers, and consult a healthcare professional for personalized advice. Keep in mind that skin health is an essential aspect of overall well-being. It deserves your care and attention.

Symptoms

Symptoms of this condition in the most straightforward terms. By the end of this article, you’ll be a mini-expert on asteatotic eczema!

1. Dry Skin: This is the first sign you’ll notice. Your skin may feel as parched as a desert, lacking its usual softness and suppleness.
2. Redness: Your skin may start to resemble a ripe tomato in color, indicating inflammation and irritation.
3. Itching: It feels like you’ve been attacked by a swarm of invisible mosquitoes. This itching can be quite intense and is a hallmark symptom of eczema.
4. Fine Cracks: The skin starts to display tiny cracks, akin to a fragile piece of pottery.
5. Rough Texture: You might notice your skin feeling more like sandpaper and less like silk.
6. Scaling: Similar to a snake shedding its skin, you might see flaky scales on your skin.
7. Inflammation: Swelling or redness is a sign your body is trying to fight something off. In this case, it’s responding to skin dryness and irritation.
8. Pain: Those fine cracks can sometimes be more than just an aesthetic concern. They can cause mild to moderate discomfort.
9. Bleeding: The cracks in your skin can sometimes go deep enough to cause minor bleeding.
10. Thickened Skin: Over time, constant scratching and irritation can lead to thicker skin in the affected areas.
11. Fissures: More serious than fine cracks, these deep splits in your skin can be quite painful.
12. Peeling: In some cases, the skin may start to peel off in certain areas, almost like a sunburn.
13. Infection: Bacteria can sneak into those cracks, leading to infection. Signs of infection can include increased pain, swelling, redness, or pus.
14. Discoloration: Eczema can change your skin color, making it lighter (hypopigmentation) or darker (hyperpigmentation).
15. Hardened Lines (Lichenification): This is when your skin starts forming hard lines due to constant scratching or rubbing.
16. Blistering: Sometimes, tiny, fluid-filled blisters may form on the skin.
17. Increased Sensitivity: The affected areas can become more sensitive to touch, temperature, or certain substances.
18. Poor Sleep: The itching and discomfort can make sleeping difficult, leading to sleep disturbances.
19. Anxiety and Depression: Long-term eczema can take a toll on your mental health, leading to feelings of anxiety or depression.
20. Impact on Daily Activities: Depending on its severity, eczema can hinder your everyday activities and impact your quality of life.

Diagnosis

Diagnosing and treating asteatotic eczema involves various tests and evaluations. We’ve put together a top list of diagnoses and tests for asteatotic eczema.

1. Clinical Examination: This is often the first step. Doctors will look at the skin’s appearance and ask about symptoms such as itchiness, dryness, and any related discomfort.
2. Medical History: The doctor will ask about your medical history, like any previous skin conditions or allergies, as this can be linked to eczema.
3. Physical Exam: Your doctor may also perform a physical exam to rule out other conditions that could cause similar symptoms.
4. Patch Testing: This test can help identify allergens that may be causing or worsening your eczema.
5. Skin Biopsy: A small piece of skin is taken to examine under a microscope. This can help confirm the diagnosis and rule out other skin diseases.
6. Blood Tests: These help rule out other conditions with similar symptoms or check for any related issues, like anemia due to excessive scratching.
7. Allergy Testing: Similar to patch testing, this can identify possible triggers for eczema flare-ups.
8. Skin Prick Test: This is another form of allergy test. It involves pricking the skin with a small amount of an allergen to see if it reacts.
9. Intradermal Test: This test involves injecting a small amount of allergen under the skin. It’s used if the skin prick test results are unclear.
10. Family History: If there’s a history of eczema or related conditions in your family, it might indicate a genetic predisposition.
11. Skin Scraping and Culture: This is done to identify possible fungal or bacterial infections that can exacerbate eczema.
12. IgE Blood Test: High levels of Immunoglobulin E (IgE) can indicate an allergic reaction, often seen in eczema patients.
13. Phototests: These tests use ultraviolet light on the skin to identify photosensitivity, which can worsen eczema symptoms.
14. Total Serum IgE Test: This test measures the total amount of IgE, a type of antibody, in the blood. It can help identify allergic conditions including eczema.
15. Food Elimination Diet: If food allergies are suspected, your doctor may recommend this diet to pinpoint specific triggers.
16. Pulse Testing: This involves eating a large amount of a suspected allergen on an empty stomach and observing for reactions.
17. Environmental Allergen Test: This test checks for allergies to common environmental factors like dust mites or pet dander.
18. Aeroallergen Testing: Similar to environmental allergen testing, this test identifies allergies to airborne substances.
19. Eosinophil Count: High levels of eosinophils, a type of white blood cell, can indicate an allergic reaction.
20. Complete Blood Count (CBC): This general health check can identify infections, inflammation, and diseases that might relate to eczema.
21. RAST Test: The Radioallergosorbent Test (RAST) checks for specific allergen-sensitive antibodies in your blood.
22. Eczema Area and Severity Index (EASI): This is a tool to assess the severity and extent of eczema.
23. SCORAD Index: Another measure of eczema severity, taking into account objective criteria like redness and subjective ones like itchiness.
24. Dermatoscopy: This non-invasive method allows the doctor to visualize the skin more clearly and can assist in diagnosing eczema.
25. Epidermal Conductance: A test that measures skin hydration. Eczema often involves dry skin, so this can be a helpful indicator.
26. Skin Hydration Assessment: This test measures the water content of the top layer of skin, again helping assess skin dryness.
27. Transepidermal Water Loss Measurement: This measures the amount of water that evaporates from the skin surface, indicating skin barrier function.
28. TEWL & D-Squame: A combination of the above two tests, often used in research settings.
29. Quality of Life Indexes: These assessments gauge the impact of eczema on daily life, which can influence treatment decisions.
30. Lifestyle Assessment: This involves evaluating factors such as stress levels, diet, and skincare routines, which can all affect eczema.

Treatment

Let’s explore of these treatments in straightforward language, to help you or your loved one find relief.

1. Moisturizers: One of the most effective treatments for asteatotic eczema is frequent moisturization. Look for creams or ointments that are rich in emollients. They work by trapping moisture in the skin, preventing dryness.
2. Avoid harsh soaps: Soaps, especially those with fragrance or alcohol, can strip the skin of its natural oils, leading to dryness. Opt for mild, unscented soaps.
3. Hydrate: Hydration isn’t just about drinking water. Using a humidifier in your home can help maintain moisture in the air and your skin.
4. Warm Baths: A warm bath can soothe dry, itchy skin. Remember to moisturize immediately after to lock in the moisture.
5. Oatmeal Baths: Oatmeal is known for its skin-soothing properties. An oatmeal bath can provide relief from itching and dryness.
6. Cotton Clothing: Wear loose, cotton clothing. It allows your skin to breathe and reduces irritation.
7. Topical Steroids: Topical steroids reduce inflammation and itching. They should be used under a doctor’s direction.
8. Avoid Scratching: Scratching can worsen eczema. Keep nails short and smooth to prevent damage.
9. Cold Compresses: Applying a cold compress can soothe itchy, inflamed skin.
10. Avoid Stress: Stress can trigger eczema flare-ups. Engage in stress management techniques like yoga or meditation.
11. Antihistamines: These medications reduce itching and are particularly useful at night to promote sleep.
12. Topical Calcineurin Inhibitors: These prescription creams or ointments work by suppressing the activities of the immune system that trigger eczema.
13. Phototherapy: In this treatment, your skin is exposed to certain types of ultraviolet light under medical supervision to reduce eczema symptoms.
14. Coconut Oil: Coconut oil can moisturize and soothe the skin, thanks to its anti-inflammatory properties.
15. Dietary Changes: Some people find relief by eliminating certain foods from their diet. Consult with a dietitian or nutritionist for guidance.
16. Avoid allergens: Common allergens like dust mites or pet dander can worsen eczema. Keeping a clean home environment can help.
17. Omega-3 Supplements: Omega-3 fatty acids, found in fish oil supplements, have anti-inflammatory properties that can help manage eczema symptoms.
18. Vitamin D Supplements: Some studies suggest Vitamin D can help in the treatment of eczema.
19. Bleach Baths: Under a doctor’s supervision, a diluted bleach bath can help kill bacteria that inflame eczema.
20. Exercise: Regular exercise can improve circulation and boost your immune system, helping to manage eczema symptoms.
21. Aloe Vera: Aloe Vera has been used for centuries for its soothing and healing properties. It can help reduce itching and dryness.
22. Manuka Honey: This type of honey from New Zealand has potent anti-inflammatory and antibacterial properties.
23. Sunflower Seed Oil: This oil can protect the skin’s barrier, providing moisturizing and anti-inflammatory benefits.
24. Witch Hazel: This plant extract has astringent and anti-inflammatory properties that can soothe eczema.
25. Evening Primrose Oil: Available as a supplement or a topical oil, it can reduce itching and inflammation.
26. Probiotics: Some evidence suggests that probiotics can support a healthy gut and skin, which can be beneficial for people with eczema.
27. Acupuncture and Acupressure: These traditional Chinese medicine practices may help reduce eczema symptoms by promoting relaxation and reducing stress.
28. Biofeedback: This technique trains people to control bodily processes, such as stress response, which can help manage eczema symptoms.
29. Hypnotherapy: Some people may find relief from eczema symptoms through hypnotherapy, which can help manage stress and promote relaxation.
30. Homeopathy: While the evidence is still inconclusive, some individuals with eczema report symptom relief from homeopathic treatments.

References