Xerotic eczema is a condition that makes your skin abnormally dry, itchy, and cracked. Also called asteatotic eczema or eczema craquelé, this type of eczema causes patches of your skin to dry out and then crack because it lacks moisture. It might affect your face, hands, or arms.
It’s one of the most common types of eczema, and you may be more likely to get it in the winter, when the air is colder and drier.
Winter Itch
You can have xerotic eczema at any time of year, but it’s especially common during the cold months of winter, so it’s often called “winter itch.” In the winter, the air in your home may be less humid than usual because of your home’s heating system, and that can dry out your skin.
Cold air and windy weather can also trigger eczema. People who live in colder climates may be more likely to have winter itch.
What Causes Xerotic Eczema
Xerotic eczema happens because the outer layer of your skin, called the epidermis, loses moisture. Several things can cause the epidermis to become dehydrated, including dry, cold air in the winter. Indoor heating can dry air enough to provoke a flare-up in people already inclined to eczema.
Xerotic eczema can affect anyone, but older adults are especially prone to it because the activity of the sebaceous and sweat glands decreases as you age. Also, winter weather tends to impact older adults more than others, and they are more likely to take medications that make them more likely to get xerotic eczema.
While xerotic eczema sometimes develops spontaneously, there are many things in the environment that may make you more likely to have it. One of them is xerosis, the medical term for abnormally dry skin. It’s often an inherited condition but can also be a sign of aging. It is marked by rough, dry skin that often cracks. Other things that may increase your risk of xerotic eczema include:
- Zinc deficiency
- Hypothyroidism
- Certain retinoids
- Diuretics
- Taking long, hot baths or showers
- Wearing wool or clothes that cause friction against your skin
Along with indoor air that’s dry from heating, some other things in the environment can trigger eczema, including cleaning products and tobacco smoke. If you notice xerotic eczema and think something in your environment may be causing it, talk to your doctor.
Xerotic Eczema Symptoms
Xerotic eczema can affect skin on different areas of the body. Symptoms include:
- Dry, crusty, or scaly patches of skin
- Fissures, or cracks, in your skin
- A hard, rough texture in affected areas
- Itchy skin
- Discolored skin (red, purple, or darker than your usual skin tone)
You may have these symptoms on your face, ears, arms, hands, legs, and torso. Xerotic eczema symptoms often appear on the shins.
What does xerotic eczema look like?
Dry, cracked skin affected by xerotic eczema may look like the pattern in a dry riverbed or cracked porcelain. This often happens on the legs. Along with skin that’s cracked and dry, patches of skin may also look red or darker than your usual skin tone.
The xerotic fissures that develop tend to take on a red, scaly look that a doctor can readily identify.
Xerotic Eczema Diagnosis
Your doctor is likely to do a physical exam so they can look for signs of xerotic eczema. They may ask about your symptoms, including when you have noticed them. They probably will ask about your medical history as well. This can help if a medical condition or medications that you take could be part of the reason for your xerotic eczema. Your doctor may also have questions about how often you bathe and what kind of soap you use as well.
If you have xerotic eczema, your doctor can usually diagnose it by examining your skin, without any further testing. But sometimes, your doctor might do a skin biopsy to confirm whether you have xerotic eczema.
Xerotic Eczema Treatment
At home
You may be able to treat xerotic eczema at home. The best way to do that is to apply an oil-based moisturizer, cream, or emollient right after bathing to seal in the moisture. Also, apply moisturizer as needed throughout the day. Stick with oil-based moisturizers, though, because ones that list water as their main ingredient may dry out your skin.
Other at home treatments include:
Gentle oatmeal baths. You can treat itchy skin with gentle oatmeal baths and a lotion with skin-moisturizing ingredients, such as camphor.
Humidifiers. Installing a home humidifier may also prevent the air in your home from becoming too dry for your skin.
Cool showers. Avoid long, hot showers or baths, because they dry out your skin. Too-frequent hand-washing is a common cause of dry skin, so try not to do it more than necessary.
Researchers have found success treating xerotic eczema using emollients that contain lactic acid and refined almond oil. People reported significant reductions in itchiness within just 30 minutes of applying the emollients over the affected patches of skin. And continued use of these emollients over a period of weeks greatly improved the overall skin moisture levels of the people involved.
With your doctor
More developed cases of xerotic eczema may require a doctor’s help and prescription medical ointments.
Doctors generally recommend cool showers (using a hydrating cleanser once a day for less than 10 minutes) and steroid and calcineurin (nonsteroidal anti-inflammatory) ointments.
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Preventing Xerotic Eczema
You can try to prevent xerotic eczema by avoiding some common practices and products that may dry out your skin and help xerotic eczema form.
Don’t take long, hot showers or baths. Instead, limit showers and baths to less than 10 minutes, and keep the water cool. Use an oil-based moisturizer right after you bathe.
Other changes you can make to prevent xerotic eczema include:
- After you bathe, use a towel gently – don’t rub your skin vigorously.
- Limit shaving.
- Avoid being close to a heat source, such as a radiator or fireplace.
- Avoid dressing in wool or clothes that create friction with your skin.
- Avoid skin contact with harsh cleaning products, such as dish detergent.
- Avoid fragrant soaps, and use gentle, fragrance-free soaps instead.
- Use a humidifier in your home.
- If you don’t have a humidifier, putting a bowl of water in each room can help keep the air moist.
- Apply moisturizer throughout the day.
If you have xerotic eczema, it’s important to avoid skin irritants and keep your skin moisturized throughout the day.
Living With Xerotic Eczema
Although xerotic eczema is more common in people over 60, it can affect anyone. Pay attention to any feelings of itchiness in your skin, especially in winter. That can be a sign that xerotic eczema is forming, and you can get ahead of it if you start moisturizing early.
Xerotic eczema can make your skin itchy, but you should try not to scratch it, because scratching could further open up cracks in your skin and leave you prone to infection. Over-the-counter anti-itch cream can help combat itchy skin. Other preventive measures, including avoiding triggers and keeping your skin moisturized, can help you avoid xerotic eczema flare-ups.
If your symptoms don’t get better after you use moisturizers, see a health care provider, such as a dermatologist. You should also see a health care provider if your skin becomes infected. Signs of infection include pain, swelling, pus, fever, and chills.
Xerotic Eczema Prognosis
Xerotic eczema is unpleasant, but it’s not a life-threatening condition. It’s a long-term condition that may go away and come back.
Xerotic eczema can’t be cured, but treatment can heal your skin. It responds well to treatment and typically improves within a few weeks of skin hydration. It’s important to apply the prescribed treatments regularly and avoid situations or products that might further irritate your skin.
If the cracks and fissures in your skin are left untreated, they might lead to other complications that can be more serious. So be sure you see a doctor if you have symptoms of “winter itch” and moisturizers haven’t helped.
Takeaways
Xerotic eczema is a common cause of dry, scaly patches of skin. It can’t be cured, but it can be treated. Oil-based moisturizers can help heal your skin, but if they don’t seem to work, you should see your health care provider. They may prescribe topical creams to help treat your symptoms. Other preventive measures, like avoiding long, hot showers, can help you avoid flare-ups.
Xerotic Eczema FAQs
What are the four types of eczema? There are several types of eczema, including xerotic eczema, atopic eczema (also called atopic dermatitis, usually found inside the elbows and knees in adults), contact dermatitis (caused by exposure to an allergen or irritant), and seborrheic dermatitis (which affects your scalp).
What is the fastest way to heal eczema? The fastest way to treat eczema is to moisturize your skin, preferably with an oil-based moisturizer or cream.
Is eczema 100% curable? You can’t cure eczema, but you can treat the symptoms. Often, you can keep xerotic eczema under control with preventive measures like applying moisturizer.
What does asteatotic mean? Asteatosis means drying, cracking, and scaling of the skin. Asteatotic eczema is another name for xerotic eczema, a skin condition that causes dry, cracked, and scaly patches.
