Why Your Skin Looks Like a Dried Riverbed: Understanding Asteatotic Eczema
Have you noticed your legs getting itchy, flaky, or even cracked. Maybe this happened after a recent vacation to a dry climate like Colorado? At Pure Dermatology, I’ve been seeing more cases of a condition called asteatotic eczema, also known as eczema craquelé. It’s a common skin issue, especially when your environment or habits strip your skin of moisture.
What Is Asteatotic Eczema?
Asteatotic eczema is a form of eczema that develops on very dry skin, most commonly seen on the lower legs. The hallmark is a cracked, flaky surface that often resembles a dried-up riverbed. It’s typically itchy and can sometimes sting or bleed if the skin becomes deeply fissured.
While it’s most common in older adults, anyone exposed to very dry air, like the low humidity of high altitudes or overly heated indoor environments, can be affected. I’ve seen several patients who developed symptoms shortly after visiting places like Colorado, where the air is much drier than Central Texas.
What Causes It?
Your skin’s outer layer acts like a protective barrier, keeping moisture in and irritants out. When this barrier breaks down, you’re more vulnerable to dryness and inflammation.
Common triggers include:
• Dry air from travel or indoor heating
• Frequent hot showers
• Harsh soaps or exfoliants
• Age-related changes that weaken the skin barrier
• Occasionally, underlying health conditions or medications
When the skin becomes too dry, it forms tiny cracks that let in irritants and release water, setting off inflammation and itching.
What It Looks Like
• Pink or red patches with thin, cracked lines
• Flaking or scaling
• Itching or burning sensations
• Most often seen on the shins, but can spread to arms or trunk
• In severe cases: bleeding, oozing, or coin-shaped spots
How We Treat It
The goal is twofold: repair the skin barrier and calm the inflammation.
1. Topical Corticosteroids
These reduce inflammation quickly. We often use a mid-strength ointment that brings relief in just a few days.
2. Moisturizers (Emollients)
Thick, hydrating creams and ointments are key.
Look for ingredients like:
o Urea
o Ceramides
o Lactic acid
o Petrolatum (Vaseline)
Apply them generously right after bathing, when skin is still slightly damp.
3. Lifestyle Adjustments
o Use gentle, fragrance-free cleansers
o Limit showers to 10 minutes or less
o Avoid hot water and over-scrubbing
o Consider using a humidifier indoors, especially if using central heating or traveling to dry places
When to See a Dermatologist
If over-the-counter moisturizers aren’t helping, or if the skin becomes painful or starts to crack and bleed, it’s worth getting checked. Asteatotic eczema is often easy to treat once diagnosed, but it can worsen quickly if ignored.
At Pure Dermatology, we’re happy to help you find the right treatment plan and prevent flare-ups. Whether your skin is reacting to a recent ski trip or just needs extra care as it changes with time, book-online with one of our board-certified dermatologists.
