Xerotic eczema—also called winter itch, eczema craquelé, or asteatotic eczema—is a common condition caused by very dry skin. It appears as red patches with dry, flaky scale and fine cracks that can look like cracked porcelain or a dried lake bed. As the area worsens, these small fissures become more visible. Some patients may also develop round (nummular) patches, though these are usually less weepy than classic nummular eczema.
Xerotic Eczema
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Xerotic Eczema (Winter Itch)
Xerotic eczema—also called winter itch, eczema craquelé, or asteatotic eczema—is a common condition caused by very dry skin. It appears as red patches with dry, flaky scale and fine cracks that can look like cracked porcelain or a dried lake bed. As the area worsens, these small fissures become more visible. Some patients may also develop round (nummular) patches, though these are usually less weepy than classic nummular eczema.
It most often affects the shins, outer arms, and sides of the body. Older adults are especially prone, and dry skin (xerosis) is one of the most common causes of itching in this group.
Xerotic eczema is more common in the winter when humidity is low. Hot showers and harsh soaps can make it worse by damaging the skin barrier. This leads to increased water loss from the skin (transepidermal water loss, or TEWL). After about age 55, the skin’s ability to repair this barrier decreases, partly due to a rise in skin pH. Restoring a slightly acidic skin environment can help improve barrier function. Some patients—especially those with FLG gene mutation—are more prone to chronic dry skin.
Treatment focuses on restoring the skin barrier:
- Take short, lukewarm (not hot) showers
- Use soap only on necessary areas (like underarms and groin)
- Choose gentle, acidic (low pH) cleansers instead of harsh soaps
- Apply a moisturizer immediately after bathing to lock in hydration
- Thick emollients like white petrolatum are very effective
- Creams with 10% urea or 5% lactic acid help hydrate and gently exfoliate
- For inflamed areas, topical corticosteroids in ointment form can reduce redness and itching
With proper skin care and barrier repair, symptoms usually improve quickly and are very manageable.
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