Asteatotic means lack of oiliness. This type of eczema is initiated by dry skin, particularly in the elderly people, whose skin loses the oily protection as the skin ages, together with perhaps improper skin care. The dry skin is itchy, and scratching will complicate the situation with more inflammation. Eventually eczema sets in.

Using excess soap, especially if it is not completely washed off, may contribute to asteatotic eczema by drying out the skin too much. The use of ‘water pills’ (diuretics) is possibly an extra factor in elderly people who may need diuretics to help correct a range of other medical conditions such as high blood pressure.

Sometimes an under-active thyroid gland, which is also common in the elderly, can be an extra cause of this.


The eczema is usually seen on the legs of elderly people. This is because the legs lose more moisture when the circulation is more stagnant in this age group, and the legs are easily reachable to be scratched. Sitting too close for long periods to radiant heat sources, such as electric fires, is also a contribution to eczema in the legs.

The skin is very itchy and red, with much superficial scaling and splitting. The pattern of scaling is often described as looking like ‘crazy paving’.

Typical Crazy Paving
Bacterial Infection

Management & Treatments

This is essentially the same as for other types of eczema, namely moisturisers, steroid cream, and antibiotics cream.

To reduce the skin dryness, ordinary soap should be avoided, because they are too alkaline. There are soaps formulated with moisturizers and with a pH value between 5.5 - 7. Extra moisturising oil can be added into bath water if bathtub is used. Plenty of moisturisers should be applied after bath, or even at any other time, in order to keep the skin supple.

If the eczema is more severe, difficult to control, or there are obvious signs of infection, then medical attention is necessary. The doctor may initially prescribe a steroid cream to contain the inflammation.

If the skin is too itchy that disturbs sleeping, some anti-histamines can be used which will cause some drowsiness, reduce the itch and promote sleep. If there is bacterial infection, then either a topical antibiotic cream or oral antibiotics will be need, otherwise steroid alone will not make it better.

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