Asteatotic eczema in older adults

It often appears on the lower legs but may involve the arms or trunk. Skin can look scaly, red or fissured and may itch enough to disturb sleep. Prompt barrier care helps reduce further cracking and scratching.

With age, skin produces less surface oil and recovers more slowly from water loss and irritation. Indoor cooling, dry weather, long hot showers, strong soap and frequent cleansing can add to that loss. Reduced mobility may also make regular moisturising harder.

The condition is sometimes called eczema craquelé because intersecting fine cracks can resemble cracked paving. Similar changes can arise from contact dermatitis, leg swelling or another skin disorder, so widespread, one-sided or treatment-resistant areas deserve assessment.

Use lukewarm rather than hot water, limit cleanser to areas that need it, and pat the skin dry. Smooth a fragrance-free cream or ointment over dry areas immediately afterward and again whenever tightness returns. Loose, soft clothing reduces rubbing over the shins and arms.

For someone with limited reach or grip, a pump container, long-handled applicator or caregiver assistance can make the routine manageable. Check the skin during application for new wounds, weeping or colour changes. Reduce trip risk by keeping moisturiser off floors and the soles of the feet.

A clinician may prescribe a topical anti-inflammatory for active eczema. Older skin can bruise or thin more easily, so use the specified amount, site and course rather than applying another person's cream.

Contact a clinician promptly for spreading redness, increasing warmth, tenderness, swelling, pus, fever or sudden confusion. These findings may accompany infection, and sudden confusion in an older person needs urgent medical evaluation even when the skin change seems minor.

Schedule a review if cracks bleed, itch interrupts sleep, the rash covers a broad area, or regular emollient use brings little relief. New lower-leg swelling, a poorly healing sore or a marked difference between the legs also merits examination.

Ask whether the appearance fits asteatotic eczema, whether leg swelling or a medicine could be contributing, and which emollient is easiest to use safely. If a steroid cream is prescribed, confirm its strength, exact application sites and when the skin should be checked again.