Discoid eczema – The complete guide

Discoid eczema is a common type of eczema. It looks like an oval or round lesion and it can be very itchy.

Discoid eczema is also known as nummular eczema or dermatitis. It can occur at any age including, childhood, but it is more common in adult males. Anyone can get discoid eczema, but people with atopic eczema, infected eczema, or allergic contact dermatitis are more likely to develop it. It can also develop in those who had eczema as a child.

It also has an association with chronic alcoholism.

What causes discoid eczema?

There are many causes of discoid eczema. they are as follows:

  • Discoid eczema can be caused by dry skin. Children and adults with atopic dermatitis can get discoid eczema or a mixture of both flexural eczema and discoid eczema. People who had atopic eczema in their childhood are often left with dry skin, these people will develop discoid eczema in their adult life, particularly on the hands.
  • Others who had no history of eczema but who nevertheless have “sensitive skin”, can develop discoid eczema, often in middle age or later.
  • Discoid eczema is more common in the cold winter months, during the winter season our the skin is exposed to central heating, dry air, and fan heaters and all of this causes the skin to dry.
  • Frequent contact with degreasing agents can remove the skin of its natural oil, leaving the skin dry and cracked, causing irritant contact dermatitis. Older people, whose skin is more drier can be more prone to discoid eczema, espicially if they have varicose and asteatotic eczema.
  • Discoid eczema can also develop on areas of the skin which are damaged, scarred from a scratch, bite, or burned.
  • It can also be caused from a allergy (for example jeans or belt buckles can cause a rash that looks like discoid eczema but is, in fact due to an allergy from nickel.
  • Emotional stress is also an another factor.

What does discoid eczema look like?

It is also known as nummular dermatitis, which means “coin-shaped”. It starts off quite suddenly on the first occasion when one or two oval dull red patches appear, the size of a coin or smaller.

These red patches start off as bumpy surfaces and fuzzy edges, usually on the lower trunk, forearms, or legs, even the legs and hands can also be affected. Within a few days, the patches often develop raised lumps that start to ooze, and they can become itchy, infected, and crusted.

Later, the surface becomes scaly (and the centers of the disc clear), leaving the skin dry and flakey. The discs may then appear (at any time between 10 days and a few months) in the same position on the opposite side of the body. Other patches may come up in different places such as the limbs.

Old patches that cleared up may also reappear.

Can discoid eczema become infected?

Yes, discoid eczema can become infected when patches of affected skin begin to weep and itch, the chances of that area becoming infected with bacteria is high.

If the skin has a yellow crust or is weepy, then that means the skin is infected (and you should see a doctor to get it treated).

The doctor might prescribe a cream or an ointment for 14 days (a combination of antibiotic and steroid). Using them longer might result in resistance to the antibiotic. If the infection spreads, a skin swab will be taken and you will be prescribed a course of antibiotic tablets to take.

How can you treat discoid eczema?

  • Emollients: people with discoid eczema will often have dry skin and should use emollients from time to time, especially during the winter seasons. There is a wide range of emollients (also called moisturizers) that can treat dry skin. If areas of the skin are wet or weeping, a cream emollient is more suitable than an ointment emollient. You can even look for emollients with antimicrobial properties.
  • Bathing: bathing can also make discoid eczema more comfortable (by removing crusts and reducing itchiness). Make sure to use lukewarm warm rather than hot water. You can add emollient bath oil to the water and an emollient soap substitute can be used for washing and showering. You can then apply emollient after bathing and showering.
  • Topical steroids: once discoid eczema is formed, the skin can become itchy, red, and inflamed, if this happens your doctor might prescribe a steroid (with a cream or an ointment). The strength of the steroid used will depend on the severity of the eczema.
  • For adults, a more stronger steroid will be used for a longer period (e.g. 2-4 weeks). children will be prescribed more moderate steroids according to thier age.
  • Only use these steroids on eczema-affected areas or as instructed by the doctor.
  • Environmental triggers: contact with detergents can make you develop discoid eczema, so its a good idea to avoid any household cleaning agents, or you can wear waterproof gloves to protect your hands. Central heated homes can also aggravate the condition (if you place a bowl of water near the radiator, you skin will become less dry). Also use a moisturizer during the winter seasons.
  • Severe discoid eczema: will require treatments like paste bandages, immunosuppresent drugs, and light therapy.