When To Seek Medical Advice
See a pharmacist or GP if you think you may have discoid eczema. They can recommend a suitable treatment.
You should also seek medical advice if you think your skin may be infected. You may need to use an antibiotic cream or, in severe cases, take antibiotics as a tablet or capsule.
A GP should be able to make a diagnosis just by examining the affected areas of skin. In some cases they may also ask questions or arrange some tests to rule out other conditions.
A GP may refer you to a doctor who specialises in skin conditions if theyâre unsure of the diagnosis or if you need a patch test.
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Causes Of Weeping Eczema
Several factors can cause eczema, including a personal or family history of allergies, stress, and exposure to environmental factors that irritate the skin.
Weeping eczema indicates infection in your eczema, usually the result of scratching the area until the skin breaks.
This broken skin allows microorganisms like bacteria, fungi, and viruses to enter the body.
Some infections that can cause weeping eczema include:
- Staph infection: A staph infection is caused by staphylococcus aureus bacteria spreading throughout the body. On typical, healthy skin, it does not cause any problems. But on skin that has been broken, bacteria can enter deeper layers, triggering an infection.
- Fungal infections: Candida albicans is a type of pathogenic yeast that normally lives on the skin and inside the body. But if it grows out of control, it can cause infection.
How Is Discoid Eczema Treated
A number of medications are available from your doctor to help treat discoid eczema, and there are also things you can do at home to make the skin more comfortable. See your GP for a diagnosis if you think that you may have discoid eczema, because other skin conditions such as psoriasis and ringworm can look very similar.
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Home Remedies For Nummular Eczema
There isnt a cure for nummular eczema, and the best way to take care of symptoms is with a doctor-prescribed corticosteroid topical rub. But that doesnt mean you cant employ techniques at home to limit the likelihood and severity of flare-ups.
You may be able to help control it by:
- Avoiding wool and other skin irritants that can trigger symptoms
- Avoiding excessive bathing and hot water
- Getting rid of harsh soaps loaded with chemicals
- Trying to avoid stressful situations and finding ways to minimize stress exercise, improving sleep hygiene, yoga and mindfulness can all help with stress relief.
There are a number of inflammatory conditions that can be aided by lifestyle decisions. Although they might not specifically target nummular eczema, they can create an internal environment that limits the chances and seriousness of an outbreak.
For example, eating more leafy greens, fruits, and vegetables instead of processed foods, refined sugars, and packaged goods can keep inflammation low, which is a preventative measure against inflammatory flare-ups.
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Is There A Way To Prevent Eczema
You can prevent eczema by avoiding triggers, for some, skin irritants like dry heat, wool, harsh soaps, fabric softeners and sweating may lead to flares, Dr. Libby said.
Dilute bleach baths using a quarter cup of bleach in a half tub of water and thoroughly mixing is also a mainstay of eczema prevention and treatment, as they have been found to reduce eczema symptoms by reducing bacterial load and inflammation on the skin, she adds.
Choice Of Topical Corticosteroid
There are different strengths of topical corticosteroids that can be prescribed depending on the severity of the eczema. Discoid eczema usually needs a stronger type of corticosteroid than other types of eczema.
You might be prescribed a cream to be used on visible areas, such as your face and hands, and an ointment to be used at night or for more severe flare-ups.
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What Do The Ecz
Once we identify nummular eczema and treat it appropriately, most people are significantly better within seven to 10 days, and, for patients who dont have another type of eczema, it often never comes back, according to Dr. Peter Lio, founding director of the Chicago Integrative Eczema Center. Even in those for whom this is a manifestation of their underlying atopic dermatitis, the nummular aspect seems to disappear quickly and then we can go back to overall management.
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Deterrence And Patient Education
Patients should be counseled that behavior modification can result in significant improvement of nummular dermatitis. Patients should be instructed to take short lukewarm showers, use gentle hydrating liquid cleansers, and apply emollients immediately after showering while the skin is still damp. The use of a bland ointment such as petroleum jelly, is recommended. Encourage patients to avoid tight clothing and irritating fabrics such as wool. Otherwise, patients must be instructed to carefully follow their prescription regimen as directed.
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What Causes Nummular Eczema
The answer is still a mystery, but there are several known risk factors associated with the condition. Most often, people assigned female at birth develop nummular eczema before theyre 30 years old, whereas people assigned male at birth generally develop the condition in their 50s or later, according to the AAD. The reasons for this discrepancy arent clear, but the answer could be tied to other discoid eczema risk factors.
For instance, people whose skin barriers have been weakened from other skin conditions, such as atopic dermatitis or contact dermatitis , are at an increased risk of also developing nummular eczema. Research shows those other forms of eczema are more common in people assigned female at birth. Having family members with a history of eczema or asthma also increases your risk of developing nummular eczema. And if youre already susceptible to developing the condition due to genetic factors, certain events, such as skin injuries or infections, can set off symptoms, according to the AAD.
What Ingredients Are Best To Help Treat Eczema
Eczema is a clinical dysfunction of the skin barrier, Dr. Libby notes. As such, genetic, environmental, and immunologic factors contribute to its flare-up, but its a priority to repair the skin barrier. Namely, ingredients to help reverse eczematic effects are humectants, emollients and occlusive moisturizers.
According to Dr. Libby, humectants help add moisture back to the skin, while emollients add back oils, lubricating and softening the skin. Occlusive moisturizers work to prevent transepidermal water loss .
Common humectants are glycerin, lactic acid, urea and hyaluronic acid, Dr. Libby adds. Emollients examples are glycol and glyceryl stearate, soy sterols, squalane, and oils like jojoba, sweet almond, etc. Common occlusives are petrolatum, dimethicone, shea butter and mineral oil.
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What Is Nummular Eczema
Nummular eczema is a skin condition that causes circular, raised spots on your skin. Nummular comes from a Latin word for coin, and the patches are coin-shaped. The lesions are often itchy, sometimes ooze clear fluid and may become crusty on top.
The condition is chronic. Patches can last for weeks to months, and flare-ups or episodes can repeatedly happen over a long period of time.
Nummular eczema is also called nummular dermatitis and discoid eczema.
Manage Your Stress And Limit Your Itching
Stress is a significant factor in discoid eczema, so anything you can do to manage your stress levels will be helpful. What works for you is likely to be different to what works for others, so find your own path here. You may prefer yoga to running, listening to music over reading a book, or turn to knitting as a good distraction from itching, rather than cooking, gardening or warm baths, but whatever remember to take yourself and your needs seriously.
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Are There Any Possible Complications
As mentioned above, bacterial infection of a patch of discoid eczema can occur and needs to be treated with antibiotics. Also, care should be taken to avoid scratching the itchy patches where possible. If you scratch a skin patch too much, scarring of your skin can occur.
After a discoid eczema skin patch has healed, in many people there will be no residual signs. However, in some people there can be some permanent brown discolouration of the skin in the affected area. In others, the affected area of skin can become paler than the surrounding skin.
How To Address Nummular Or Discoid Eczema
The good thing is that nummular or discoid eczema is easier to address than long-term, allergic eczema . Dr. Markowitz encourages patients to first visit their dermatologist to confirm that they actually have nummular eczema. Once there, your derm will likely prescribe a topical or prescription steroid, depending on the severity.
If you manage the skin really well and combat that dryness at home, however, you can get it under control by using products that help seal in moisture, she says. Stick to mild, non-fragrant soaps and always follow up with a really thick moisturizer. We recommend the CeraVe Itch Relief Moisturizing Cream which is steroid-free, non-comedogenic and approved by the National Eczema Association.
Dr. Markowitz also recommends getting a humidifier in your home, which can help hydrate your skin. All of these little tricks may help manage nummular eczema, so you might not need to go the prescription route, but youll need to keep up with all those remedies to prevent it from returning, she says. Also, remember to consult with your dermatologist for the best treatment route.
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Topical Steroids To Reduce Inflammation
A topical steroid is a steroid cream or ointment that is applied to your skin. In discoid eczema, topical steroids are applied to the skin patches to reduce inflammation. Ointments tend to be better than creams because they tend to hold water in your skin better and form a better protective barrier for your skin.
Do not use the steroid cream or ointment on normal skin. Also, steroids should only be used when discoid eczema has flared up. They should not be used in between times to keep discoid eczema away. This is because long-term steroid cream use can have some effects on your skin, including thinning of your skin. See the separate leaflet called Topical Steroids for Eczema for more details.
Sometimes wet wrap treatments are used with a topical steroid to treat discoid eczema. Your skin is made wet first with lukewarm water so that it is well hydrated. Then, a steroid ointment is applied to the affected areas of skin. Next, damp pyjamas or bandaging are used to seal in the steroid ointment for around one hour. However, do not try such treatments unless advised by your doctor.
In severe cases, steroid tablets taken by mouth or given by injection may be needed to treat discoid eczema.
Note: when using both an emollient and a topical steroid, you should apply the emollient first. Wait 10-15 minutes after applying an emollient before applying a topical steroid. That is, the emollient should be allowed to absorb before a steroid is applied.
Diagnosis Of Discoid Eczema
The doctor inspects your skin and analyzes your medical history. A skin biopsy may also be performed to determine whether the rash is discoid eczema.
The doctor may perform a patch test if they suspect the rash to be caused by an external allergic reaction. According to a study, allergic contact dermatitis is relatively common in persistent discoid eczema . Hence, a patch test is recommended for all patients with severe discoid eczema.
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Dr. Chan recommends Avenes XeraCalm A.D. Lipid-Replenishing Balm as one of her favorite eczema creams. Why? It nourishes that itchy feeling, helps rebalance the skins microbiome and seals in moisture for up to 48 hours.
It helps calm dry, irritated and sensitive skin by helping to reduce itching, and alleviating redness and inflammation, Dr. Libby notes, too, as one of her favorite eczema creams.
The Symptoms Of Discoid Eczema
The symptoms of discoid eczema often get misdiagnosed, with the commonplace circular lesions usually being mistaken for ringworm.
It is important to be familiar with these symptoms in order to achieve a quicker diagnosis, giving you a better chance of catching the affliction in the early stages and taking preventative measures to boost your recovery time.
- Inflammation: Inflammation normally occurs in eczema as the result of an immune response to skin irritants, allergens or invasive pathogens. The immune system releases a number of inflammatory chemicals such as histamine, which cause the affected area to swell as they body fights off potential infections and tries to repair any damage
- Itchiness: Itchiness often appears during discoid eczema and can be one of the more infuriating symptoms, usually disturbing sleep patterns and placing the sufferer at risk of developing a secondary bacterial infection due to continuous scratching
- Red patches: Discoid eczema is synonymous with the red coin-shaped patches that normally form on the legs. These patches can be very uncomfortable, often burning or stinging, and are usually extremely itchy
- Blistering: Blisters are formed in the epidermal layers of the skin and commonly contain a clear fluid or occasionally blood or pus. These abrasions can form a coin-like circle, developing into the dry, red patches associated with discoid eczema
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Treatment Of Severe Discoid Eczema
An introduction to discoid eczema. Discoid eczema is estimated to affect 1 in every 500 and typically appears between the ages of 50 and 70. 1 This form of eczema is chronic and sometimes considered one of the trickier types of eczema to treat as it is difficult to determine its causal factors, and it is often confused with other skin infections such as ringworm.
Topical steroid withdrawal, also known as TSW, topical steroid addiction, or red skin syndrome, is a reaction to the overuse.
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Moderate To Severe Eczema Treatment Apr 13, 2022 · The FDA approved the use of Dupixent for the treatment of moderate to severe eczema in adults in 2017. More recently, this biologic for eczema has been approved for use in children ages 6 and up. Feb 15, 2007. Topical corticosteroids should be first-line treatments for patients with atopic dermatitis flare-ups.
Wet wraps: This is another way to treat eczema that hasn’t responded to other treatments. You take a warm bath then “seal” the moisture in your skin with a moisturizing cream. Then, you wrap the.
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What Are The Symptoms Of Nummular Eczema
The most common and noticeable symptom of nummular eczema is a patch of coin-shaped lesions on the body. The lesions frequently develop on the arms or legs, but they may eventually spread to the torso and hands. They may be brown, pink, or red.
Other symptoms may include:
- lesions that are very itchy and burn
- lesions that ooze fluid and eventually crust over
- red, scaly, or inflamed skin around the lesions
Signs of eczema clearing or new flare-ups:
- Flatter spots are visible.
- Skin discoloration is present in the area where the spot flattens. In dark skin, this discoloration is known as postinflammatory hypopigmentation and may last for several months.
- A new flare-up may show up as a large, raised patch on top of an old, healing spot instead of a coin-shaped lesion.
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Nummular Eczema Versus Ringworm: Whats The Difference
Nummular eczema can be mistaken for a common infection that appears as a circular, itchy rash: tinea corporis, which is known as ringworm. It tends to present, as the name suggests, like a ring, Dr. Makhzoumi says. The two skin conditions are almost indistinguishable except for one subtle clue. Ringworm bumps are typically flat and have scaling on the border whereas an entire nummular eczema patch can be raised and scaly, Dr. Silverberg says. Further, the center of a ringworm patch may look like your typical skin color rather than red or brown, Dr. Silverberg says.
Ringworm, which can be spread from person to person , is caused by more than 40 species of fungi, including Trichophyton, Microsporum, and Epidermophyton, according to the Centers for Disease Control and Prevention . You can get ringworm by touching surfaces, objects, people, or animals that have ringworm. If you regularly shower at the gym and people you have been in contact with suddenly develop itchy, flat circles with scaly borders, that could be a sign that your skin rash is possibly pointing to ringworm.