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How To Treat Discoid Eczema

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.

Can Eczema Look Like Little Bumps

These bumps are called papules. Eczema refers to a range of related skin conditions. When eczema looks like small lumps rather than a rash, doctors may refer to the condition as papular eczema. This article will explain what papular eczema is, who is most likely to experience it, and how people can treat it.

Enhancing Healthcare Team Outcomes

Inflammatory dermatoses such as nummular dermatitis are often treated by primary care physicians, nurse practitioners, physician assistants, or dermatologists. Although the differential diagnosis of nummular dermatitis is quite broad, it is most often clinically diagnosed by recognizing its patterns of morphology, distribution, and epidemiology. Ancillary testing such as skin scraping with potassium hydroxide preparation, bacterial swab for culture and sensitivities, or biopsy may be performed either in the primary care or dermatologic setting. If the nummular dermatitis is unresponsive to conservative management and topical corticosteroids, it is appropriate to consult a dermatologist. A specialist should supervise patch testing, narrowband UVB treatment, or systemic immunosuppressant, or immunomodulatory therapy.

Treatment of nummular dermatitis can be optimized with an interprofessional team approach. The patients nurse, primary care provider, or dermatologist should monitor for therapy compliance, report any adverse effects, and relay the response to therapy to the remainder of the team. This type of interprofessional teamwork will enhance patient outcomes and minimize adverse reactions in caring for patients with nummular dermatitis.

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Can Discoid Eczema Become Infected

Yes when patches of affected skin begin to weep and itch, the chances of that site becoming infected with bacteria are high, particularly if scratched. Sometimes a skin infection may spark off a flare of discoid eczema. If the surface has a yellow crust or is very weepy, the skin is probably infected and you should see your doctor to get treatment.

The condition can become more widespread if any infection is left untreated, while treatment of the infection can help clear up the eczema.

Symptoms And Signs Of Nummular Dermatitis

Nummular Eczema

Plaques and patches of nummular dermatitis are erythematous and scaly, typically intensely pruritic, and are coin-shaped and well-demarcated but not sharply. They can number from 1 to about 50 and tend to be from 2 to 10 cm in diameter. They are often more prominent on the extensor aspects of the extremities and on the buttocks but also appear on the trunk.

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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.

What Does Eczema First Look Like

Dry skin. Itching, which may be severe, especially at night. Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and in infants, the face and scalp. Small, raised bumps, which may leak fluid and crust over when scratched.

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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.

How To Use Emollients

Nummular eczema causes, symptoms, treatment, prevention, and home remedies | Discoid Dermatitis

Use your emollient all the time, even if you’re not experiencing symptoms, as it can help prevent the return of discoid eczema. Many people find it helpful to keep separate supplies of emollients at work or school.

To apply the emollient:

  • use a large amount
  • do not rub it in smooth it into the skin in the same direction that the hair grows
  • for very dry skin, apply the emollient every 2 to 3 hours, or more often if necessary
  • after a bath or shower, gently dry your skin and then immediately apply the emollient while the skin is still moist

If you’re exposed to irritants at work, make sure you apply emollients regularly during and after work.

Do not share emollients with other people.

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What Happens If You Leave Eczema Untreated

Infected eczema can also lead to more dangerous complications. For example, if left untreated, a serious staph infection may cause sepsis, a potentially life threatening type of blood infection. In addition, severe eczema herpeticum can cause infections in the cornea of the eye, which may lead to blindness.

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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How To Manage Discoid Eczema

As with any kind of eczema, the key to managing discoid eczema involves three steps:

  • Identifying and avoiding your triggers
  • Soothing inflammation/itchiness
  • Applying emollients

It is often possible to manage a flare of discoid eczema at home and without prescribed medication , but if the problem doesnt improve or worsens, or if youre worried about infection, then consult a doctor or pharmacist.

Other Types Of Eczema

discoid eczema treatments

Eczema is the name for a group of skin conditions that cause dry, irritated skin. Other types of eczema include:

  • atopic eczema the most common type of eczema, it often runs in families and is linked to other conditions such as asthma and hay fever
  • contact dermatitis a type of eczema that happens when the skin comes into contact with a particular substance
  • varicose eczema a type of eczema that usually affects the lower legs and is caused by problems with the flow of blood through the leg veins

Page last reviewed: 30 October 2019 Next review due: 30 October 2022

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How Is Nummular Eczema Diagnosed

Your doctor may be able to diagnose nummular eczema by asking you about your medical history and visually inspecting your skin. They may also order a skin sample to be taken by superficially scraping the skin.

A dermatopathologist will analyze the skin cells and try to determine whether the rash is nummular eczema or another skin condition.

If your doctor suspects the lesions are a result of an external allergic reaction, they may perform an allergy test as well. This test is done in the doctors office. It involves leaving a patch on your skin for several days and watching for a reaction.

Keeping Your Skin Clear

After treatment, your skin might return to normal. But nummular eczema often comes back — possibly in the same area. If you have frequent flares, ask your dermatologist whether you should make any specific lifestyle changes. Your doctor might suggest stress management techniques or changing a medication you take that could be irritating your skin.

If your doctor believes an allergy or hypersensitivity is to blame, a type of allergy test called patch testing can help sort it out. Up to half of people with nummular eczema who donât respond to the typical treatments have some type of allergy. Once you know what youâre allergic to — perhaps a metal like nickel, a fabric like wool, or a fragrance in your personal care products — you can avoid it.

To maintain healthy skin and lessen the risk of the condition coming back, itâs also important to keep your skin well-hydrated. These might help:

  • Quick, lukewarm showers
  • Thick moisturizing cream
  • A humidifier if the air in your home is dry

Show Sources

American Academy of Dermatology: âEczema Types: Nummular Eczema,â âNummular Eczema Diagnosis and Treatment,â âNummular Eczema Self-Care.â

National Eczema Association: âNummular Eczema,â âWhat is Eczema?â

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Natural Eczema Treatment: 13 Home Remedies For Eczema

By Kathleen McCoy, BS

May 30, 2017

Is your skin red, dry, scaly and extremely itchy? Have you been diagnosed with eczema? The skin condition eczema is believed to affect over 30 million Americans. So, what is eczema? In fact, eczema isnt a single condition it is actually a group of skin conditions that includes atopic dermatitis, contact dermatitis, dyshidrotic eczema, hand eczema, neurodermatitis, nummular eczema and stasis dermatitis. Finding a soothing, natural eczema treatment can be life-changing for those suffering from this frustrating condition.

Eczema typically first appears in very young children with research finding that 65 percent of cases occur before infants hit their first birthday, and 90 percent of those affected have their first cases before they turn 5 years old. Of further concern is that eczema in children is becoming more and more common. Diseases eczema can resemble include psoriasis, rosacea and dermatitis, but its a different condition.

A study conducted by the Department of Pediatrics at Cincinnati Childrens Hospital Medical Center found that 39 percent of Caucasian children develop eczema by 3 years old. Interestingly, this same study found children that have a dog in the home are significantly less likely to develop eczema at any age.

Most People Are Familiar With The Skin Condition Eczema However What Many People Dont Know Is That There Are Several Different Types Of Eczema Each Type Has Its Own Causes Symptoms And Treatments

A Closer Look at Discoid Eczema

Discoid Eczema is one type of eczema. It is a rash that appears on the skin that looks like red coin-shaped discs, causing inflammation, itching and can be incredibly uncomfortable. Discoid Eczema is also known as nummular dermatitis or nummular eczema, due to its coin like shape.

It can appear on all parts of the body, although its typically found on the lower legs, hands and forearms. Unfortunately, Discoid Eczema is a chronic condition, which means it is long term. Fortunately, there are ways to manage the condition, reducing itching and discomfort.

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Causes And Risk Factors Of Nummular Eczema

If you have sensitive skin, you may also develop NE if you dont take care. NE is triggered by factors that cause dry skin, says Friedler. If you have a history of skin reactions or eczema, be wary of taking long, hot showers, using harsh or strongly scented soaps, and allowing your skin to become too dry. You may also notice flare-ups during winter, when the air outside is cold and dry and the forced heat indoors is dry, too, notes Friedler.

What Is The Treatment Of Discoid Eczema

As discoid eczema is associated with loss of skin barrier function, it is important to:

Protect the skin from injury.This type of dermatitis often starts after minor skin injuries, so careful skin protection is required. If the hands are affected, use gloves and tools to make sure the skin is not irritated by friction, detergents, solvents, other chemicals, or excessive water.

Apply emollients frequentlyEmollients include bath oils, soap substitutes and moisturising creams. They can be applied to dermatitis as frequently as required to relieve itching, scaling, and dryness. Emollients should also be used on the unaffected skin to reduce dryness. It may be necessary to try several different products to find one that suits. Many people find one or more of the following helpful: glycerine and cetomacrogol cream, white soft paraffin/liquid paraffin mixed, fatty cream, wool fat lotions, or urea cream.

Avoid allergens

If patch testing has identified contact allergy, exposure to the allergen should be avoided.

Anti-inflammatory treatments include:

Topical steroidsTopical steroids are anti-inflammatory creams or ointments available on prescription to apply just to the patches once or twice daily for 24 weeks. Topical steroids reduce symptoms and clear the dermatitis.

AntibioticsAntibiotics are often prescribed if the dermatitis is blistered, sticky, or crusted. Sometimes discoid eczema clears completely on oral antibiotics, only to recur when they are discontinued.

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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.

Diagnosis Of Discoid Eczema

Discoid Eczema: Causes, Symptoms and Treatment

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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Causes Of Discoid Eczema

The cause of discoid eczema is unknown, although it may happen as a result of having particularly dry skin.

When your skin is very dry it cannot provide an effective barrier against substances that come into contact with it. This could allow a previously harmless substance, such as soap, to irritate your skin.

It’s important to look carefully at all the chemicals in cosmetics and toiletries that may have come into contact with your skin. Contact dermatitis, a type of eczema caused by coming into contact with a particular irritant, may have a role in discoid eczema.

Some people with discoid eczema also have a history of atopic eczema, which often happens in people who are prone to asthma and hay fever. However, unlike atopic eczema, discoid eczema does not seem to run in families.

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.

Design: Hannah Packer

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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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