Discoid Eczema - what is it and how can I treat it?

Discoid eczema - or nummular dermatitis - is a chronic skin condition that causes itchy skin, as well as the skin to become swollen and cracked in circular or oval patches.

Find out how to identify symptoms of this condition and what you can do to treat discoid dermatitis below.

Discoid eczema, also known as discoid dermatitis or nummular dermatitis, can cause patches of eczema that appear circular or in an oval shape. These patches can also be coin-shaped and sized and often start as mild discoid eczema. Discoid dermatitis can often be mistaken for psoriasis due to the similarity of symptoms between the two.

This condition is not limited to one specific part of the body, although typically it does not affect the face or scalp. Early-stage or mild discoid eczema typically starts on the limbs, particularly the legs. 

Some other features of discoid eczema include: 

• Dull red colouration or darker shade than your usual skin colour 
• Slightly bumpy surface with fuzzy edges 

After a few days, the patches can become raised and develop blisters which then start to ooze, which can become very itchy, cracked, crusty, and infected if not left untreated. Eventually, the patches and surface become scalier with the centres of the patches clear, making the skin dry and flaky. Over time, these patches may reduce or increase in occurrence, usually in the same places as they appeared initially.  

Due to the nature of the condition and its characteristics, the reoccurrence of discoid eczema after clearing up or treatment means it can leave pale areas (post-inflammatory hyperpigmentation) and general hyperpigmentation in people with darker skin tones.

Due to the centre of the patch becoming clear and leaving a round area of discoloured skin, discoid eczema can also be mistaken for ringworm. Similar symptoms can appear such as the skin being:  

• Dry and crusty 
• Itchy 
• Swollen 
• Reddened 

However, ringworm appears on the skin as ring-shaped patches and is a fungal infection that is very contagious. You can usually identify discoid dermatitis as coin-shaped patches. 

Fundamentally, discoid dermatitis is a condition that can be brought on by several things, such as extremely dry skin, whereas ringworm is a fungal infection that can be treated with fungal medicines. 

While discoid eczema is a long-term (chronic) condition, it can be managed with various treatments to help relieve the symptoms as well as manage the condition.  

Discoid eczema treatment includes: 

• Creams and emollients – these are essential to moisturise the skin and stop it from becoming dry. 
• Topical corticosteroids – creams and ointments which contain a steroid that are applied to the skin to help relieve symptoms of itchiness and redness. 
• Antihistamines – medicines that reduce itchiness of skin conditions like discoid eczema. 
• Oral corticosteroids – for severe flare-ups that cannot be solely treated with topical corticosteroids. 
• Antibiotics – administered by your doctor. 
• Steroid injections – can be utilised if other treatments do not work on particularly stubborn cases of one or two discoid eczema patches.  

It is important to acknowledge that although discoid eczema treatment is intended to manage the condition as well as treat the symptoms that may occur, discoid eczema can still appear months or years after treatment has concluded. 

Eucerin AtoControl Acute Care Cream offers intensive care for flare ups from conditions like atopic dermatitis and discoid eczema by targeting irritated and itchy patches of skin. 

Eucerin AtoControl Body Care Lotion is ideal for skin impacted by conditions like discoid eczema and atopic dermatitis which has been specially formulated to soothe and intensely moisturise irritated and dry skin. 

Eucerin AtoControl Bath and Shower Oil is soap-free and enriched with a high concentration of Omega-3 and Omega-6 Oils to gently cleanse and soothe skin with atopic dermatitis and discoid eczema. 

All products are clinically and dermatologically proven to deliver results while being gentle on atopic skin. 

The causes of nummular dermatitis aren’t clear or entirely known. However, generally, eczema can be exacerbated by having very dry skin. Other proponents of discoid eczema can be the weather, as this condition is more common in the cold winter months, due to our skin being exposed to hotter conditions when indoors such as central heating, dry air or low humidity which all dry out the skin.  

Another factor could be contact dermatitis, which could be a trigger for discoid eczema if the skin encounters a chemical irritant within toiletries and cosmetics like certain soaps, shampoos and shower gels. 

You should seek medical advice if you spot potential symptoms of discoid eczema as only a medical professional can diagnose the condition correctly. They can also recommend treatment which can include antibiotics, topical or oral corticosteroids. 

If the skin becomes infected due to the discoid eczema patches oozing, appearing very inflamed and crusting, it’s highly advisable to get medical advice as this would have to be treated with specific medication prescribed by a doctor. 

Diagnosing discoid eczema is done by examining the skin generally, looking for any irregularities in appearance. If a doctor is unsure or uncertain about their diagnosis, it may be recommended to undertake tests to rule out other conditions.  

These can be:  

• Skin patch testing: to rule out contact dermatitis. 
• Scrapings: to rule out conditions like fungal skin infections like ringworm. 
• Bacterial swabs: commonly carried out to test for bacterial colonisation or infection. 

Discoid eczema typically tends to be a long-term condition which can relapse and have flare-ups in specific times of the year, such as in the cold winter months or in very dry conditions. However, discoid eczema can be treated or left to resolve itself, however this can mean symptoms can last a lot longer without treatment. If the condition worsens, it is recommended to visit your doctor for further treatment to manage the condition.