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DISCOID ECZEMA
Discoideczemaisafairlycommonskincondi onwhichhasaverydis nctappearancewithovalorround
lesions.Ito encausesonlyminordiscomfort,althoughsome mesitcanbeveryitchy.Thiscondi oncan
beunsightly,butthereareanumberofthingsyoucandoathometoimproveit,aswellasavarietyof
treatmentsavailablefromyourdoctor.

Who gets discoid eczema?

Discoideczemaisapa ernofeczemaseeninchildrenwithatopiceczema,adults(o enintheir50sand
60s)andtheelderly,especiallyduringthewintermonths.Itismorecommoninmenthaninwomen.The
developmentofdiscoideczemainlaterlifemaybeassociatedwithatopiceczemainchildhood.People
exposed tostrongdetergentsandotherdegreasingagents,at homeorat work,arealsomorelikelyto
developit.

What causes discoid eczema?

Theexactcauseofdiscoideczemaisnotknown,althoughdryskinisperhapsthemostcommonfeature.
Childrenwithatopiceczemacanpresentwithdiscoideczemaoramixtureofbothflexural(skincreases)
and discoid eczema. People who had atopic eczema in childhood are o en le with dry skin these
peoplemaydevelopdiscoideczemaasadults,par cularlyonthehands.Otherswithnohistoryofeczema
but who nevertheless have 'sensi ve skin' which is drier than normal can also develop discoid eczema,
o eninmiddleageorlater.Frequentcontactwithdegreasingagentscanremovethenaturaloilsofthe
skin,leavingitdryandcrackedandcausinganirritantcontactderma s.
Discoideczemaismorecommoninthecoldwintermonths,whenourskinisexposedtocentralhea ng,
dryair(lowhumidity)andfanheaters,whichalldrytheskin.Theelderly,whoseskinisdrierandthinner,
canbemorepronetodiscoideczemaespeciallyiftheyhavevaricoseandasteato ceczema.
Discoid eczema can also develop on an area of skin that has been damaged or scarred from a scratch,
bite,burnorlocalisedareaofinfec on.
Itisonlyrarelyduetoaspecificallergy,suspectedwhendiscsareseeninanunusualplace.Forexample,
jeanstudsorbeltbucklescancausearashthatlooksratherlikediscoideczemabutis,infact,duetoan
allergy to nickel. If this is the case, you will possibly be referred to a dermatologist who may carry out
patchteststohelpfindoutthecauseoftheallergy.
Emo onalstressmayplayapartinthedevelopmentofdiscoideczema,butisunlikelytobethesole
causeofit.Worrycanmakethecondi onworse,ormorelonglas ng,andanysourcesofconcernshould
bedealtwithifpossible.

What does discoid eczema look like?

Anothernamefordiscoideczemaisnummularderma s,whichmeans'coinshaped'eczema.Itusually
appearsquitesuddenlyonthefirstoccasion,whenoneortworoundorovaldullredpatchesappear,the
sizeofa50pencepieceorsmaller.Thesepatchesstartowithaslightlybumpysurfaceandfuzzyedges,
usuallyonthelowerlegs,trunkorforearms,although handsandfingerscanalsobeaected.Within a

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DISCOID ECZEMA
fewdaysthepatcheso enbegintoooze,andtheycanbecomeveryitchy,crustedandinfected.Lateron,
thesurfacebecomesscalyandthecentresofthediscsclear,leavingtheskindryandflaky.Atany me
between 10 days and a few months later, other discs may appear, o en in the same posi on on the
opposite side of the body other patches may then come up in dierent places, such as on limbs
previouslynotaected.Oldpatchesthathaveapparentlyclearedupmayalsoreappear.
Withtreatmentthecondi oncanbeimprovedinmanycases,althoughdiscoideczemadoestendtorecur
andmayleavepaleareas(postinflammatoryhypopigmenta on)anddarkareas(hyperpigmenta on)in
pa ents with darkly pigmented skin. Usually, the skin returns to a perfectly normal appearance a er
severalmonths,andscarringisveryrare.

Can discoid eczema become infected?

Yeswhen patchesofaectedskin begin toweepanditch,thechancesofthatsite becominginfected
with bacteria are high, par cularly if scratched. Some mes a skin infec on may spark o an a ack of
discoideczema.Ifthesurfacehasayellowcrustorisveryweepy,theskinisprobablyinfectedandyou
shouldseeyourdoctortogettreatment.
The condi on can become more widespread if any infec on is le untreated, while treatment of the
infec oncanhelpclearuptheeczema.

How is discoid eczema treated?

Anumberofmedica onsareavailablefromyourdoctortohelptreatdiscoideczema,andtherearealso
some things you can do at home to make the skin more comfortable. See your GP for a diagnosis (and
treatment)ifyouthinkthatyoumayhavediscoideczema,becauseotherskincondi onssuchaspsoriasis
andringwormcanlookverysimilar.

Emollients
Peoplewithdiscoideczemao enhavedryskinthatshouldbetreatedtoimprovetheexis ngeczemaand
helppreventfurthera acks.Awiderangeofemollients,alsoknownasmoisturisers,areavailabletotreat
dryskinvariousbrandscanbeboughtfromasupermarketorpharmacy,andsomecanbeprescribedby
your doctor or nurse. It is best to experiment to see which one suits you best, but below are some
guidelineswhichmayhelpyouchoose:

Dry,flakyskinismosteec velytreatedusingagreasyprepara on,i.e.anointment,which

containsahighpropor onofoil.

Ifareasofskinareweeping,orwet,aspatchesofdiscoideczemacanbe,acreamismore
suitable.

Moisturisersareverysafeandcanbeappliedasfrequentlyasrequiredeveryhourifnecessary
topreventyourskinfromfeelingdryandbecomingflaky.

Itispossibletobecomesensi vetoapar cularingredientinmoisturisingcreamsorointmentsseethe

Na onalEczemaSocietyinforma onleafletonemollientsformoredetails.

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Bathing
Bathingcanmakediscoideczemamorecomfortablebyremovingcrustsandreducingitchiness,buthot
watercanaggravatethecondi onsobathsshouldbelukewarm.Anemollientbathoilcanbeaddedto
thewateroranemollientsoapsubs tutecanbeusedforwashingandshowering.A erbathingand
showeringisagood metoapplyamoisturiserwherevertheskinisdry.

Steroid Creams
Oncediscoideczemahasdeveloped,theskincanbecomeveryred,itchyandinflamedifthishappens,
yourdoctormayprescribeasteroid,withacreamorointmentbase,toapplytotheaectedareastohelp
themclearup.Thepotencyofthesteroidusedwilldependontheseverityoftheeczema;generally,for
discoideczemaamorepotentsteroidwillbeusedforlongerperiods,e.g.24weeksdependingonthe
areaofthebody.Onlyusethesteroidcreamonareasofskinwitheczemaunlessotherwiseadvisedby
yourdoctorornurse.Dryskinnotaectedbyeczemaisbesttreatedwithanemollient.

Treatments for infection

If your skin is infected (crus ng, oozing and very inflamed), see your doctor or nurse to get a specific
treatmentforthis.Ifonlyafewpatchesareinfected,acreamorointmentcontainingacombina onof
an bio c plus steroid may be prescribed. These should be used with cau on, as resistance to the
an bio c or poten al sensi vity to the prepara ons can occur. Other interven ons that can be used
includeemollientswithan microbialingredients.Iftheinfec onismorewidespread,askinswabmaybe
takenandyouwillbegivenacourseofan bio ctabletsorcapsulestotakeinthiscase,completethe
prescribedcourse,eveniftheinfec onclearsupbeforeallthetabletsaretaken.

Environmental triggers
Contactwithdetergentscanmakeyoumorelikelytodevelopdiscoideczema,soitisagoodideatoavoid
directcontactwithanyhouseholdcleaningagents,orwearwaterproofglovestoprotectyourhands.Dry
airincentrallyheatedhomescanaggravatethecondi onifyouplaceabowlofwaterneareach
radiator,yourskinislesslikelytobecomedry.Incoldweatherapplyamoisturisertoyourskinbefore
goingoutandalsoatregularintervalswhenindoors,especiallyifcentralhea ngmakesyourhomedry.

Conclusion
Discoideczemacanusuallybecontrolledwiththeabovetreatments,avoidingtriggerssuchassoaps,
bubblebath,overhea ngandcertainfabrics.Regularuseofemollientswillmaintaintheskinbarrierand
preventdryness.Mostpeoplefindthatdiscoideczemaeventuallyclearsupcompletely.Forsevereand
extensivediscoideczemaothertreatmentsmayberequiredandareferraltodermatologyshouldbe
madebeforetheseareini ated;forexample,pastebandages,topicalcalcineurininhibitors,oralsteroids,
azathioprine,ciclosporin,methotrexateandultravioletlighttherapy.

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FACTSHEET

National Eczema Society January 2015

The Na onal Eczema Society is a registered charity in England and Wales (number 1009671) and in Scotland
(number SCO43669) and is a company limited by guarantee (registered in England, number 2685803). Oce:
11 Murray Street, LONDON, NW1 9RE.

We are dedicated to improving the quality of life for people with eczema and their carers.

Eczema aects FIVE MILLION children and adults in the UK every year.

ALL our informa on is clinically evidence based and wri en by or verified by dermatology experts.

The Na onal Eczema Society receives no Government or Health Service funding, relying en rely on
voluntary income from the general public, Companies and Trusts.

DISCLAIMER
These details are provided only as a general guide. Individual circumstances dier and the Na onal Eczema Society
does not prescribe, give medical advice or endorse products or treatments. We hope you will find the informa on useful but it does not replace and should not replace the essen al guidance given by your general prac oner, dermatologist and dermatology nurse.

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