Discoid eczema

Discoid eczema (also known as nummular eczema/dermatitis) is a fairly common type of eczema that can occur at any age, including childhood, but is seen more frequently in adults. It has a distinctive appearance with oval or round lesions, and can be very itchy.

Symptoms

Round or oval patches
Usually the size of a 50 pence piece or smaller
Dull red colour or darker than you usual skin colour
Bumpy surface with fuzzy edges
Patches can develop raised lumps or blisters which start to ooze, and they can become very itchy, crusted and infected
The surface may then become scaly and the centre of the discs clear, leaving the skin dry and flaky
Patches may reappear or come up in other areas of the body
Usually affects the lower legs, trunk or forearms, although hands and fingers can also be affected
Tends to reoccur and may leave pale areas (post-inflammatory hypo-pigmentation) and dark areas (hyper-pigmentation) in people with darker skin tones

Triggers

Detergents

Contact with detergents can make you more likely to develop discoid eczema, so it’s a good idea to avoid direct contact with household cleaning agents or wear waterproof gloves to protect your hands.

Overheating

Discoid eczema is more common in the cold winter months, when our skin is exposed to central heating, dry air (low humidity) and fan heaters, which dry the skin. If you place a bowl of water near each radiator, your skin is less likely to become dry.

Stress

Worry may play a part in the development of discoid eczema, but is unlikely to be the sole cause of it. Worry can make the condition worse or more long-lasting. Any sources of concern should be addressed, if possible.

See other eczema triggers

Treatments

A number of medications are available from your GP to help treat discoid eczema, and there are steps you can take at home to make the skin more comfortable. Some of these include:

Emollients - Various brands can be bought from a supermarket or pharmacy, and some can be prescribed. It’s best to experiment to see which one suits you best. Emollients can and should be used for both moisturising and washing. In cold weather, apply a moisturiser to your skin before going out and also at regular intervals when indoors, especially if central heating makes your home dry.
Baths and showers - Bathing can make discoid eczema more comfortable by removing crusts and reducing itchiness, but hot water can aggravate the condition, so baths should be lukewarm. An emollient should always be used as a soap substitute when bathing and showering. Apply more leave-on emollient after bathing and showering.
Topical steroids - If your skin becomes itchy, red or darker/lighter than your usual skin colour, your doctor may prescribe a steroid with a cream or ointment base. Usually adults are prescribed a more potent steroid for longer periods. Children will be prescribed topical steroids according to their age and eczema severity.
Antibiotic and steroid creams - If only a few patches are infected, a cream or ointment containing a combination of an antibiotic and a steroid may be prescribed. These are prescribed for a 14-day treatment course.
Antibiotics - If the infection is more widespread, a skin swab may be taken and you will be given a course of antibiotic tablets, capsules or syrup (for children).

All treatments

FAQs

The exact cause of discoid eczema is not known, although dry skin is perhaps the most common feature. People who had atopic eczema in childhood are often left with dry skin and may develop discoid eczema as adults, particularly on the hands. Others with no history of eczema but have ‘sensitive skin’, which is drier than normal, may also develop discoid eczema, often in middle age or later.

Discoid eczema is also more commonly seen in;

People who had atopic eczema in childhood are often left with dry skin and may develop discoid eczema as adults, particularly on the hands

People with ‘sensitive skin’, which is drier than normal, may also develop discoid eczema, often in middle age or later

People who have previously had other types of eczema such as allergic contact dermatitis or infected eczema

Those with chronic alcoholism

Children of colour

Older people whose skin is drier and thinner

Those with an area of skin that has been damaged or scarred from a scratch, bite, burn or localised area of infection.

Those who have experienced skin dryness as a side effect of medications

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 a healthcare professional to get treatment. The condition can become more widespread if any infection is left untreated.

After a flare up, skin usually returns to normal appearance, and scarring is very rare. Discoid eczema can also resolve completely for some people.

It usually appears quite suddenly on the first occasion, when one or two round or oval patches appear. These are a dull red colour or a darker shade than your usual skin colour, depending on skin tone, and the size of a 50 pence piece or smaller. These patches start off with a slightly bumpy surface and fuzzy edges, usually on the lower legs, trunk or forearms, although hands and fingers can also be affected. 

Other skin conditions, such as ringworm (fungal infections) and psoriasis can look similar. See your GP for a diagnosis and treatment.

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Living with eczema (for adults) booklet

Supportive, practical information for adults managing eczema, based on the latest research and regularly reviewed by doctors and nurses.