What is discoid eczema?

Discoid eczema is a type of eczema characterised by the shape of its lesions, i.e. the circular itchy, dry patches it leaves on the skin. It’s also known as nummular eczema or nummular dermatitis, which refers to ‘nummus’, the Latin word for coin, because the patches are round and coin-shaped.

This type of eczema tends to affect slightly more older men than women or children, but anyone can get it. It can look a bit like other skin conditions (such as ringworm, which is actually a fungal condition, or plaque psoriasis) which need different treatment, so it’s important to get a diagnosis if a flare persists.

What are the symptoms of discoid eczema?

Patches of discoid eczema tend to start as small bumpy or spotty round or oval areas anywhere on the body. These patches can spread evenly outwards, eventually leaving an area of clear skin in the centre of the disc. The outer ring of the patch can be itchy, inflamed, weeping or crust over. As the flare starts to resolve, the patches can dry up and become scaly. Like many types of eczema, the circular lesions can become infected.

On skin of colour, the patches might be discoloured (darker or lighter than the surrounding skin) for some time after the flare has subsided. The patches can be brown, purple, grey, pink or red.

What causes discoid eczema?

Like other kinds of eczema or dermatitis, discoid eczema has several different possible causes; a flare might have been caused by one particular trigger or by the conjunction of two or more different factors, although it’s not totally clear why some people get this particular form of eczema and not others.

Possible contributing factors include:

• Dry skin
• Dry weather
• Contact with irritating substances (detergents, ingredients in toiletries, metals etc)
• Damage to the skin from insect bites, burns or injury
• Poor circulation in lower legs (see also stasis eczema, which can manifest as discoid eczema)
• An impaired skin barrier
• Some medications

What part does stress play in discoid eczema?

Emotional stress seems to be a significant factor in cases of discoid eczema, as it does for many chronic skin conditions. For some people, stress will be the most common trigger of their condition, with life events that cause distress or anxiety provoking their eczema to flare up.

How does that work? Well, stress causes the release of inflammatory substances in the body, designed to help you cope with immediate threats to your safety. It’s a part of the body’s defence system, but can be triggered more easily in some people than others. If your emotional distress continues longer term, these inflammatory hormones can affect your skin, resulting in itchy, inflamed areas and an impaired skin barrier.

The feedback loop

One of the hardest things about managing eczema of any sort is the feedback loop that means the eczema itself makes it hard for sufferers to get rid of it. Stress-induced eczema is further exacerbated by the stress, discomfort and self-consciousness of having eczema; itchiness causes further damage to the skin which in turn triggers more itching.

Breaking these vicious circles can be incredibly hard, so here are some strategies for managing stress-induced discoid eczema.

Anti-itch strategies

• Cold compresses, ice towels, 
• Pressing down on itchy skin, rather than scratching
• Oat or mineral salts baths
• Wrapping, covering or bandaging itchy areas
• Using a soft-toothed brush or comb gently on the area
• Distract your hands with activities such as knitting

Self-care strategies

• Drink plenty of water
• Eat healthy omega-rich, gut-friendly food
• Find time to walk in the fresh air
• Try gentle exercise like yoga, pilates, swimming
• Meditation
• Journalling
• Gardening

Remember to talk to your doctor about your stress if you think it is significantly affecting your eczema, especially if you’re struggling with depression or feeling overwhelmed with anxiety.

Other strategies to manage a flare-up of discoid eczema include avoiding irritants in your toiletries and household, and the regular application of soothing emollients, such as Balmonds Skin Salvation or Daily Moisturising Cream.

Recommended products:

Balmonds Skin Salvation
with hemp and beeswax

Balmonds Daily Moisturising Cream
with shea butter and calendula

Balmonds Cooling Cream
with shea, menthol, aloe vera & lavender