Discoid eczema | nidirect

Discoid eczema, also known as nummular or discoid dermatitis, is a long-term skin condition. It causes skin to become itchy, reddened, swollen and cracked in circular or oval patches. See your pharmacist or GP if you think you may have discoid eczema so they can recommend a suitable treatment.

Symptoms of discoid eczema

Circular or oval patches of eczema

Circular or oval patches of eczema can affect any part of the body, although they don’t usually affect the face or scalp.

They start as a group of small red spots or bumps on the skin which join up to form larger pink, red or brown patches that can range from a few millimetres to several centimetres in size.

Blistering

At first, these patches of eczema are often swollen, blistered (covered with small fluid-filled pockets) and ooze fluid.

Itchiness and pain

The patches also tend to be very itchy, particularly at night.

Dry, crusty, cracked and flaky skin patches

Over time, the patches may become dry, crusty, cracked and flaky. the centre of the patch also sometimes clears, leaving a ring of discoloured skin that can be mistaken for ringworm.

Discoid eczema causes circular or oval patches of eczema on the skin

You may just have one patch of discoid eczema, but most people get several patches. The skin between the patches is often dry.

Patches of discoid eczema can sometimes become infected.

Signs of an infection can include:

• the patches oozing a lot of fluid
• a yellow crust developing over the patches
• the skin around the patches becoming red, hot, swollen, and tender or painful
• feeling sick
• chills
• feeling unwell

When to get medical advice

See your pharmacist or GP if you think you may have discoid eczema so they can recommend a suitable treatment.

You should also seek medical advice if you think your skin may be infected. You may need treatment.

Your GP should be able to make a diagnosis just by examining the affected areas of skin. In some cases they may also ask questions or arrange some tests to rule out other conditions.

Your GP may refer you to a dermatologist (a doctor who specialises in managing skin conditions) if they’re unsure of the diagnosis or if you need patch testing.

Causes of discoid eczema

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

Dry skin means your skin can’t provide an effective barrier against substances that come into contact with it. This could allow a previously harmless substance, such as soap, to irritate (damage) 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 occurs in people who are prone to asthma and hay fever. However, unlike atopic eczema, discoid eczema doesn’t seem to run in families.

Other possible triggers

An outbreak of discoid eczema may sometimes be triggered by a minor skin injury, such as an insect bite or a burn.

Some medicines may also be associated with discoid eczema, as patches of eczema can appear in people taking:

• interferon and ribavirin – when they’re used together to treat hepatitis C 
• tumour necrosis factor-alpha (TNF-alpha) blockers – used to treat some types of arthritis
• statins (cholesterol-lowering medication) – which can cause dry skin and rashes

Dry environments and cold climates can make discoid eczema worse, and sunny or humid (damp) environments may make your symptoms better.

Treating discoid eczema

Discoid eczema is usually a long-term problem. But medications are available to help relieve the symptoms and keep the condition under control.

Without treatment, discoid eczema can last for weeks, months or even years. It may also keep recurring – often in the same area that was affected previously.

Treatments used include:

• emollients – moisturisers applied to the skin to stop it becoming dry
• topical corticosteroids – ointments and creams applied to the skin that can help relieve severe symptoms
• antihistamines – medications that can reduce itching and help you sleep better

There are also things you can do yourself to help, such as avoiding all the irritating chemicals in soaps, detergents, bubble baths and shower gels.

Additional medication can be prescribed if your eczema is infected or particularly severe.

Occasionally, areas of skin affected by discoid eczema can be left permanently discoloured after the condition has cleared up.

Other types of eczema

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

• atopic eczema (also called atopic dermatitis) – 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 occurs when the body comes into contact with a particular substance
• varicose eczema – a type of eczema that most often affects the lower legs and is caused by problems with the flow of blood through the leg veins

• Discoid eczema

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Discoid eczema – NHS

Discoid eczema, also known as nummular or discoid dermatitis, is a long-term (chronic) skin condition that causes skin to become itchy, swollen and cracked in circular or oval patches.

Without treatment, discoid eczema can last for weeks, months or even years. It may also keep coming back – often in the same area that was affected previously.

Symptoms of discoid eczema

Discoid eczema causes distinctive circular or oval patches of eczema. It can affect any part of the body, although it does not usually affect the face or scalp.

Credit:

Phanie / Alamy Stock Photo https://www.alamy.com/stock-photo-nummular-eczema-72432322.html?pv=1&stamp=2&imageid=98CEB49C-1F7D-44C0-860A-2DCA2646A698&p=218214&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d2%26resultview%3dsortbyPopular%26npgs%3d0%26qt%3dE5RG4J%26qt_raw%3dE5RG4J%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d%7bA883FDE5-7F3D-4472-81F5-B61111916852%7d%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d1%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3d%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d

The first sign of discoid eczema is usually a group of small spots or bumps on the skin. These then quickly join up to form larger patches that can range from a few millimetres to several centimetres in size.

On lighter skin these patches will be pink or red. On darker skin these patches can be a dark brown or they can be paler than the skin around them.

Initially, these patches are often swollen, blistered (covered with small fluid-filled pockets) and ooze fluid. They also tend to be very itchy, particularly at night.

Over time, the patches may become dry, crusty, cracked and flaky. The centre of the patch also sometimes clears, leaving a ring of discoloured skin that can be mistaken for ringworm.

You may just have 1 patch of discoid eczema, but most people get several patches. The skin between the patches is often dry.

Patches of discoid eczema can sometimes become infected. Signs of an infection can include:

• the patches oozing a lot of fluid
• a yellow crust developing over the patches
• the skin around the patches becoming hot, swollen and tender or painful
• feeling sick
• feeling hot or shivery
• feeling unwell

When to seek medical advice

See a pharmacist or GP if you think you may have discoid eczema. They can recommend a suitable treatment.

You should also seek medical advice if you think your skin may be infected. You may need to use an antibiotic cream or, in severe cases, take antibiotics as a tablet or capsule.

A GP should be able to make a diagnosis just by examining the affected areas of skin. In some cases they may also ask questions or arrange some tests to rule out other conditions.

A GP may refer you to a doctor who specialises in skin conditions (dermatologist) if they’re unsure of the diagnosis or if you need a patch test.

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.

Other possible triggers 

An outbreak of discoid eczema may sometimes be triggered by a minor skin injury, such as an insect bite or a burn.

Some medicines have been linked to discoid eczema. You should not stop taking any prescribed medicine without talking to the doctor who prescribed it for you.

Dry environments and cold climates can make discoid eczema worse, and sunny or damp (humid) environments may make your symptoms better.

Treating discoid eczema

Discoid eczema is usually a long-term problem, but medicines are available to help relieve the symptoms and keep the condition under control.

Treatments include:

• emollients – moisturisers applied to the skin to stop it becoming dry
• topical corticosteroids – ointments and creams containing a steroid that are applied to the skin and may relieve severe symptoms
• antihistamines – medicines that can reduce itching

There are also things you can do yourself to help, such as avoiding all the irritating chemicals in soaps, detergents, bubble baths and shower gels.

Additional medicine can be prescribed if your eczema is infected or particularly severe.

Occasionally, areas of skin affected by discoid eczema can be left permanently discoloured after the condition has cleared up.

Find out more about treating discoid eczema.

Other types of eczema 

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

• atopic eczema (also called atopic dermatitis) – 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: 23 March 2023
Next review due: 23 March 2026

About skin | Xerosis – Symptoms, Causes and Solutions

Most people suffer from some form of xerosis or simply dry skin during their lives. When this problem becomes serious, it affects people both physically and emotionally. The key to defeating the symptoms of xerosis is proper daily skin care that does not worsen skin condition and provides proper care and hydration. Understanding the various causes of dryness and applying the appropriate care helps individualize the process to improve its effectiveness.

What is xerosis?

Xerosis is the medical name for dry skin. It comes from the Greek words “xero”, which means dry, and “osis” – disease, disease. Xerosis is associated with a lack of moisture in the skin, may occur as a result of aging (age-related xerosis) or accompany certain diseases such as diabetes. As a result, the skin becomes dry, rough and tight, which can develop into keratinization, lead to peeling and peeling of the skin.

Whenever you are in doubt about the condition of your skin, it is important to consult a dermatologist for an accurate diagnosis. You can also use a skin test to diagnose.

Internal and external factors can damage the skin’s ability to hydrate.

The ability of the skin to regulate hydration, or saturation of its upper layers with moisture, depends on three main processes occurring at different depths in the skin: ), salts and amino acids, absorb and bind large amounts of water;

– skin’s own protective lipids (eg ceramide-3) perform the vital function of reducing water loss through evaporation;

– In the deeper layers, the skin’s own natural hydration system transfers water to the surface through aquaporin channels.

This delicate system works quite precisely and is able to adapt to the needs of skin hydration, maintaining the necessary concentration of moisture with changes in the external environment. However, several internal (endogenous) and external (exogenous) factors can disrupt this system, resulting in dry skin. The severity of symptoms depends on a number of complex factors.

Signs and symptoms of xerosis

Xerosis is a common skin condition that millions of people experience in either chronic or acute form. Just as the skin’s hydration system is maintained by many factors, lack of moisture in the skin can manifest itself in a variety of ways. Most often, dry skin will show only a few of these symptoms, while very dry skin will usually have all of these symptoms to some degree.

• Thickening is due to the fact that the skin loses its elasticity due to dehydration. When there is a lack of moisture, the skin becomes less elastic and loses volume.
• Roughness (keratinization) is also caused by dryness, which increases the rate of cell death in the upper layers of the skin, resulting in a thick layer of dead cells on the surface of the skin.
• Scaly skin is similar to keratinized skin, with the difference that the upper horny layer of the skin becomes dry and inelastic.
• Skin flaking occurs when dry skin particles are shed. Sometimes it looks like fine dust.
• Itching is another effect that occurs due to dry skin and is a sharp reaction to the discomfort caused by tight skin that does not function properly.
• sensitivity is caused by the inability of dry skin to resist irritants such as hot water, perfume and other substances that can penetrate the skin’s surface. However, skin sensitivity is not always associated with dryness.
  Dry skin can appear on any part of the body, although it generally occurs in places that are most exposed to external influences.

Inflammatory skin diseases such as atopic dermatitis and psoriasis predominantly result in localized xerotic skin.

Always seek professional advice and a diagnosis from a physician if you develop any of these symptoms.

What causes xerosis?

Three major skin imperfections have been shown to cause dryness.

When the skin lacks lipids or another natural moisturizing factor, it becomes dry.

Lack of protective skin lipids

The cells of the stratum corneum are connected to each other with the help of epidermal lipids. These lipids are essential for maintaining healthy skin by providing a protective barrier and retaining moisture. When lipids are absent, the skin may become dry and may feel tight and rough.

Lack of natural moisturizing factor (NMF)

In addition to urea, several other natural moisturizing factors (NMF) are present in the skin. These include PCA, lactic acid, salts and sugars. Like urea, this natural moisturizing factor draws and locks moisture close to the stratum corneum (the top layer of the skin), preventing it from becoming dry, flaky and damaged.

Inefficiency of own skin moisturizing system

Aquaporins are microscopic water channels located in cell membranes that control the transport of water in and out of the cell.
Aquaporins form a system that transfers moisture through the various layers of the skin’s epidermis.

Dry skin factors

Some external factors provoke the physiological changes described above, which can lead to xerosis.

Frequent washing can destroy the lipid barrier of the skin.

– Dry skin is more often associated with low air humidity (winter time, sometimes hot summer).

– Frequent cleansing causes breakdown of the skin’s natural barrier. The danger increases with the use of aggressive cleaners and detergents.

– The sun’s rays can cause dry skin, and ultraviolet rays increase the rate of moisture evaporation from the skin’s surface. In the long term, it can lead to premature aging of the skin, affecting its ability to maintain the required level of hydration.

Intrinsic factors: age, dehydration, diet, medication, and disease.

– Studies have shown that the concentration of lipids in the stratum corneum decreases with age. This can lead to age-related dryness.

– Diet is important as natural lipids and nutrients are essential for healthy skin.

– Some medications, especially diuretics, cause dehydration, which can lead to dry skin.

– Skin diseases such as atopic dermatitis, psoriasis and diabetes are characterized by the symptom of dry skin.

What can be done?

For a long time, the treatment of xerosis has been more symptomatic, with the aim of short-term relief of symptoms by topical application of lipids, mainly vegetable oils, humectants, and PUFs such as urea and lactic acid. Since the causes and factors behind xerosis have become known, doctors have found that a more holistic, integrated approach to treating xerosis produces significantly better results. This strategy consists of avoiding or minimizing the causes and factors that contribute to the development of xerosis, focusing on providing the necessary daily facial and body skin care, cleansing and moisturizing.

Cleansing dry skin

The use of mild cleaners is recommended.

Gentle but effective cleansing of the skin is essential not only for the subsequent application of topical products, for example, in atopic dermatitis, but also for moisturizing the face when caring for dry skin. Choosing a product that is suitable for cleansing the skin and does not compromise the skin’s barrier function is critical to the effectiveness of further hydration and skin care.

Skin Hydration Improvement

Skin hydration is regulated in various ways, each of which depends on many factors. For effective treatment of xerosis, it is necessary to influence every factor involved in the regulation and maintenance of skin hydration.

Use products with urea, an important moisturizing ingredient.

Dry skin often lacks urea, the main moisturizing component. Other causes of xerosis are a lack of another natural moisturizing factor (NMF) and protective skin lipids. Topical delivery of these vital substances can restore the skin’s ability to regulate hydration. In addition, the newest humectant, the compound of glycerol and glucose, glycerol glucoside (GG), has been shown to stimulate the skin’s own hydration system.

In clinical trials, compared to urea-lactic acid-glycerol lotion (with similar functions), moisturizers containing NMF series, glyco-glycerol and ceramide-3 provided better skin hydration and long-lasting hydration, demonstrating successful progress in the treatment of xerosis. In addition, both of these moisturizers significantly improved the hydration and protective function of the skin, eliminated visible dryness and roughness of the skin to the touch compared to their counterparts. Very good skin tolerance was also noted.

In summary, skin care products such as the Eucerin UREA range use unique combinations of powerful moisturizing ingredients to target the major skin blemishes caused by xerosis and provide the most advanced therapeutic options for this skin condition.

Avoidance of factors contributing to xerosis

In addition to good cleansing and moisturizing, it is very important to avoid factors that contribute to the development of dry skin. This will help alleviate the problem of dry skin and reduce the need for treatment.

Make sure you are drinking enough water.

– Avoid dry air by spending less time outside in hot and dry or cold weather and using humidifiers when the heat is on.

– Reduce your time in hot water by taking quick warm showers instead of long hot baths.

– Use gloves when washing dishes to avoid exposure to hot water and harsh detergents.

– Wear natural materials such as cotton and silk that do not irritate the skin. Wool is also a natural material but can irritate atopic skin and should be avoided in this condition.

– Try to use laundry detergents without dyes or fragrances, as they can remain on clothes after washing and irritate dry skin.

edited by

Anastasia Timoshkina

Training Manager, Eucerin Brand Expert

Corresponding articles

Dry spots on the skin: three common dermatological diseases

July 5, 2020

Dry spots on the skin are a common dermatological symptom that can indicate both a temporary failure and a violation of the barrier functions of the epidermis, and a skin disease. It all depends on the size of the spots, the clarity of their boundaries, as well as the duration of their presence on the skin.

The causes of dryness can be divided into two large groups:

• non-specific – allergic reactions to household chemicals, laundry soap, cosmetic products, dehydration due to cold and wind;
• specific – then the spots become a manifestation of dermatological diseases.

Sometimes a person may notice that dry spots appear on his skin after a certain event occurs, for example, after washing clothes with his hands. Then the reason is obvious and easy to eliminate. But if dry spots on the skin do not go away, itch, peel off, you should consult a doctor.

Dry spots with scales

Pink raised dry spots on the body and head may indicate psoriasis. With this dermatological pathology in humans, raised plaques appear on the skin – psoriatic papules. They protrude above the surface of the skin, cause intense itching and flake, tend to spread and merge.

Psoriasis is a chronic autoimmune disease in which rashes are most often localized on the elbows, head, knees and groin. Dry pink spots covered with white scales are foci of chronic inflammation. Under the influence of internal autoimmune processes, epidermal cells divide several times faster than necessary. As a result, small scales are constantly separated from dying skin cells.

Atopic dermatitis and its differences from psoriasis

Atopic dermatitis can also cause dry patches on the body. And as with psoriasis, they cause itching. Due to the increased sensitivity of the skin to environmental factors, the mechanisms of its self-regulation are violated, including the barrier function. That is, allergies serve as a trigger for atopic dermatitis, but the tendency to such a skin reaction is genetically laid down.

Most often, atopic dermatitis occurs in children. The disease has a chronic course, when exacerbations are replaced by periods of remission. Here are the typical signs of atopic dermatitis:

• dry skin;
• peeling and redness of the eyelids;
• dry flesh-colored plaques on the trunk and extensor areas of the body;
• cracks.

It is difficult for a person who does not have a medical education to distinguish psoriasis from atopic dermatitis, but a doctor can easily make a differential diagnosis. There are several differences that may speak in favor of a particular pathology. Atopic dermatitis often affects children, psoriasis can debut in adulthood. Psoriatic plaques are raised above the skin, and scales can be seen. Dry spots in atopic dermatitis are flat. It is also important to consider typical localization.

Useful links: State Center of Urology in Moscow – Clinic of Urology named after R. M. Fronshtein of the First Moscow State Medical University named after I.M. Sechenov

Dry eczema

Sometimes white, dry, scaly patches on the skin of the legs can indicate dry eczema. With this disease, dryness and tightness of the skin first occurs, then peeling and unbearable itching join, cracks may occur. In addition to the legs, the hands, the space between the fingers, and even the face are often affected.