What is discoid eczema?

Discoid eczema is the name given to a variety of atopic dermatitis or eczema which is characterised by circular or oval patches of itchy, dry or inflamed skin; the condition is also known as nummular eczema, after the Latin name for ‘coin’, referring to the coin-shaped patches. It’s a type of eczema that is slightly more commonly found in older men, but anyone can develop it.

Some people find the patches are intensely itchy, others find that they’re just dry.

Discoid eczema is a chronic skin condition, which means it isn’t contagious, and can’t be cured; people who develop discoid eczema are more likely to get further flare-ups, often in the same spot as was previously affected. However, management of the condition is possible, if sufferers identify their triggers and keep their skin well moisturised.

Appearance of discoid eczema

These patches can appear anywhere on the body in clusters or just as one or two lesions. The circular lesions can start quite small, maybe just a tiny raised patch or small collection of bumps, blisters or spots, but can spread outwards to form rings of 2-3cm across. Often, the circular lesions are most inflamed at their outer edges; as they grow larger, they can leave an area of clear skin in the centre of the ring.

Discoid eczema can vary in appearance quite considerably: the patches can be brown, purple, silver, red or pink, varying to greater or lesser extent from the surrounding skin tone and colour. 

What’s the connection between discoid eczema and scars?

A flare of discoid eczema can be triggered by various things, just like many kinds of eczema; these triggers range from contact with irritant substances, emotional stress, to being in a dry environment, and some medications. One trigger for discoid eczema is damage to the skin; the eczema can appear where the skin has been injured, whether by an insect bite, a burn, a graze or some other trauma. Sometimes the eczema develops on an old scar or the site of an injury. 

So, the primary connection between discoid eczema and scars, is that the condition often develops on injured skin or scars, rather than causing them. However, because discoid eczema is such a persistent condition, with flares lasting for weeks or even months, it can end up causing quite considerable damage to the skin, including long term scarring.

What affects whether discoid eczema will leave a scar?

• A secondary infection by bacteria such as staphylococcus can result in scarring
• The duration of a flare; a very persistent patch can lead to lichenification (ie thickening of the skin)
• Damage from scratching, if a lesion is very itchy it’s more likely to cause damage

It isn’t uncommon for skin to be left thickened, scaly, or discoloured after eczema flares, although in most cases this damage will eventually fade, either completely or to some extent.

Hyperpigmentation is more likely in darker skin and should be taken seriously, as there can be considerable emotional impact for those left with permanent and visible skin damage.

How to prevent scarring from discoid eczema

As with most types of eczema, the way to prevent damage to your skin is all about managing the flare in three different important ways.

1. Identifying, then avoiding, triggers for flares

Your particular triggers can vary considerably, and can act in combination; this means that a dry, cold winter can aggravate stress-induced skin inflammation, which can in turn become further irritated by an ingredient in your shampoo or laundry detergent. Whether it’s aircon, pets, medication, insect bites or perfume that is making your skin irritated, the key is to identify the trigger as soon as possible, so you can then avoid it.

1. Breaking the itch-scratch cycle & reducing inflammation

   Scratching the itch can be considered a secondary trigger as it prolongs a flare, so breaking the itch-scratch cycle is an important part of managing your eczema. Try cold compresses, ice packs, patting rather than scratching, and self-care like meditation, yoga, gentle exercise. You might want to try using naturally anti-inflammatory emollients which contain ingredients such as calendula and chamomile.

2. Keeping your skin in good condition during and after flares

   This part of eczema management involves looking after your skin by keeping it well hydrated, protected and fed with the nutrients it needs to repair and regenerate itself. Emollients are key to this part of the management plan. You can use them in various ways, from ‘soak and seal’ (having a warm bath, then applying an intensive emollient immediately afterwards), to wrapping the area in bandages or protective clothes, as well as making sure that the emollients you use are enriched with omega-rich oils, and do not contain irritant ingredients.

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