In this blog we investigate the itchy skin condition discoid dermatitis, and find out what might trigger a flare-up.
What is discoid dermatitis?
Dermatitis is a general term for all different kinds of skin irritation, and can be caused by a wide variety of things, from contact with irritating substances, to less concrete triggers such as stress. Eczema is a chronic (long-term) kind of dermatitis, which also has several subcategories, one of which is discoid dermatitis. This type of eczema can affect people of all ages, though it’s most likely to be seen in adults, and is a bit more common in men than women.
What are the symptoms of discoid dermatitis?
The most obvious symptom of discoid dermatitis are the characteristic circular or oval patches of sore skin (its other name, ‘nummular eczema’, means ‘coin-shaped’). These patches are usually inflamed, intensely itchy, and can get hyper- or hypopigmented (brown, grey, purple or red depending on skin colour) as the flare clears up, particularly on dark skin.
Typically, discoid eczema starts as itchy, bumpy or blistered skin, which can get swollen, itchy and crusty. The little bumps or blisters grow in size, usually ending up making patches around 1-3cm in diameter. These patches can get very dry, after a weepy, then a crusty stage, and can remain for weeks or months. As they grow, the circular patches can end up with clear skin in the middle, and the itchiness confined to the edges.
It’s worth remembering that other skin conditions (such as ringworm, which is a fungal infection) can appear in circular patches too; discoid eczema will often need a diagnosis from a medical professional so you can be sure to distinguish it from other kinds of eczema.
What causes discoid dermatitis?
Discoid dermatitis, like other types of eczema, doesn’t seem to have one definite cause; it might not always be very clear at all what’s triggered a flare up, but it’s likely to be a combination of factors, including having very dry skin and an impaired skin barrier. Unlike some kinds of eczema, discoid dermatitis doesn’t seem to run in families, but it seems to have an association with conditions that do have a genetic component, like asthma, hay fever or atopic dermatitis.
This makes it quite a complicated condition to manage! An outbreak can be triggered by a specific event or injury, but it’s less clear why it happens to some people and not others, or why the discoid dermatitis tends to recur in the same places.
There does seem to be an association with chronic alcoholism in adult men who are prone to discoid dermatitis.
Things that might trigger an occurrence of discoid dermatitis, or which put you at greater risk for getting a flare, include:
- Insect bites
- Contact with irritant substances
- Varicose veins or poor blood flow in the legs
- Dry skin/an impaired skin barrier
- Cold, dry weather
- Being a man over 55
- Medications such as interferon and ribavirin (when used in combination), tumour necrosis factor-alpha (TNF-alpha) blockers, and statins
How do you treat discoid dermatitis?
Discoid dermatitis can be a difficult condition to shift; it can require medication, as left untreated, the patches of irritated skin can last for months, if not years, and can get infected.
Treatment might include a combination of the following:
- Wet wraps
- UV phototherapy
Sufferers also need to protect their skin from further injury, and avoid irritant substances, including in their skincare.
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If you require medical advice we recommend you always contact your healthcare professional.
If you or someone you are caring for seems very unwell, is getting worse or you think there's something seriously wrong, call for emergency services straight away. For general medical advice, please contact your healthcare professional, this article does not contain or replace medical advice.
Do not delay getting help if you're worried. Trust your instincts.