Many of us deal with dry, itchy skin from time to time. Typically, all that is needed is some good lotion and possibly anti-itch cream to solve the problem. Eczema, however, is a skin condition that causes your skin to become dry and scaly, intensely itchy and turn red due to allergic reactions or immune system disorders. The most common form of eczema is called atopic dermatitis – with the word “atopic” referring to a form of an allergy. If you suffer from atopic dermatitis, you are more prone to asthma and allergies. You are also more likely to get another type of eczema called nummular eczema (also known as nummular dermatitis or discoid eczema).
WHAT IS NUMMULAR ECZEMA?
Nummular eczema looks and acts differently than other types of eczema. The word “nummular” is derived from the Latin word for “coin,” as the eczema spots look round – or coin-shaped – on the skin. It can be difficult to treat because it can affect you in different ways. The spots can be very itchy or not itchy at all. They may be dry and scaly or feel very wet. The cause of nummular eczema is unknown, but it is believed that certain skin sensitivities and other triggers play a role in its development.
WHAT ARE NUMMULAR ECZEMA TRIGGERS?
Known triggers for nummular eczema include the following:
- A sensitivity to metals, such as nickel.
- A sensitivity to certain medicines – specifically topical antibiotics such as, Neomycin, Isotretinoin and Interferon.
- A sensitivity to formaldehyde.
- Damage to the skin from insect bites, abrasions or chemical burns.
- A reaction to inflammation, as from atopic dermatitis.
- Poor blood flow and/or swelling in the legs.
- A skin infection caused by bacteria.
- Severe dry skin, especially in the winter.
WHAT ARE NUMMULAR ECZEMA SIGNS AND SYMPTOMS?
As stated above, a sign of nummular eczema is its round, coin-like appearance. At first, the patches on the skin look like a group of tiny, reddish spots and blister-like sores that ooze fluid. The sores enlarge and grow together to form one round patch. Nummular eczema signs and symptoms also include:
- Round or oval patches that range in size from less than one inch to bigger than four inches.
- Patches that occur mainly on the legs, but can appear on the torso, arms, hands and feet.
- Patches that are pink, red or brown, and are well defined.
- Patches that itch and burn, ranging from slight to severe. They may become worse at night, disturbing sleep.
- Blisters that leak fluid and become crusty and scaly.
WHO GETS NUMMULAR ECZEMA?
Men tend to get nummular eczema more often than women. They typically have their first outbreak between 55 and 65 years of age. Woman who suffer from nummular eczema are usually younger, they tend to be teenagers or young adults. It is rare for a child to have the condition.
HOW IS NUMMULAR ECZEMA DIAGNOSED AND TREATED?
The coin-like shape of nummular eczema can resemble the look of ringworm. It is important to confirm that it is not a fungal infection before treating the condition. When diagnosing nummular eczema, your dermatologist will examine your skin. The doctor may also swab the sores if there is a suspicion of a fungal infection. Patch testing (skin tests to determine allergies) may also be recommended, because an undiagnosed allergy can prevent nummular eczema from clearing up.
Unfortunately, there is no cure for nummular eczema, but it can be effectively treated and controlled. Treatment for nummular eczema consists of the following:
Protection – The first line of defense is to protect your skin from getting scraped or cut, as a skin injury can worsen nummular eczema.
Hydration – The use of moisturizers to calm and protect the damaged skin is recommended. You can hydrate and heal your skin by taking a long, lukewarm bath or shower once a day. Within minutes of getting out, apply a moisturizer to your still-damp skin. Adding a bath oil that is recommended by your dermatologist can also help relieve the itching, scaling and dryness.
Medication – In most cases, you will also receive a prescription steroid cream to calm the inflammation. When milder creams don’t help, more powerful steroid creams will be required. Under certain circumstances, where steroids aren’t appropriate or are over-used, your doctor may prescribe phototherapy (light therapy), coal-tar creams or non-corticosteroid topical creams such as Protopic or Elidel.
The sites of nummular eczema are prone to infection from bacteria such as Staphylococcus aureus (staph). Typically, a week or two of oral antibiotics will help clear the infection. More severe cases may have to be treated with oral or injected cortisone.
If you have a more severe case or widespread nummular eczema, you may also need to try medicated bandages and bed rest in a cool, moist room (kept moist with a humidifier).
HOW DO YOU MANAGE NUMMULAR ECZEMA?
To prevent nummular eczema from returning once your skin clears, dermatologists recommend the following:
- Moisturize at least once a day, particularly after bathing.
- Avoid activities that irritates your skin, such as anything that dries or heats up your skin.
- Avoid stressful situations.
- Avoid exposure to environmental irritants, such as household cleaners and chemicals.
- Bathe in only lukewarm water, as hot water will irritate your skin.
- Use only mild, gentle cleanser instead of soap that dries the skin.
- Use a humidifier for moister air.
- Wear loose clothing, and avoid fabrics such as wool that cause itchy skin.
- Wash clothing in dye-free, fragrance-free detergents and avoid using fabric softeners.
- Know and avoid your triggers, your skin will only remain clear when you keep clear of any and all skin sensitivities.
WHAT IS THE OUTCOME FOR NUMMULAR ECZEMA?
Nummular eczema can clear up completely with proper treatment. Patches that appear on the thighs, legs and feet may take longer to heal and can leave behind permanent spots that are either darker or lighter than your skin.
It may take up to a year for your skin to clear, or it may take several years. The patches may also go away and return – usually in the same place as the first outbreak. One positive outcome of nummular eczema is that, for some people, it seems to clear up completely and leaves no long-term issues like other forms of eczema.
If you’ve enjoyed reading this article on Nummular Eczema, you may also like to read How to Remove Scars Naturally.