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Nummular eczema

Nummular eczema, also known as nummular dermatitis, is an allergy-related disorder in which a stubborn rash of itchy, coin-shaped spots or patches appears on the skin.

As the lesions get older they may clear in the center or become scaly, resembling a fungus (ring worm) or psoriasis.

The condition tends to be chronic, with periods when it gets much better or worse. It is more common in the winter.

The cause is uncertain and there is no known way to prevent it, however avoiding substances that make the symptoms worse is often a way to avoid outbreaks.

For those who suffer from this disorder - most often older men - there is most often a personal or family history of asthma, allergies or atopic dermatitis.

What makes nummular eczema worse

• dry skin

• frequent bathing (no more than once a day as it can cause dry skin)

• lanolin and wool or rough clothing

• soaps

• fabric softeners

• certain foods

• environmental irritants

• extremes of hot or cold temperatures

• stress

Signs and symptoms

• Coin-shaped skin lesions that may ooze and become crusty

• Itching

• Scaly or raw skin

• Inflamed or red skin

Home treatment

There is no cure for nummular eczema, however It is possible to find a treatment routine that controls it.

• Use lukewarm water for bathing and showering. Hot water dries out the skin.

• Choose gentle, soap-free cleansers made for your skin type.

• Air-dry or towel-dry your skin by patting, not rubbing.

• Moisturize your skin while it is still damp to prevent dry skin.

• Moisturize frequently with soothing skin lotions, (choose products made for your skin type that contain no known harmful chemicals ). These products and moist bandages soothe scaly, dry patches or areas that are healing.

• Avoid wearing wool or rough clothing; 100% cotton clothing is the best choice.

• Wash laundry in dye-free, fragrance-free detergents.

• Avoid using fabric softeners or dryer sheets of any kind.

When to see a doctor

Make an appointment with a doctor or dermatologist if your symptoms continue despite treatment, or if you develop a fever or redness or pain in the area of the rash.

Very strong prescription strength cortisone ointments applied to the skin are the most often prescribed medications.

Periodic dermatological exams are necessary when cortisone ointments are used for an extended period of time because they have side effects.

See a doctor if an infection develops. The sites of nummular dermatitis are prone to staphylococcus infection ("Staph"). In such cases, a week or two of oral antibiotics can be helpful.

Persistent itch outbreaks can be controlled with ultraviolet light treatments given in the dermatologist's office.

Those with severe symptoms may be given skin ointments or creams that contain tar, corticosteroids, skin softeners, or moisturizers.

In rare, severe cases, the doctor may prescribe more powerful corticosteroids to be taken by mouth or injection.

Nummular eczema is a long-term (chronic) condition. Medical treatment and avoiding irritants can help reduce symptoms.

The coin-shaped rash is a distinctive symptom, however if you are not sure what skin problem you have, seeing a doctor will put your mind at ease and get you started on the proper path to control and treat it.

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