What is nummular eczema?

Nummular eczema is one of many different types of dermatitis; it’s a chronic inflammatory skin condition, and is relatively common, especially in older men (over 55) and younger women. It’s called nummular (which means ‘coin-shaped’) because of the distinctive ring pattern it makes on the skin; in fact, it’s also known as discoid eczema or discoid dermatitis.

What does nummular eczema look like?

This kind of eczema tends to start off as just a few little spots on the skin; sometimes the spots are fluid-filled, like blisters, and sometimes they’re just small bumps. Gradually the spots form into circular or oval patches of sore, dry, itchy skin, which expand outwards in rings. As the circles increase in size, they can end up with a clear patch of skin in the centre of a ring of inflamed skin; it’s the outer edge that tends to be the most itchy and sore.

What causes nummular eczema?

Nummular eczema has various known triggers, which can set off or aggravate a flare-up of the condition, but its root cause is unclear! Unlike some other types of eczema, it doesn’t seem to run in families, but it does have a connection with dry skin. It could be that having dry skin means you’re more susceptible to getting irritated by certain substances, ingredients or conditions, though there’s not a good explanation for why nummular eczema develops in rings, but other types of atopic dermatitis don’t!

These are the most likely culprits for triggering a flare-up of nummular eczema:

• Irritant ingredients in toiletries or household cleaning products
• Injury to the skin, e.g. insect bites, burns, scratches, surgery
• Some medications (particularly some used to treat arthritis, high cholesterol and Hepatitis C)
• Dry, cold environments
• Stress or anxiety
• Poor circulation in the lower legs

How to manage nummular eczema

Nummular eczema, being a chronic condition, isn’t something that you can cure; if you have one episode, then it may recur, often in the same place as your previous flare. However, armed with a bit of knowledge about what makes it worse, it’s possible to reduce the frequency and severity of the flares.

Tips for getting rid of nummular eczema

Avoid irritants

Different people are affected by different things, but there are some substances which seem to trigger dermatitis in a great number of eczema sufferers! These include alcohol, scent/fragrance, synthetic preservatives, soap, sulphates, strong detergents, and other additives to toiletries etc. It can help people with recurrent nummular eczema to swap to natural skincare, SLS-free shampoo, and milder cleaning products.

Protect your skin

Although accidents are obviously very hard to avoid, and there’s only so much you can do to avoid injury, it’s worth being aware of how sensitive your skin is - particularly if you can protect it from insect bites, for example! Wear gloves when gardening, and long sleeves and trousers when walking.

Control your environment

Cold, dry air can be enough to set off a flare of nummular eczema, if your skin is already dry! As well as using intensive emollients, check your home environment’s humidity and temperature. Aircon and central heating both have the effect of drying out the air, and dry air will cause your skin to lose moisture more rapidly, so you may need to invest in a humidifier, and keep the temperature just a bit cooler (not cold, but definitely not too hot) than is usual in winter.

Manage your stress

Stress and anxiety can have an unexpectedly profound effect on skin, with stress hormones triggering the release of inflammatory substances in the body, which in turn damage the skin barrier and cause that infernal itch. Take your well-being seriously by finding stress management strategies that work for you, whatever that turns out to be. It could be that your body is calmed by walking in the woods, or knitting, or swimming, or doing yoga. 

Get your circulation moving

Poor blood flow in the lower legs can cause a kind of eczema called stasis or venous eczema, which sometimes manifests as nummular. Try using support stockings, and ask your doctor for exercises you can do even while sitting down.

Moisturise!

One of the key ways of managing nummular eczema is to keep your skin happy and hydrated with emollients! Find one that you like - unscented of course! - and apply whenever you need to. Oils are good for after bathing, creams are good for unbroken but dry skin, and balms, with their high oil content, are the most effective for tackling extremely dry patches.

If your skin is really itchy, sore or cracked, try Skin Salvation balm, which is less likely to sting on open skin, and can help support the regeneration of a healthy skin barrier. For daily maintenance, use our shea butter and hemp Daily Moisturising Cream, and try countering the dehydrating effects of bathing with some Bath & Body Oil.

If symptoms don’t improve after a week, or get worse, consult your doctor; there are various other options you can try: antihistamines to help ease the itchiness, antibiotics (if the eczema is infected) or a short course of topical steroids if the inflammation is not calming down.

Recommended products:

Balmonds Skin Salvation
with hemp and beeswax

Bath & Body Oil
with lavender, hemp and olive

Balmonds Daily Moisturising Cream
with shea butter and calendula