There's no simple cure for discoid eczema, but medicines can help to ease the symptoms.
There are many different preparations for each type of medicine and it's worth taking time with a pharmacist or GP to find the best one for you.
A range of emollient products, soap substitutes and some topical corticosteroids can be bought from pharmacies without a prescription. Some of them are cheaper to buy this way than with a prescription.
Ask a pharmacist for advice on the different products and how to use them. See a GP if your eczema does not improve after using an over-the-counter product.
There are also some things you can do yourself that may help to control symptoms of discoid eczema, such as:
See a GP if you think your skin is infected. For example, if there's excessive weeping or tenderness in the patches of eczema.
Infection can spread quickly, and the use of topical corticosteroid creams can mask or further spread the infection.
Emollients are moisturising treatments you apply directly to your skin to reduce water loss and cover it with a protective film. They're often used to help manage dry or scaly skin conditions such as eczema.
Several different emollients are available. You may need to try a few to find 1 that works for you. You may also be advised to use a combination of emollients, such as:
The difference between lotions, creams and ointments is the amount of oil they contain. Ointments contain the most oil so they can be quite greasy, but are the most effective at keeping moisture in the skin. Lotions contain the least amount of oil so are not greasy, but can be less effective. Creams are somewhere in between.
Creams and lotions tend to be more suitable for swollen (inflamed) areas of skin. Ointments are more suitable for areas of dry skin that are not inflamed.
If you've been using a particular emollient for some time, it may become less effective or may start to irritate your skin. If this is the case, a GP will be able to prescribe a different product.
Use your emollient all the time, even if you're not experiencing symptoms, as it can help prevent the return of discoid eczema. Many people find it helpful to keep separate supplies of emollients at work or school.
To apply the emollient:
If you're exposed to irritants at work, make sure you apply emollients regularly during and after work.
Do not share emollients with other people.
Occasionally, some emollients can irritate the skin. If you have discoid eczema, your skin will be sensitive and can react to certain ingredients in over-the-counter emollients.
If your skin reacts to an emollient, stop using it and speak to a GP or pharmacist who can recommend an alternative product.
Emollients added to bath water can make your bath very slippery, so take care getting in and out of the bath.
To treat the patches of discoid eczema, a GP may prescribe a topical corticosteroid, which you apply directly to your skin, to reduce inflammation.
There are different strengths of topical corticosteroids that can be prescribed depending on the severity of the eczema. Discoid eczema usually needs a stronger type of corticosteroid than other types of eczema.
You might be prescribed a cream to be used on visible areas, such as your face and hands, and an ointment to be used at night or for more severe flare-ups.
When using corticosteroids, apply the treatment accurately to the affected areas. Unless instructed otherwise by a doctor, follow the patient information leaflet that comes with the medicine.
Do not apply the corticosteroid more than twice a day. Most people only have to apply it once a day.
To apply the topical corticosteroid, take the following steps:
Speak to your prescriber if you've been using a topical corticosteroid and your symptoms have not improved.
Topical corticosteroids may cause a mild and short-lived burning or stinging sensation as you apply them. In rare cases, they may also cause:
Most of these side effects will improve once treatment stops.
Generally, using a stronger topical corticosteroid, or using a large amount, will increase your risk of getting side effects. You should use the weakest strength and the smallest amount possible to control your symptoms.
If you have a severe flare-up, your doctor may prescribe steroid tablets to take for up to a week.
If steroid tablets are taken often or for a long time, they can cause a number of side effects, such as:
For this reason, a doctor is unlikely to prescribe repeat courses of steroid tablets without referring you to a specialist.
If your eczema becomes infected, you may also be prescribed an antibiotic.
If you have an extensive area of infected eczema, you may be prescribed an antibiotic to take by mouth. This is most commonly flucloxacillin, which is usually taken for 1 week.
If you're allergic to penicillin, you might be given an alternative such as clarithromycin.
If you have a small amount of infected eczema, you'll usually be prescribed a topical antibiotic, such as fusidic acid. These medicines come as a cream or ointment you apply directly to the affected area of skin.
Some topical antibiotics also contain topical corticosteroids.
Topical antibiotics should usually be used for up to 2 weeks as necessary.
Antihistamines are a type of medicine that stop the effects of a substance in the blood called histamine. Your body often releases histamine when it comes into contact with an irritant. Histamine can cause a wide range of symptoms, including sneezing, watery eyes and itching.
Antihistamines may be prescribed during flare-ups of discoid eczema to cope with the symptom of itching, particularly if it's interfering with your sleep. However, they will not treat the damaged skin.
Many older types of antihistamines can make you feel sleepy (drowsy), which can be useful if your symptoms affect the quality of your sleep. Otherwise, ask a pharmacist or GP to recommend a "non-sedating" antihistamine.
Some people may find complementary therapies, such as herbal remedies, helpful in treating eczema, but there's little evidence to show these remedies are effective.
If you're thinking about using a complementary therapy, speak to a GP first to ensure the therapy is safe for you to use. Make sure you continue to use other treatments a GP has prescribed.
If the treatments prescribed by a GP are not successfully controlling your symptoms, they may refer you for assessment and treatment by a doctor who specialises in skin conditions (dermatologist).
Further treatments that may be available from a dermatologist include: