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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. The patches show well on camera, and a doctor can prescribe steroid creams and treat infection.
- What it is: a long-term type of eczema that causes itchy, swollen, cracked patches shaped like coins, from a few millimetres to several centimetres across.
- Where: most often the legs, and also the arms, hands and body; usually not the face or scalp.
- Usual course: without treatment patches can last weeks, months or years; a potent steroid cream usually clears a patch in 2 to 4 weeks, and it often comes back in the same place.
- Emergency: call 112 for red, hot, spreading skin with a high temperature and feeling very unwell or confused.
Painful, punched-out blisters or sores spreading quickly over eczema, especially with feeling unwell, need urgent in-person care. Red, hot, spreading skin with a high temperature and feeling very unwell or confused needs 112.
Can an online doctor treat discoid eczema?
Yes, usually. Discoid eczema has a typical look, with round, itchy patches that may ooze, so a doctor by video can recognise it, tell it apart from ringworm, psoriasis and pityriasis rosea, and prescribe treatment. The doctor checks for infection, which is common in oozing or crusted patches, and treats it. Severe discoid eczema that does not respond may need a dermatologist.
How an online consultation helps with discoid eczema
- A clear diagnosis: Discoid eczema and ringworm look alike but need opposite treatments; the doctor tells them apart.
- Treatment strong enough: A steroid cream or ointment of the right strength, and how long to use it.
- Infection treated: Antibiotics when patches are weeping, crusted or sore.
- Fewer flares: Emollients, soap substitutes and a plan for when patches come back.
What the doctor checks in an online consultation
The doctor asks about:
- The patches: where they are, how big, how many, and whether they ooze, crust or blister.
- Itch: how bad it is, and whether it keeps you awake.
- Triggers: a cut, burn or insect bite at the site, cold, dry weather, and skin products.
- Infection: yellow crusts, a lot of oozing, pain, and feeling hot, shivery or unwell.
- Your health: other eczema, varicose veins, alcohol, and the medicines you take.
- What you have tried: creams, including antifungal and steroid creams, and how long you used them.
Before the call, find good light, and show both a fresh patch and an older one if you have them.
Discoid eczema symptoms
Discoid eczema causes distinctive circular or oval patches. They:
- range from a few millimetres to several centimetres across
- are often swollen and blistered at first, and ooze fluid
- become dry, crusty and cracked over time
- are very itchy, especially at night
- can be pink or red, or dark brown or paler than the surrounding skin on darker skin
- usually appear on the legs, arms, hands and body, but not usually on the face or scalp
Most patches are 1 to 3 cm across, and they often appear on both sides of the body, for example on both arms. They start as a cluster of small spots or tiny blisters that join up, and new patches can appear over weeks to months. As a patch heals, its centre can clear, leaving a ring that is easily mistaken for ringworm. The skin between the patches is often dry.
Discoid eczema or something else?
Swipe sideways to compare →
| Condition | What points to it |
|---|---|
| Discoid eczema | Very itchy, coin-shaped patches that may ooze, often several, often on the legs |
| Ringworm | One or a few rings with a raised, scaly edge and a clearer middle, slowly spreading outwards |
| Psoriasis | Thick, well-defined plaques with silvery scale, often on elbows, knees and scalp |
| Pityriasis rosea | One larger patch first, then oval patches on the chest and back |
Ringworm treated with a steroid cream can spread, and discoid eczema treated with an antifungal cream does not improve, which is why the diagnosis matters.
How discoid eczema is diagnosed
Usually by its look, which works on camera. When the picture is unclear, tests rule out other conditions: skin scrapings for a fungal infection, swabs for bacteria, patch testing for a contact allergy, and occasionally a small skin sample.
What causes discoid eczema?
The cause is unknown, but it is linked to very dry skin and a weak skin barrier, which lets normally harmless substances, such as soap, irritate the skin. It can happen at any age but is seen more often in adults, and it is slightly more common in older men and younger women. Unlike atopic eczema, it does not run in families. An outbreak can be triggered or made worse by:
- a minor skin injury, such as an insect bite or a burn, and old scars
- dry environments and cold climates
- heat, sweating and scratching
- soaps, bubble baths, body washes and detergents, and wool or synthetic fabrics against the skin
- other types of eczema, including a contact allergy to metals such as nickel
- varicose veins, in patches on the lower legs
- heavy drinking
- some medicines that dry the skin; do not stop a prescribed medicine without talking to the prescriber
Bacteria on the skin, especially Staphylococcus aureus, play a part in some cases, and infection is common in oozing patches. Discoid eczema is classed as a type of eczema, an inflammation of the outer layer of the skin, rather than an autoimmune disease.
How to manage discoid eczema at home
- Use emollients often, every day, even when the skin looks clear.
- Wash with an emollient instead of soap, and avoid soaps, detergents, bubble baths and shower gels.
- Keep your nails short, and try to pat rather than scratch.
- Protect your skin from cuts, burns and bites where you can.
- Bath or shower no more than once a day, for a quarter of an hour at most, without soap.
- Wear soft cotton next to the skin rather than wool or synthetic fabrics, and keep your bedroom cool if heat makes it worse.
- Leave at least 20 minutes between a steroid cream and an emollient.
- Keep clothes and bedding with emollient on them away from naked flames and cigarettes, and wash them often: dried emollient makes fabric catch fire more easily.
See a pharmacist or doctor if you think you have discoid eczema, and get medical advice if the skin looks infected: oozing a lot of fluid, a yellow crust, hot, swollen, painful skin around the patches, or feeling hot, shivery or unwell.
Which discoid eczema treatment might the doctor recommend?
Treatment depends on how active the patches are and whether they are infected. This is the framework the doctors use, in line with NHS and dermatology guidance.
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| A few itchy patches | Emollients and a steroid cream or ointment for 2 to 4 weeks | Yes | Not usually needed |
| Weeping, crusted or sore patches | Antibiotics, as a cream or tablets, with steroid treatment | Yes | If you feel unwell |
| Itch keeping you awake | An antihistamine at night | Yes | Not usually needed |
| Patches that keep coming back | A maintenance plan and a review of triggers | Yes | Not usually needed |
| Severe or widespread despite treatment | Light treatment or tablets from a dermatologist | Yes, to assess | For specialist treatment |
Round, itchy patches that will not settle? A doctor can confirm what they are and treat them in one consultation.
See available times →Treatment options for discoid eczema
What you can do yourself
- Apply emollients generously and often.
- Use an emollient as a soap substitute.
- Avoid triggers such as skin injury and harsh products.
Prescription treatment
A prescription is never issued without a consultation. Discoid eczema usually needs a potent steroid ointment or cream, because mild steroids are usually not strong enough. It is applied thinly to the patches only, until the redness and swelling settle, often for 2 to 4 weeks, and restarted at the first sign of a patch coming back. When patches are blistered, sticky or crusted, the doctor may prescribe an antibiotic, as a cream, a cream combined with a steroid, or tablets in severe cases. Tacrolimus ointment and pimecrolimus cream are non-steroid options. A sedating antihistamine can help sleep for a short time, while non-sedating ones generally do not help the itch. If the doctor prescribes, use the prescription at a pharmacy near you.
Specialist treatment
For severe or persistent discoid eczema, dermatologists may use light treatment, tablets that calm the immune system, such as methotrexate, azathioprine or ciclosporin, or newer treatments such as dupilumab, tralokinumab or JAK inhibitors.
What does not help
Antifungal creams do not treat discoid eczema. Soaps, bubble baths and shower gels dry the skin and make it worse, and scratching breaks the skin and lets infection in.
How long does discoid eczema last?
Without treatment, discoid eczema can last for weeks, months or even years, and patches often come back in the same place, especially if treatment is stopped too soon. It cannot be cured, but it can be controlled: it can go into remission for long periods, and many cases eventually clear. It tends to come back in cold winter months, while sunny or humid weather helps many people.
On darker skin, the patches can leave dark brown marks that last for months after the eczema has settled.
Special situations
Patches on the lower legs
Discoid eczema is common on the lower legs, and it is linked with varicose veins, so the doctor may ask about them.
Winter, heat and holidays
Dry, cold winter weather often brings patches back, so keep up emollients through the colder months. Sun helps most people when taken in moderation, but heat and sweating can aggravate it: on a warm holiday, wear loose cotton and keep using emollients.
Infected eczema
Oozing, yellow crusts and soreness are signs of infection. Painful, punched-out blisters spreading quickly can mean a herpes infection of the eczema, which needs urgent in-person care.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When discoid eczema is treated online, and when you need in-person care
Treated online: diagnosis of discoid eczema, steroid creams and ointments, antibiotics for infected patches, antihistamines, and maintenance plans.
In-person care: severe or widespread discoid eczema that does not respond, light treatment and specialist tablets, an uncertain diagnosis, and painful, spreading blisters.
When to get in-person care
Call 112 or go to an emergency department now for:
- red, hot, spreading skin with a high temperature and feeling very unwell, faint or confused
Get medical advice the same day for:
- painful, punched-out blisters or sores spreading quickly over eczema, especially if you feel unwell
- patches that are hot, swollen and painful, with a yellow crust, and feeling hot, shivery or unwell
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about discoid eczema: show the patches on camera in good light, and say which creams you have tried.
- Leave with a plan: what to do, what to use and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s discoid eczema? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Ringworm can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about discoid eczema
What is discoid eczema?
Discoid eczema, also called nummular eczema, is a long-term type of eczema that causes itchy, swollen and cracked patches shaped like coins, most often on the legs.
What causes discoid eczema?
The cause of discoid eczema is unknown, but very dry skin seems to play a part. A minor skin injury, such as an insect bite or burn, can trigger it, and cold, dry weather makes it worse.
What flares up discoid eczema?
Discoid eczema flares with dry skin, cold, dry weather, heat and sweating, scratching, soaps, body washes and detergents, wool or synthetic fabrics, minor skin injuries and skin infection. Heavy drinking and some medicines that dry the skin are also linked.
Is discoid eczema an autoimmune disease?
No. It is classed as a type of eczema, an inflammation of the outer layer of the skin linked to a weak skin barrier and very dry skin. It does not run in families, and it is not contagious.
Is discoid eczema the same as ringworm?
No. Both discoid eczema and ringworm cause round patches, but ringworm is a fungal infection with a scaly edge and a clearer middle. They need different treatments, so the diagnosis matters.
Is it discoid eczema, ringworm or psoriasis?
Discoid eczema patches are round, itchy, swollen and often weepy or crusted, usually several at once on the legs or arms. Ringworm is usually a single ring with a raised scaly edge and a clearing centre that spreads outwards. Psoriasis plaques are thicker, drier and covered in silvery scale, typically on the elbows, knees and scalp, and itch less. Pityriasis rosea starts with one larger patch followed by many smaller ovals on the trunk. The doctor can usually tell them apart on camera.
How long does discoid eczema last?
Without treatment discoid eczema can last weeks, months or years, and it often comes back in the same place. Treatment controls flares, and it often settles eventually.
What is the best treatment for discoid eczema?
For discoid eczema, emollients used often, and a potent steroid cream or ointment for active patches, often for 2 to 4 weeks, because mild steroids are usually not strong enough. Infected patches need antibiotics.
How can I prevent discoid eczema coming back?
Keep the skin from drying out: moisturise the whole body with a thick emollient at least once a day and after every wash, use a soap substitute instead of soap or shower gel, bathe in warm rather than hot water, humidify dry rooms in winter, wear cotton rather than wool next to the skin, protect the legs from knocks and insect bites, and treat the first sign of a patch with the prescribed steroid. Discoid eczema tends to return, but these habits make flares rarer.
Is discoid eczema contagious, and can it spread?
Discoid eczema is not contagious: it cannot be caught from other people. On your own skin, new patches can appear over weeks to months, and patches that become infected need treatment.
Is discoid eczema dangerous?
Not usually, but discoid eczema can be very itchy and long-lasting. The main risk is infection: oozing, yellow crusts and soreness need treatment, and painful, punched-out blisters spreading quickly need urgent in-person care.
Why is discoid eczema so itchy at night?
Discoid eczema patches are typically very itchy, and the itch peaks at night because the skin warms under bedding, the body’s natural anti-inflammatory hormone dips in the evening and there are fewer distractions. Regular emollients, treating active patches with the prescribed steroid, keeping the bedroom cool and a sedating antihistamine at bedtime all help.
Will discoid eczema leave marks?
On darker skin, discoid eczema patches can leave dark brown or, less often, pale marks that last for months after the eczema has settled; these are not scars and fade slowly on their own, faster when flares are treated early, scratching is avoided and the area is protected from the sun.
Can an online doctor treat discoid eczema?
Yes, usually. A doctor can recognise discoid eczema on camera, tell it apart from ringworm and psoriasis, and prescribe steroid creams and antibiotics when they are needed.
- Discoid eczema, NHS, National Health Service (UK), reviewed 23 March 2023.
- Discoid eczema, DermNet, New Zealand, revised September 2020.
- Discoid eczema, British Association of Dermatologists, Patient Hub, updated May 2023.
- Eczema: discoid eczema, Primary Care Dermatology Society (UK), patient leaflet, updated 14 November 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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