“[NE] is a manifestation of sensitive skin that is triggered by environmental factors, and it can also happen in almost anyone who practices poor skin care,” says Suzanne Friedler, MD, a board-certified dermatologist with Advanced Dermatology in New York City. NE can also occur in patients who regularly moisturize and practice good skin care, but whose skin lacks the proteins needed to lock moisture into the skin (such as collagen, elastin, and keratin, according to the Cleveland Clinic). To understand what NE is, exactly, look closely at the words. “Nummular means coin-like and eczema is sensitive skin. Therefore, people with NE display coin-shaped, itchy red patches on their skin,” Dr. Friedler says. Although this condition is treatable, it can be incredibly uncomfortable because of the itch, and may return even after treatment.
“When you have one single patch, it could be caused by so many things, including a fungal infection or hives,” says Emma Guttman-Yassky, MD, PhD, the Waldman Professor and System Chair of Dermatology and Immunology at the Icahn School of Medicine at Mount Sinai School of Medicine in New York City. In a small number of cases, NE may be associated with a skin allergy, such as a nickel allergy, adds Dr. Guttman-Yassky. “We would perform a patch test on these patients to identify any allergies,” she says. While most cases are not associated with skin allergy, she says it is still good practice to rule this out with a test.
Prognosis of Nummular Eczema
Even once NE is treated and goes away, there is a possibility it may come back. “Recovery and relapse depend on the person’s predisposition to sensitive skin — which is genetic — as well as their skin-care habits,” says Friedler.
Keep showers short. Stick to 10 minutes or less.Shower with lukewarm to warm water.Cleanse with soaps labeled for sensitive skin.Avoiding cleansing rash areas directly.After your shower, when skin is damp, moisturize with a heavy cream to lock in hydration.Reapply body cream throughout the day.Wear soft, breathable fabrics.Sleep with a humidifier in your bedroom.
Medication Options
Alternative Medicine Options
While having one or few patches makes you a good candidate for a topical cream, if you have a widespread or severe case, Guttman-Yassky says your dermatologist may talk to you about phototherapy. “Phototherapy treatments penetrate the outer layers of skin and reduce inflammatory cells,” Guttman-Yassky says. These treatments may be used all over skin, or a specific type of laser called an excimer laser can be used to target affected areas only, she adds. Phototherapy may also be recommended if four weeks of topical treatment and proper skin care do not clear the coin-shaped patches, per Guttman-Yassky. Phototherapy requires commitment and may be burdensome, as patients often have to go to the office three times per week for treatment, says Guttman-Yassky. What’s more, not every dermatologist office will offer phototherapy. Talk to your doctor about the right options for you.
Prevention of Nummular Eczema
To prevent future flare-ups of NE, practice the smart skin-care tips outlined above in the treatment section. That includes routine use of moisturizer, short showers, and use of a humidifier on cold, dry days. If NE is caused by a contact allergy, avoid the triggering allergen to prevent a flare-up.
The AAD supplies need-to-know info on nummular eczema, eczema, and general skin health. National Eczema Association Learn about the seven types of eczema, including nummular eczema. After reading about NE, stay on the site for more about living with eczema, patient stories, and new treatments in development. HealthyChildren.org Eczema often starts in childhood. If your child has eczema, use the American Academy of Pediatrics’ handy Symptom Checker to understand the signs, triggers, and treatment for this condition, plus information on when to call the pediatrician and photos to help with identification.
Favorite App to Help Heal Your Skin
EczemaWise Developed by the National Eczema Association, this smart tool can help you track your symptoms and identify your diet and lifestyle triggers. The app is available on the App Store and Google Play.
Favorite Online Support Network
MyEczemaTeam MyEczemaTeam is social network and online support resource with over 35,000 members that you can turn to for answers, advice, and tips for overcoming the challenges of living with eczema.
