A.Vogel Talks Discoid Eczema

Discoid eczema is often misdiagnosed as ringworm and can be considered one of the more difficult variants of eczema to treat

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Felicity Mann
Skin Health Advisor
@AVogelUK
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An introduction to discoid eczema

Discoid eczema is estimated to affect 1 in every 500 and typically appears between the ages of 50 and 70.1 

This form of eczema is chronic and sometimes considered one of the trickier types of eczema to treat as it is difficult to determine its causal factors, and it is often confused with other skin infections such as ringworm.

The condition gets its name from the coin shaped rash that often appears as its most prominent symptom. This rash usually occurs in the legs and is more often seen in middle-aged men, although younger women in their earlier twenties have been known to contract the affliction.

1http://patient.info/health/discoid-eczema

The causes of discoid eczema

Discoid eczema can be difficult to diagnose, especially since it often appears in conjunction with contact eczema and atopic eczema.

There is no definitive cause of discoid eczema, but there are a number of risk factors and triggers than can stimulate a potential episode.

It is good to have an understanding of these causes so that you may have a better idea of how to avoid them in the future.

  • Weak immune system: Eczema is more likely to occur in those that have a weakened or compromised immune system. This is because your immune system will be more predisposed to becoming fatigued or overwhelmed by your eczema symptoms and will lack the stamina necessary to adequately respond to the properly and produce the necessary chemicals. Your immune system might be made more vulnerable to this if you are obese, malnourished or suffer from an intense psychological condition such as stress. It’s also possible that your genetics could be a factor, as your immune system may naturally produce too many IgE anti-bodies that will eventually over-react to a potential irritant or allergen
  • Poor nutrition: Your diet can have a significant impact on your immune and digestive systems, having the power to either exaggerate or ease your eczema symptoms. A diet high in food products such as alcohol, caffeine, refined sugars, salt and processed fats can place pressure on your digestive system, being low in nutritional value and difficult to break down in the gut, whilst also flooding your immune system with inflammatory chemicals, which can impact your symptoms. A study conducted by the Well Cornell Medical College in Houston, Texas found that alcohol could even be implicated in the development of discoid eczema2, making it essential that you eliminate this substance from your diet
  • Stress: If you are feeling stressed it can take its toll on your immune system, instigating a ‘flight of fight’ reaction. When your body perceives that you are in precarious situation that might inhibit your survival then it will stimulate your sympathetic nervous system. Once this happens, a number of inflammatory chemicals will be released to dilate your blood vessels and prepare your body for vigorous physical exercise. These chemicals can inflame your eczema symptoms and, if this process is repeated enough times, your immune system will eventually become sluggish and fatigued. Stress can also have an adverse effect on your digestive system, triggering bouts of diarrhoea and constipation that may influence the levels of toxins present in your system and upset the population of friendly bacteria in your gut
  • Dry skin: Discoid eczema is more likely to appear in those that have a pre-existing history of dry, sensitive skin. When your skin is dry, it is more exposed and vulnerable to allergens and irritants, which can permeate the epidermis and trigger a reaction from your immune system. It’s not uncommon for sufferers of discoid eczema to have had atopic eczema in the past, as this condition is known to take a toll on your skin cells
  • Environment: Your environment can stimulate eczema symptoms by irritating your sensitive skin. This can occur when temperatures are cold, usually in winter when you are confronted by low humidity emitting from heating systems like radiators, which can exacerbate the condition of your skin, making it dryer and more brittle
  • Irritants: If your skin is already sensitive and dry, then exposure to irritants and allergens can increase your chances of experiencing an episode of discoid eczema. The condition is known to appear after an insect bite or the usage of certain skin cosmetics, because your skin is being irritated by the foreign particles entering your immune system. When this happens it can trigger an immune response to the affected area, stimulating eczema symptoms such as inflammation, redness and the distinctive coin shaped rash associated with discoid eczema
  • Medication: Certain types of medication, such as statins or TNF-alpha blockers can cause an outbreak of discoid eczema. This is because they can both stimulate side-effects that can potentially affect the skin, drying it out and exposing it to harmful allergens and irritants.3

2http://www.ncbi.nlm.nih.gov/pubmed/21611681

3http://www.nhs.uk/Conditions/Eczema-(discoid)/Pages/Causes.aspx

The symptoms of discoid eczema

The symptoms of discoid eczema often get misdiagnosed, with the commonplace circular lesions usually being mistaken for ringworm.

It is important to be familiar with these symptoms in order to achieve a quicker diagnosis, giving you a better chance of catching the affliction in the early stages and taking preventative measures to boost your recovery time.

  • Inflammation: Inflammation normally occurs in eczema as the result of an immune response to skin irritants, allergens or invasive pathogens. The immune system releases a number of inflammatory chemicals such as histamine, which cause the affected area to swell as they body fights off potential infections and tries to repair any damage
  • Itchiness: Itchiness often appears during discoid eczema and can be one of the more infuriating symptoms, usually disturbing sleep patterns and placing the sufferer at risk of developing a secondary bacterial infection due to continuous scratching
  • Red patches: Discoid eczema is synonymous with the red coin-shaped patches that normally form on the legs. These patches can be very uncomfortable, often burning or stinging, and are usually extremely itchy
  • Blistering: Blisters are formed in the epidermal layers of the skin and commonly contain a clear fluid or occasionally blood or pus. These abrasions can form a coin-like circle, developing into the dry, red patches associated with discoid eczema
  • Stress: Stress is a common psychological response to highly visible skin conditions such as discoid eczema, and can often have a negative effect on a patient’s confidence and self-esteem, impacting their day to day lives. It also place pressure on the immune system, stimulating the release of inflammatory chemicals that can exaggerate physical symptoms, forming a vicious cycle
  • Sleep deprivation: Sleep deprivation can occur during episodes of discoid eczema when symptoms such as stress, itchiness or irritation prevent the sufferer from getting a good night of sleep. This can then have an effect on the patient’s emotional wellbeing, making them feel less able to cope with their physical symptoms the following day, ultimately stressing the immune system and perpetuating an unpleasant cycle of stress and discomfort.

Home remedies

There are many different tried and tested home remedies associated with discoid eczema, with most of them favouring ways to relieve the itchiness and inflammation that is so prevalent with the condition. However, if you notice that these solutions are aggravating your symptoms in any way, then it is important that you speak to your doctor to discuss any alternatives.

  • Relax: Try not to stress out during an episode of eczema. Stress can have an extremely negative effect on your digestion and your immune system so it is beneficial to try and relax and spend time doing the things that you want to do, like reading a good book or indulging in a luxurious bath. You could try taking up meditation as this is very good at teaching you how to take control of your mind and body as well as proper breathing techniques
  • Good nutrition: What we eat is very important, especially when it comes to easing our eczema symptoms and supporting our immune system. This might seem like a broken record, but it really is critical that we try to include foods that are rich in anti-oxidants, vitamins and omega 3 fatty acids as these can work to give the immune system a much-needed boost and can be very beneficial for dry, sensitive skin. Try to incorporate more fruit and vegetables into your diet, increasing your intake of anti-inflammatory foods, like ginger, garlic and onions. If you feel yourself reaching for a cup of tea or coffee, try a mug of Bambu instead, or some anti-oxidant rich herbal tea. Drink plenty of water, at least 8-10 glasses a day, to avoid becoming dehydrated as this will only make your skin more vulnerable and slow down your immune responses
  • Avoid irritants: If you suffer from discoid eczema then it is likely that you have dry, sensitive skin that is prone to irritation and infection. It is essential to try and take small steps to supporting your skin and avoiding aggravation, by switching from branded, conventional cosmetics to organic and fragrance-free products that are generally kinder to your skin. Allergens such as pollen can also irritate your skin, so it might be worthwhile trying to minimalise your contact with these irritants
  • Oatmeal: Not just part of a nutritious and wholesome breakfast, oatmeal is also good at naturally exfoliating your skin, removing dead skin cells and relieving the relentless itchiness associated with the condition. Mix well with some water and apply topically as a paste, or alternatively add a few handfuls to your evening bath  
  • Coconut oil: Coconut oil is full of anti-oxidants and can work as a natural anti-inflammatory agent, strengthening the immune system and hydrating the skin, encouraging skin cells to grow and rejuvenate. This oil can be taken internally or applied externally to the affected area. If you are interested in purchasing some coconut oil then why not check out the range available at Your Health Food Store
  • Aloe vera: Aloe vera has been used for centuries in the treatment of minor burns, meaning that it might alleviate the burning sensation associated with the red patches that are synonymous with discoid eczema. The plant extract can also be used to moisturise the skin and prevent it from becoming dry and damaged, reducing any inflammation or rawness that might have occurred. You could even try aloe vera juice, which can be taken internally to support your digestive system
  • Honey: Unprocessed, raw honey might not sound like a substance you want sticking to your skin, but it has proven to be very valuable when it comes to keeping skin protected and hydrated. If it is applied topically, it can strengthen the epidermal layer of skin, protecting it from irritants and allergens whilst locking in moisture, soothing the symptoms of dry skin. Manuka honey works best although it would be wise to remember to wash it off thoroughly to avoid any vengeful bees or unwanted stickiness. If you are interested in this option, please check out the range of Manuka honey products available at Your Health Food Store.

Herbal remedies

There are a number of herbal remedies that are useful when it comes to combatting the symptoms of discoid eczema. It is important to note, however, that if your symptoms continue to persist or worsen then you should speak to your local GP as soon as possible.

  • Neem Cream: The benefits of neem have been widely acclaimed when it comes to easing skin irritation. Neem Cream is made from extracts of neem leaves and can be applied topically to sooth dry or damaged skin, working to alleviate irritation and itchiness. Neem cream may not be suitable for pregnant or breastfeeding women, or those that suffer from nut allergies
  • Vitamin C: Nature-C is a chewable vitamin C supplement made from fruit extracts. It can be taken to support the immune system but can also be very beneficial for your skin, aiding the absorption of iron and working as a natural anti-inflammatory agent
  • Viola tricolor: Viola tricolor is made from extracts of wild pansy and is often used in the treatment of inflamed skin conditions like eczema. The remedy is also rich in flavonoids which can work to regulate the capillary membranes, strengthening and supporting your skin cells. Viola tricolor is suitable for children over the age of 2 but you may need to seek permission from your doctor before taking, if you are pregnant or breastfeeding
  • Molkosan®: It is estimated that around 70% of your immune cells can be found in your gut, making it essential that you support this critical area of the body, especially when you consider the negative impact that poor digestion can have on your eczema symptoms. Molkosan® is a pre-biotic that is rich L+ lactic acid and can work to create a positive environment for your friendly gut bacteria. This product can be taken by almost anyone but may not be suitable if you are breastfeeding or pregnant
  • Stress Relief Daytime: Made from extracts of Valerian, Stress Relief Daytime is a natural stress remedy works to help you feel calm in moments of pressure or difficulty. It is good at regulating your moods, allowing you to feel more in control and enabling you to cope with difficult eczema symptoms
  • Dormeasan®: Dormeasan® is a natural sleep remedy that helps to support a normal sleep cycle. Made from extracts of Valerian and hops, it will not leave you feeling drowsy or unfocused the next day and might be worthwhile considering if you find that your eczema symptoms are preventing you from getting a good night’s sleep. It may not be suitable for those whose medication is affected by alcohol consumption or pregnant women.

Conventional medicine

If your symptoms continue to persist in severity and show no signs of abating then you might need to speak to your doctor about the conventional medicines that are available. You should always take these as directed by your doctor and be aware of any negative or detrimental side-effects.

  • Steroid creams: Steroid creams usually have to be prescribed by your doctor and typically they are applied topically to the affected area in an effort to diminish swelling and itchiness. Nevertheless, steroid medication should not be taken persistently and can stimulate side-effects such as acne, which may only inflames your eczema symptoms even more
  • Emollients: Emollients are a form of moisturiser that is applied directly to the affected area and there are usually different types to suit different complaints. However, there are some emollients that might not be compatible with your skin type, often expounding existing symptoms or triggering an allergic reaction. If you feel as though this is the case, then you should contact your doctor immediately
  • Anti-histamines: Anti-histamines can normally be bought over the counter at most pharmacies and are normally advised to reduce swelling and inflammation. There are some anti-histamines though, that are unsuitable to take if you plan on driving or operating machinery due to side-effects such as drowsiness
  • Anti-depressants: If you feel as though your physical symptoms are having an impact on your emotional and psychological wellbeing then your doctor might recommend a course of anti-depressants. The effects of this medication can vary from person to person and sometimes you will need to try different variants before you discover one that works for you.

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