Nummular dermatitis is one of the most difficult forms of eczema to treat because it is often recalcitrant to treatment. It often presents with round, coin-shaped patches of scaly, itchy, pink (and sometimes oozy) skin.
This form of eczema is often seen in people who do not have a personal or family history of eczema or atopic dermatitis and can occur in men or women of any age. It can be considered a “tipping-point” eczema where the skin barrier gets dried out enough that is “tips” into eczema.
Infection is Often Associated
It is often associated with an infection with a virus like molluscum, or with Staph (Staphylococcus aureus) somewhere else on the body. This co-infection may consist of a mild folliculitis (pimple-like bumps in the hair follicles on the trunk, buttocks, legs or arms), an obvious carbuncle or abscess, or even just a colonization by Staph. aureus in the nostrils.
When associated with molluscum, the nummular dermatitis will resolve when the mulluscum are treated or resolved. When associated with co-infection with Staph. aureus, this form of eczema usually requires that the Staph. infection be addressed at the same time as the eczema in order to get rid of the eczema.
Depending on the location and severity of nummular dermatitis, something as mild as a daily benzoyl peroxide wash or bleach bath, or in severe cases, oral antibiotics may sometimes be necessary.
To address the eczema component of nummular dermatitis, we recommend the following:
- Use a benzoyl peroxide wash 3-4 times/week for as long as the condition persists. (Be careful because you can become allergic to benzoyl peroxide). You can find benzoyl peroxide in the acne aisle at most drug stores. Another alternative would be to do bleach baths 3-4 times/week. This entails filling a regular-size bathtub half-way and adding ¼ cup of bleach. Soak in the tub for about 20 minutes.
- Apply TrueLipids® Eczema Experts 1% Hydrocortisone Barrier Cream to relieve the itch and to help with the inflammation.
- Help to replace more skin barrier lipids and to prevent further water loss from the skin, apply TrueLipids® Relieve & Protect™ Ointment on top of the Hydrocortisone Cream.
- Sometimes nummular dermatitis can be very recalcitrant to treatment and may require prescription-strength topical steroids or in very few cases, it may even require oral steroids like prednisone.