Why Does Eczema Become Infected?
People with eczema get skin infections far more often than people without it. Infection can trigger flares, make eczema harder to treat and, occasionally, become serious. Knowing the signs helps you act early.
Why eczema skin is vulnerable
The barrier is broken. Healthy skin is a physical shield. Eczema skin is dry, cracked and often scratched open, giving bacteria and viruses a way in.
The skin's defences are weaker. Eczema skin produces fewer of the natural antimicrobial substances that normally keep bacteria in check.
Staph thrives on eczema. Staphylococcus aureus is found on the skin of most people with active eczema, often in large numbers, compared with a minority of people without eczema. It does not always cause obvious infection, but its toxins drive inflammation and itch.
Scratching spreads it. Fingernails carry bacteria from one area to another and push them into broken skin.
Signs of bacterial infection
Weeping or oozing skin
Yellow or golden crusts
Small pus-filled spots
Eczema that suddenly worsens or stops responding to usual treatment
Increasing redness, heat, swelling or pain
Eczema herpeticum: a medical emergency
Eczema can also become infected with the cold sore virus (herpes simplex). This is called eczema herpeticum. Look out for:
clusters of small, painful blisters or punched-out sores
rapidly spreading painful rash
fever or feeling unwell
If you suspect eczema herpeticum, seek urgent same-day medical care. In the UK, call NHS 111 or go to A&E; in the US, go to urgent care or an emergency department. It needs antiviral treatment promptly, and involvement around the eyes needs to be seen urgently.
Fungal infections
Fungal infections can also occur, particularly in skin folds, and can be mistaken for eczema.
Reducing the risk of infection
Keep eczema well controlled – inflamed skin is the most vulnerable.
Moisturise from clean tubs using a clean spoon or pump dispenser, not fingers.
Keep nails short.
Use prescribed antiseptic or antibacterial treatments as directed.
Avoid close contact with anyone who has an active cold sore.
How we approach bacteria at eczema-doc
Because bacteria play such a central role in many people's eczema, our treatment approach addresses bacterial colonisation alongside inflammation and the skin barrier, rather than treating each separately.
Book a video consultation if your eczema keeps getting infected.
This article is for general information and does not replace individual medical advice.