Skin affected by eczema, an inflammatory skin condition, can sometimes become infected. Infected eczema often arises because of damage to the skin barrier, which can be worsened by scratching. Scratching can lead to open sores and cuts, which can further diminish the skin barrier’s effectiveness. This can allow bacteria, viruses, and fungi to enter and cause infection. Notable culprits include staph and herpes, but other microbes are also capable of causing eczema-related skin infections.

People with all types of eczema, including atopic dermatitis and contact dermatitis, can develop infections. People with atopic dermatitis are particularly susceptible to bacterial and viral skin infections, as they may have large quantities of staph microbes living on their skin.

Risk factors for infected eczema include very dry skin and repeatedly scratching itchy areas. Rarely, eczema-related skin infections can cause more serious conditions, like eczema herpeticum, cellulitis, and even sepsis, which may require more intensive therapy and hospitalization.

Symptoms of Infected Eczema

Identifying whether your eczema is infected is critical to optimizing your skin health and preventing complications. Ask yourself:

• How does the affected area compare to my usual eczema?
• Does my skin look or feel more inflamed than usual?
• Does my skin feel itchier or more painful than usual?
• Are there any new skin lesions, like a blister or crust?
• Do I have a fever, chills, or otherwise feel unwell?

Additionally, several key symptoms are commonly associated with infected eczema:

• Redness
• Swelling
• Warm skin
• Tenderness
• Pus
• Oozing
• Yellow crusting
• Blisters

In more serious cases of infected eczema, other symptoms may be present:

• Fever
• Sweating
• Fatigue
• New rashes in typically unaffected areas of skin

Tell your health care provider if you suspect your eczema is infected, especially if you have a fever or new rashes.

Treatment for Infected Eczema

If your health care provider determines that your eczema is infected, they may prescribe medication to fight the infection. The type of treatment you receive is typically determined by the type of infection you have — bacterial, viral, or fungal. Many treatment regimens also include topical steroids, which can help reduce inflammatory symptoms (and antihistamines to help prevent itchiness).

For Bacterial Infections

If you have a bacterial infection such as staph, your doctor may prescribe topical or oral antibiotics with corticosteroids. Mupirocin ointment is commonly used topically. The doctor may prescribe penicillins or sulfa-based antibiotics as a first-line medication. If an untreated staph infection results in a more serious condition such as cellulitis, hospitalization and more intensive care may be required.

For Viral Infections

If you have an infection caused by a virus such as the herpes simplex virus, you may be prescribed antivirals (for example, valaciclovir or aciclovir). These medications are helpful if your doctor determines you have eczema herpeticum, which would be accompanied by fatigue, a crusting or blistering rash, and fever.

For Fungal Infections

Fungal infections like ringworm typically require antifungals and sometimes corticosteroids.

Preventing Infected Eczema

Working with your health care provider to create a comprehensive eczema treatment plan is ideal for preventing infected eczema. People with poorly controlled eczema (particularly atopic dermatitis) are at a higher risk of developing infected eczema. Sticking to your treatment plan — including using moisturizers, lotions, and emollients as necessary — is an important foundation for preventing eczema-related skin infections. For best results, be sure to use any prescription medicines as prescribed.

By avoiding scratching, you can reduce damage to your skin barrier and decrease your skin’s susceptibility to infection. MyEczemaTeam members have shared that breaking the itch-scratch cycle has proven difficult, but there are ways to control scratching. Oral and topical antihistamines may help reduce itching. Breaking the cycle of itching and scratching is difficult but important to prevent infections.

One MyEczemaTeam member noted that when using a humidifier at night, they “noticed a difference immediately.” Other MyEczemaTeam members have reported that maintaining appropriate moisturization allowed them to interrupt the itch-scratch cycle. Home remedies containing ingredients like aloe vera and shea butter helped soothe their skin and reduce irritation. Identifying and addressing your triggers and allergens may go a long way in reducing your scratching to help prevent infected eczema.

A bleach bath may also help prevent infection. Bleach baths involve bathing with a full bathtub of water and a quarter cup of household bleach. The bleach helps kill bacteria that thrive on eczematous skin, reducing the likelihood of infection.

One MyEczemaTeam member noted that they “found taking bleach baths very helpful,” especially when followed by moisturizer. Although bleach baths can help prevent eczema-related skin infections, they may not work for everyone. These baths can sometimes cause further irritation and dryness. Talk to your dermatologist about bleach baths to determine if this remedy is right for you.

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Has your eczema become infected? What have you used to treat it? Share your experience in the comments below, or start a conversation by posting on MyEczemaTeam.