Infected Eczema

Overview

Infected eczema means eczema skin has become infected, usually by bacteria and sometimes by a virus. Eczema is a skin condition that makes skin dry, itchy, and cracked. When cracks or scratches let germs in, the skin can become infected. It is not a new type of eczema.

Yes. Skin infection is one of the more common problems for people with eczema, especially when the skin is cracked, scratched, or poorly controlled.

Anyone with eczema can get an infection, but it is more likely in children, people with severe or frequent eczema flares, and people whose skin barrier is damaged.

Symptoms

Common symptoms

• More redness, warmth, swelling, or pain in the eczema patches
• Yellow or honey-coloured crusts on the skin
• Pus or fluid leaking from the skin
• New small blisters or sores
• Itch that gets worse or skin that feels tight and sore
• Fever or feeling unwell

Symptoms in children

• Fever, fussiness, or poor feeding
• More scratching and irritability
• Crusty or weeping patches that spread
• New blisters or sores
• Trouble sleeping because of itch or pain

Symptoms in older adults

• Fever may be low or absent
• Confusion or sleepiness can be an early sign
• Skin may tear easily and feel very painful
• Infection can spread quickly
• Dehydration or feeling generally unwell

Causes

Main causes

• Bacteria that normally live on the skin getting into cracked or scratched eczema
• Scratching and broken skin
• Viral infections spreading on eczema skin
• Poorly controlled eczema with dry, cracked skin
• Close contact with someone who has a skin infection

Risk factors

• Severe or frequent eczema flares
• Open scratches, sores, or cracked skin
• A weakened immune system or medicines that lower immune defences
• Not using moisturiser regularly
• Hot, humid weather or sweating
• Being a child or baby with eczema

When to see a doctor

See a doctor urgently if:

• You see pus, yellow crusts, or fluid leaking from the skin
• The skin is hot, very painful, or swelling
• You or your child has a fever or feels unwell
• New blisters or sores appear
• The infection is not improving after 24 to 48 hours
• A baby under 3 months has a fever

Book a routine appointment if:

• You get repeated skin infections
• Your eczema is hard to control
• You are unsure whether the skin is infected
• Sleep, school, or work is affected
• You need help with an eczema care plan

Diagnosis

A doctor or nurse usually diagnoses infected eczema by looking at the skin and asking about symptoms. They may ask about fever, pain, recent flares, and how quickly the skin changed.

Tests that may be done

• A skin swab if there is pus or crusting
• A viral swab if there are blisters or sores
• Blood tests if you are very unwell or the infection is spreading

What to expect at your appointment

Most appointments are quick. The clinician will check the skin and decide whether treatment is needed. If you feel very unwell or the skin is changing fast, say so clearly and ask for urgent help.

Treatment

Treatment aims to clear the infection and calm the eczema. A clinician will decide what is suitable based on your age, symptoms, and whether the infection is bacterial or viral. Keep using moisturiser and follow your eczema care plan.

Self-care at home

• Keep skin moisturised with a gentle moisturiser, often called an emollient
• Wash gently with lukewarm water and avoid harsh soaps or fragrances
• Do not scratch, squeeze, or pick crusts
• Keep nails short and clean
• Use cool compresses to soothe sore skin
• Wear soft, loose cotton clothing
• Avoid known triggers such as heat, sweat, and scratchy fabrics

Medical treatments

A clinician may prescribe medicines to treat the infection. For a bacterial infection, this may be antibiotic medicines taken by mouth or put on the skin. For a viral infection, antiviral medicines may be used. They may also prescribe anti-inflammatory creams to calm the eczema. Always follow the clinician's plan and do not use leftover medicines.

When is surgery considered?

Surgery is rarely needed. If an infection forms a pocket of pus, called an abscess, a clinician may drain it.

Living with this condition

Follow your eczema plan, keep skin moisturised, and check the skin every day. Treat flares early. If you or your child has a fever or feels unwell, stay home and seek advice. Return to school or work when you feel better.

Lifestyle tips

• Keep nails short and clean
• Wear soft, loose cotton clothing
• Avoid fragrances, harsh soaps, and scratchy fabrics
• Use moisturiser every day, even when skin looks clear
• Keep rooms cool and avoid overheating
• Wash hands often and do not share towels

Diet and exercise

No special diet is proven to cure infected eczema. Eat regular balanced meals. Gentle exercise is fine if you feel well. Wash sweat off gently and moisturise after. Avoid getting too hot.

Mental health and emotional wellbeing

Skin infections can be stressful, embarrassing, and can disrupt sleep. This can affect mood and confidence. These feelings are common. If you feel low, anxious, or unsafe, talk to a clinician. If you are in crisis, contact your local emergency number or a local crisis service.

Prevention

You cannot always prevent infected eczema, but good eczema care lowers the risk. Keep skin moisturised, avoid scratching, treat flares early, and wash hands often.

Vaccines

There is no vaccine for infected eczema itself. Keep up with routine vaccinations recommended by your local health service.

Screening programmes

There is no screening programme for infected eczema. If you have eczema, check your skin regularly and seek advice early for signs of infection.

Complications

If left untreated

• Infection can spread into deeper skin, called cellulitis
• A pocket of pus, called an abscess, can form
• A viral skin infection can spread quickly
• Sepsis, a life-threatening reaction to infection, is rare but serious
• Scarring or dark marks can remain after healing
• Poor sleep, missed school, or missed work

Long-term outlook

Most people recover well with prompt treatment. Eczema may still need ongoing care, but early help lowers the risk of serious problems. Many people find a care plan that keeps their skin calmer over time.

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