Managing Infections With Eczema

It is common for people with atopic dermatitis (eczema) to get skin infections. Most skin infections fall into 3 main categories based on what caused the infection: bacterial, viral, or fungal. The best treatment for a skin infection depends on the underlying cause.^1-4

Eczema and increased infection risk

Eczema may be caused by several different factors. Many of these also play a role in a person’s risk for infection. For example, people with eczema tend to have a weakened skin barrier. Skin dryness and itching, and resulting scratching, can make this even worse. When the skin barrier is weak, invaders like bacteria or viruses can get into the body easily and cause an infection.^1-3

Also, people with eczema often have changes in their immune system response. And they may be using treatments that weaken their immune system to help control their eczema symptoms. Both of these things can impact a person’s ability to fight off germs. This can lead to skin infections as well as other infections throughout the body.¹

When a person has eczema, the natural mix of germs that live on their skin may change. Everyone is exposed to germs all the time, but not all of them are harmful. Some play important roles in the way the body functions. However, people with eczema may have an imbalance of these germs that can put them at an increased risk of developing infections.^1-4

Bacterial infections

People living with eczema often have a greater amount of Staphylococcus aureus (S. aureus) bacteria on their skin. These bacteria cause exacerbations of eczema and can lead to what is commonly called a staph infection.^1-5

Other types of bacterial infections on the skin include cellulitis and skin abscesses. The skin around the nostrils and lips are common sites for skin infections, especially in kids. When this happens, it is called impetigo.^1-4

The signs of a bacterial infection can vary. Common symptoms include:^1-4,6

• Weeping, wet, or oozing sores
• White or yellow pus
• Redness and skin warmth
• Skin swelling or tenderness
• Yellow or honey-colored skin crusting
• Feeling feverish

Treating bacterial skin infections is important because they can spread to larger areas of skin quickly. Skin infections can even spread to the bones or blood. If this happens, the infection can become life-threatening.¹

Minor bacterial infections on the skin can be treated with topical creams. If an infection starts to spread or has happened before, oral antibiotic drugs may be needed. If a person has repeated infections, diluted bleach baths may be recommended by your healthcare provider.^1-4,6,8

Viral infections

People are exposed to viruses all the time. Kids in daycare or school are exposed to an especially high number of viruses. These viruses include herpes (herpes simplex virus), chickenpox (varicella virus), and poxviruses like molluscum contagiosum. While many of these viruses sound scary, they are quite common.^1-4,6

Signs of a potential viral infection on the skin may include:^1-4,6

• Fluid-filled blisters, especially in groups
• Shallow, open sores on the skin (including on the hands, feet, and mouth)
• Painful areas of eczema
• Bloody skin crusting
• Pearly, skin-toned, dome-shaped bumps on the skin
• Fever
• Fatigue or severe tiredness

For most people, minor viral infections get better on their own. However, viral infections in people with eczema may need extra support. Antibiotic drugs do not work for viral infections, only bacterial ones. But antiviral drugs can be helpful in certain cases.^1-4

Some viruses, like HSV, can spread quickly and lead to severe complications. This is called eczema herpeticum, and it requires immediate medical attention.^1-4

Fungal infections

We also have fungi on our skin at all times. Many types of fungi do not bother us. Some even help keep our bodies working normally. The most common types of fungal infections in people with eczema are yeast infections (caused by a fungus called candida) and ringworm (tinea infection).^2,4,7

Candida infections affect moist areas of the body like the armpits or groin. Tinea infections can be anywhere on the skin or scalp. They create small, ring-like marks, which is why the infection is called ringworm. Ringworm is not caused by a worm or parasite.^2,7

The symptoms of fungal infections can vary based on where the infection is. Symptoms may include:^2,7

• Scaly or white patches on the feet or between the toes
• Red, ring-like marks on the arms, legs, belly, or groin
• Itching or pain
• Greasy, flaky patches on the scalp or skin
• Hair loss

Like with other infections, there are treatment options that can help. Topical antifungal creams are used for minor infections. Oral antifungal drugs are used in more severe cases.^2,4

Ways to prevent infections

There is no way to completely prevent an infection from occurring. But some common tips may reduce your risk for infections. These include:^1,2,7,8

• Regularly moisturizing the skin to keep it strong
• Taking all eczema treatments as prescribed (including when and in what order to use creams and moisturizers)
• Washing hands thoroughly before applying any treatments to the skin
• Avoiding sharing bedding, clothing, or towels with others
• Bathing regularly (potentially with diluted amounts of bleach if recommended by your doctor)
• Drinking plenty of water and eating a well-balanced diet

Also, being on the lookout for changes in your eczema and reporting them to your doctor right away can help prevent complications.