Weepy Sores (Wet Eczema) in Atopic Dermatitis

Atopic dermatitis (eczema) causes many skin changes. Severe eczema can lead to large areas of skin breakdown that ooze fluid. This is called weeping. When skin is weeping, it may be a sign of wet eczema.¹

What are weepy sores?

The skin helps maintain water balance and keep bodily fluids in. When the skin is inflamed, the skin surface breaks down. Meanwhile, blood vessels in the skin get larger (dilate) so they can deliver oxygen and nutrients to the site of irritation or injury.^1,2

When blood vessels dilate and the skin surface is not strong, blood, water, and other fluids can ooze out of the skin. Areas of the skin that are actively oozing are often called weepy sores. The fluid that oozes is clear, straw-yellow, or tinted red.^1,2

Inflammation and skin breakdown that leads to weepy sores can be caused by a variety of things. Things that might create wounds that weep as they heal include:^1-3

• Cuts
• Scrapes
• Burns
• Pressure sores (sores from lying in one spot and not moving)
• Inflammatory conditions like eczema

Fluid oozing is a normal part of wound healing. However, it can be a sign of infection too.^1-3

Why do weepy sores occur with eczema?

Wet eczema is a complication of eczema. Eczema occurs because of an overactive immune system and a weakened skin barrier. These factors can lead to irritation and sores as eczema patches arise.¹

It is possible to develop small blisters that weep fluid during an eczema flare-up. But wet eczema often affects larger areas.¹

There may not be any obvious blisters present. The weakened skin surface, inflammation, and blood vessel dilation can create patches of oozing on their own. These patches often occur in the same areas that are commonly affected by eczema, like the creases of the elbows or back of the knees. These patches may eventually crust over as they heal.¹

Wet eczema versus infection

Wet eczema can result from actively inflamed patches or healing patches of eczema. But weeping sores also can be a sign of infection. Because their skin barrier is not as strong as it should be, people with eczema have a greater risk of developing infections.^1,4,5

Weeping eczema patches will resolve with eczema treatments and time. But infections need additional treatment to heal.^1,4,5

Common infections that can cause weepiness or come along with wet eczema are staph infections and viral infections. Staph infections are caused by the bacteria Staphylococcus aureus. These infections often involve pus, but sores may weep clear fluid.^1,4,6

Staph infections and certain infections caused by Streptococcus (strep) germs can cause impetigo. Impetigo is an infection that leads to weepiness and honey-colored crusting around the nose, lips, and chin.^1,4,6

Weepiness can also be a sign of a viral infection. One possible cause is infection with the herpes simplex virus (HSV). This virus also causes cold sores. Viral infection with HSV on top of actively inflamed eczema can spread quickly and lead to complications.^4,5

How are weepy sores treated?

If you have wet eczema or areas of large weeping sores, consult your doctor as soon as possible. They can help you protect these areas of skin from getting infected or prescribe options to reduce symptoms. They can also determine if you have an underlying infection that needs treatment.

You can reduce your risk of developing wet eczema by doing your best to prevent an eczema flare. You can:^1,2,7

• Use moisturizer regularly
• Take over-the-counter allergy drugs like Benadryl to help with itching
• Keep inflamed areas clean with non-irritating soap and water
• Not pop any noticeable blisters or touch open sores
• Cover inflamed areas with thick creams (emollients) and bandages
• Take all eczema treatments as your doctor prescribes, including prescription creams and drugs
• Reduce stress as much as possible to prevent future flares
• Avoid known environmental or food triggers
• Seek medical attention as soon as you notice areas of weeping

Once wet eczema occurs, you may need to be treated with additional drugs. You may also be given instructions to care for your wounds so they will not get infected. These instructions may include using specific dressings and emollients.^1,8

If your doctor notices signs of a skin infection, you may need to take antibiotic or antiviral drugs depending on the underlying cause.⁸