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This information explains the types of infection which commonly affect Atopic Eczema, and their treatment.

Infection in Atopic Eczema can be obvious. For example, if there is crusting, weeping, swelling, redness, pain and there may be ‘pus’. Sometimes none of these signs is visible but the eczema isn’t improving. This too could be due to an infection.

Staff in our Dermatology outpatient clinic will often take a skin swab to find out if there is an infection and what type of infection it is. These swabs are like a cotton bud and are gently rubbed over the eczema. They are then sent away to the laboratory for testing. 

Bacteria or viruses may cause skin infection.

Bacteria

The most common type in eczema is staphylococcus aureus (often abbreviated to ‘staph’). There is an increased level of these bacteria on the skin of people with eczema and if there is a break in the skin it can cause infection. If the skin is heavily infected with bacteria the treatment for this is antibiotics by mouth e.g. flucloxacillin.

Sometimes the skin is treated with an antibiotic cream/ointment as well as, or instead of, antibiotics by mouth. An antiseptic bath additive or emollient may also be used to reduce the bacteria on the skin e.g. potassium permanganate.

To prevent infection it is important to gain control of the eczema by using the treatments prescribed. Emollients, which moisturise the skin, are particularly important as they provide a barrier to stop entry of the bacteria into the skin.

There are other bacterial infections of the skin, which require slightly different antibiotics.

Virus (herpes simplex)

People with eczema are more susceptible to infection as their skin is often broken or cracked. The herpes simplex virus, commonly known as the ‘cold sore virus’, can infect eczema sufferers if the person with eczema comes with someone with the virus. The skin will blister and within a few days it will be crusty, weepy and have distinctive lesions, which are often said to look like the holes a hole punch makes. The child or adult may feel unwell and have an increased body temperature.

The treatment for this infection is with acyclovir, which is taken by mouth. It is very important to seek medical attention if you suspect this infection as it can rapidly make a child or adult very unwell. It is also therefore important to avoid contact with someone with a cold sore if you have eczema.