How to treat infected eczema

“Eczema” is an umbrella term for a group of inflammatory skin conditions.

The National Eczema Association estimates that more than 31 million people in the United States live with some type of eczema.

Common symptoms of eczema may include:

• itchy skin
• dry or sensitive skin
• rashes
• heat in the affected area
• changes in skin color and texture around the rashes
• scaly patches that tend to peel
• blisters

Eczema skin may also be more prone and vulnerable to infections, which may involve new symptoms.

Symptoms of infected eczema

Bacteria, fungi, or viruses can cause skin infections. The most common symptoms may include:

• redness (or skin darkening, depending on your skin color), which is also present in eczema
• swelling in the affected area
• crusty skin
• skin that is painful or warmer to the touch
• pus-filled bumps or clear discharge
• fever

Eczema skin may be more vulnerable to staph infections (caused by the bacteria Staphylococcus aureus) and herpes infections (caused by the herpes simplex 1 virus, which can also cause cold sores around your mouth).

Treatment for skin infections in eczema

If you think you may have a skin infection, seeking the support of a healthcare professional is highly advised.

Experts suggest that a skin infection may require prompt treatment with antibiotics or antivirals, depending on the cause. This will help avoid possible complications.

Treatment for each type of infection may involve the following:

• Bacterial infections (like those caused by staph): These require antibiotics that you either apply to the skin or take by mouth. Examples include dicloxacillin and cephalexin (Keflex).
• Fungal infections: Candida may be treated with a cream containing clotrimazole (Lotrimin AF) and tinea with miconazole (Micatin).
• Viral infections (like those caused by herpes): A healthcare professional may prescribe antiviral medications like acyclovir (Zovirax) or valacyclovir (Valtrex). Eczema herpeticum, which is a painful skin infection caused by the herpes virus, can spread very quickly, so medical support is advised.

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Treatment for eczema

A dermatologist may help you build a plan to manage your eczema and reduce the chance of skin infections. Managing eczema may involve a combination of:

• skin care, including applying moisturizer and being gentle with your skin
• managing triggers of eczema (i.e., avoiding things that cause your eczema to flare up)
• light therapy
• medications

The medications your dermatologist or doctor recommends will depend on the type of eczema you have. 

Eczema medications may include:

• oral corticosteroids like prednisolone (Omnipred)
• topical steroids like triamcinolone (Trivaris)
• topical calcineurin inhibitors, such as pimecrolimus cream (Elidel) or tacrolimus ointment (Protopic)
• PDE4 inhibitors, like crisaborole ointment (Eucrisa)
• antihistamines, like cetirizine (Zyrtec)

Other possible treatment options include:

• dupilumab (Dupixent), which is given as an injection and works to reduce systemic inflammation
• JAK inhibitor tablets, like abrocitinib (Cibinqo), which also reduce inflammation
• tralokinumab-ldrm (Adbry), which is injected when you need stronger medication than a topical treatment
• immunosuppressors, like azathioprine (Imuran) and methotrexate (Trexall)

How to prevent skin infections when you have eczema

Keeping your skin clean and well moisturized will help you reduce discomfort and the chance of skin infections.

Scratching the skin may be one of the most common triggers for skin infections. This is because it may damage the surface and make it easier for fungi, bacteria, and viruses to enter.

These steps may help you get itch relief and reduce your chances of damaging the skin:

• applying cold compresses to your skin, particularly if you’re itchy
• moisturizing regularly with a cream or ointment that contains ceramides (a type of fatty acid that is naturally found in skin cells)
• acupuncture
• taking a bath in vinegar water or adding diluted vinegar to a cold compress
• wearing breathable, soft, and natural clothing
• using skin cleansers that have a low pH
• patting your itchy skin (instead of scratching it)
• not sitting on rough surfaces like grass or rough carpet with bare legs
• trying wet wrap therapy

Your healthcare professional may also recommend diluted bleach baths or mupirocin, which is an antibiotic ointment applied to your skin, to reduce your risk of infection. These should be done only following your healthcare professional’s guidelines.

Summary

Eczema skin may be more prone to skin infections, a common complication that involves oozy skin, localized pain, and inflammation.

Depending on what causes the infection, treatment may involve antibiotics, antivirals, or antifungals. 

Skin infections require prompt medical support because they may spread or cause complications.