Eczema is primarily found in infants, and most children outgrow eczema by the time they are about 10 years old. In cases where eczema persists into adulthood, people are typically able to manage their condition with medicated creams.

Sometimes, eczema may become infected. Typically, this happens when a virus or bacteria gets into open blisters or wounds at the site of an eczema rash.

It is important for people with eczema or caregivers of children with eczema to know what causes eczema to become infected, the signs and symptoms, and what treatment options are available.

What causes infected eczema?

Eczema infections are caused by a variety of potential viruses, bacteria, or fungi. The following are some of the more common microbes responsible for causing infected eczema:

• Staphylococcus aureus (Staph infection)
• fungal infections, such as ringworm (tinea)
• herpes simplex virus

Staphylococcus aureus is a type of bacteria found on the skin of nearly all people with eczema. It also lives on the skin of about 20 percent of healthy adults.

Staphylococcus aureus thrives on weeping or broken skin. In cases of a staph infection, eczema spreads more quickly and makes healing more difficult.

Ringworm is a common source of fungal infection in eczema. Ringworm can be found all over the body and typically appears as isolated patches. It can also occur between the toes, where it is known as athlete’s foot.

Fungal infections are more likely to occur in people with eczema, but they are relatively common in all individuals.

Herpes simplex can also cause infections in people with eczema, so it is a good idea for people with eczema to avoid people with cold sores, where possible.

A secondary infection of the skin caused by the herpes simplex virus is called eczema herpeticum. If it is not correctly diagnosed and treated with antiviral therapy, it can cause serious consequences, even leading to blindness or death.

Most people that have infected eczema will have an open sore in the affected area. The open sores usually develop because a person has been scratching their skin.

Symptoms of an eczema infection

Infected eczema is easy to recognize because the area will usually appear more inflamed.

A person with infected eczema may also experience the following:

• burning
• extreme itching
• fluid drainage
• blistering
• white or yellow pus

In more advanced cases, a person may experience more severe symptoms including:

• fever
• chills
• aches
• fatigue

If anyone experiences any of these symptoms at the site of eczema, they should seek medical intervention to treat the infection.

Complications

Infected eczema is a complication of eczema, but it can produce its own problems and issues.

Some common complications of infected eczema may include:

• prolonged eczema flare – the infection needs to be treated before the eczema will heal
• increased itchiness and blisters
• growth problems in children using steroids
• eventual resistance to topical steroids with prolonged use
• scarring

Infected eczema can also lead to more dangerous complications. For example, if left untreated, a serious staph infection may cause a blood infection known as sepsis.

In general, the younger the person is, the more likely they are to develop complications from an infection. Infants and young children are at particular risk of developing blood or bacterial infections, so a doctor should examine them as soon as possible.

When to see a doctor

If a child or infant develops a rash, it is a good idea to contact a doctor to rule out more serious infections.

If a person has chronic eczema flares, they should see their doctor if they develop a fever, experience chills, have reduced energy, or develop signs of infection, such as oozing blisters and excessive itchiness.

Treatment

Treatment for infected eczema varies based on the type of infection present. If the cause of the infection is a virus, a doctor may prescribe an antiviral medication.

In cases of bacterial infections, a doctor may choose to use either an oral or topical antibiotic. Doctors are likely to recommend creams for mild cases and prescribe oral antibiotics for more advanced cases. A doctor may also prescribe a steroid cream to reduce associated swelling and redness.

Fungal infections require antifungal creams or medication. Similarly, a steroid cream may also help with a fungal-infected eczema rash. Some antifungal creams that may help with the infection are available over the counter.

Natural treatments

Some people and caregivers may want to supplement medication with natural alternatives to treat or prevent infections from coming back.

People seeking natural remedies for infected eczema may choose to try the following:

• essential oils, such as evening primrose and tea tree
• herbal supplements for eczema flares
• natural soaps and creams with emollients
• probiotics while taking antibiotics
• oatmeal baths to help soothe and dry the eczema

Prevention

A person can help prevent infected eczema by reducing eczema flares and avoiding scratching. Also, those with eczema should keep their skin as clean as possible. When flares occur, a person should follow the recommended treatment plan to help manage and reduce the flare.

For flares occurring in folds or naturally more moist areas of the skin, care should be taken to keep the area dry and clean.