Monkeypox is a rare infection that appears on the skin as raised spots, which turn into small blisters filled with fluid. These blisters eventually form scabs, which later fall off. The skin symptoms of monkeypox have the potential to be confused with infected eczema, particularly eczema herpeticum, which is a serious viral herpes infection. For more information on the other symptoms of monkeypox, which appear before the skin symptoms, please see the NHS website. For more information on eczema herpeticum, please see this page.
Children and adolescents with a history or presence of atopic eczema are at risk of more severe monkeypox. If you suspect that you or your child has monkeypox – or eczema herpeticum – please seek immediate same day medical advice.
Monkeypox vaccine (MVA-BN) and cautions for people with eczema
The vaccine recommended to protect against monkeypox is a third generation Modified Vaccinia Ankara (MVA) vaccine, which was first developed in the 1950s for the prevention of smallpox. See the UK Health Security Agency (UKHSA) website for more information. For most people, the monkeypox vaccine has a favourable safety profile.
People with atopic eczema, though, may be more likely to experience certain side effects from the vaccine. These include more intense local skin reactions (such as the skin becoming red or darker than usual, depending on skin tone, swelling and itching) and other general symptoms (such as headache, muscle pain, feeling sick or tired), as well as a flare-up or worsening of their eczema. In rare cases, people with atopic eczema have experienced serious reactions to the vaccine with widespread infection of the skin.
National Eczema Society and the UKHSA recommend that people with atopic eczema seek a risk assessment before taking the vaccine in order to balance the risk from exposure to monkeypox and the risk of possible side effects from vaccination.
The MVA vaccine is currently being offered to people in the UK at high risk of exposure to monkeypox. Note there have been challenges reported in obtaining sufficient supplies of the vaccine (as of August 2022). The UKHSA recommends MVA is offered to:
- healthcare workers caring for patients with confirmed or suspected monkeypox
- men who are gay, bisexual or have sex with other men, and who have multiple partners, participate in group sex or attend sex on premises venues. Staff who work in these premises may also be eligible
- people who have been in close contact with someone who has monkeypox – ideally they should have the vaccine within 4 days of contact, but it can be given up to 14 days after.
- NHS webpage on monkeypox: https://www.nhs.uk/conditions/monkeypox/
- National Eczema Society webpage describing eczema herpeticum: https://eczema.org/information-and-advice/living-with-eczema/skin-infections-and-eczema/
- UKHSA vaccination information: https://www.gov.uk/government/publications/monkeypox-vaccination-resources/monkeypox-waiting-for-your-vaccination
- UKHSA information on the smallpox (MVA) vaccination: https://www.gov.uk/government/publications/monkeypox-vaccination-resources/protecting-you-from-monkeypox-information-on-the-smallpox-vaccination
- UKHSA recommendations for the use of pre and post exposure vaccination during a monkeypox incident: https://www.gov.uk/government/publications/monkeypox-vaccination
Tuesday 13 September, 6:00 – 6:45pm
Register for the webinar here.
In this webinar, Dr Paula Beattie will talk about how topical steroids can be used safely and effectively to manage eczema inflammation. She will also address concerns over the safety of topical steroids, including topical steroid withdrawal.
Dr Beattie is a Consultant Dermatologist and Honorary Senior Lecturer at the Royal Hospital for Children in Glasgow, and a member of National Eczema Society’s Medical Advisory Board.
Need advice on coping with one or more aspects of living with eczema? Have a rummage in our toolkit to find information on flare-ups, itch, sleep, relationships, parenting and more…
Whether you’ve had eczema all your life or you were recently diagnosed – or you have a baby, child or teen with eczema – it can be helpful to get to grips with or revisit the basics, to make sure you’re using your treatments in the most effective way and reducing exposure to triggers where possible.
To find out how to use eczema treatments, reduce exposure to common triggers and manage flare-ups, take a look at the following pages:
Factsheets (for factsheets on Emollients and Topical steroids, and common triggers in the home – Household irritants)
Eczema and relationships
If you or your partner has eczema, your relationship can come under pressure as a result. It’s important to be as open, honest and direct as possible, while staying sensitive to each other’s needs.
To give you more confidence in navigating the tricky realm of romantic relationships, please see our Relationships and eczema page.
Eczema and sleep disturbance
If you or your child has eczema, it’s likely that you or they will at some point have disturbed sleep. Waking in the night can lead to a relentless succession of broken nights over weeks or months, leaving you and your child exhausted and irritable.
To help you create the most eczema-friendly sleep environment and maximise your chances of a restful night, take a look at our Sleep and eczema page.
Eczema and school
Managing eczema at school can be daunting. The school environment has the potential to throw up many challenges: triggers, finding time and space to apply creams, self-consciousness and even bullying.
For tips on managing eczema in primary and secondary school, and on building relationships with teachers and other school staff, check out our Eczema and school page (aimed at parents/carers and school staff).
Eczema and mental health
Eczema can affect your mental and emotional wellbeing in a variety of ways. It might affect how you feel, or your mood. It might make you feel down or fed-up, and that might – but not necessarily – include depression. It can also lead to feeling stressed, worried or anxious, and impact upon your self-esteem and body image.
For advice on coping with the psychological aspects of eczema, please see our Mind-body connection page.
Eczema and stress
Stress is our natural response to feeling threatened or under pressure. Many people report that stress makes their eczema worse and increases the itch, and there may be both physical and psychological reasons for this.
For tips on managing stress, please check out our Stress and eczema page.
Information for parents/carers
Eczema affects 20% of children in the UK and around 1 in 20 have severe disease. Uncontrolled eczema has a huge impact on a child’s quality of life.
To help you support your baby, child or teenager with eczema, we have advice and resources on the following pages:
Need further information?
Please contact our Helpline by email at firstname.lastname@example.org, or call us on 0800 448 0818 (Monday to Friday, 10:00am – 4:00pm, apart from Bank Holidays).
National Eczema Society has heard from many parents via our Helpline who are worried about the impact of using hand sanitisers and increased hand-washing when their children go back to school. We have some tips for managing hand eczema in light of these precautions below, and an information sheet here, that you can print out and show the school.
- Parents/carers may need to discuss with the school before term or on the first day of term the importance of children being able to bring their own soap to school and double-washing (washing first with soap for 20 seconds and then with emollient). If your child has an Individual Health Care Plan for managing eczema in school, the hand-washing instructions should be amended.
- We advise that children bring their own soap to school, as soap from a dispenser could contain ingredients that are harsh on the skin. Brands of soap recommended by people with eczema on our social media channels included Dove, Faith in Nature and Simple. Olive oil soaps were also recommended.
- Children should bring emollient with them to school and apply it after washing their hands as well as at other times during the day. Provide your child with a travel-sized dispenser (available from bigger pharmacies and online), and decant their preferred emollient into it. They can keep this in their pocket for washing and moisturising at school.
- If your child’s hands start to get sore or cracked due to frequent hand-washing, ask the school if they can wear cotton gloves – remember to apply lots of emollient underneath the gloves and provide two pairs, which the child should change at lunchtime. We list suppliers of 100% cotton gloves in our Clothing stockist list.
- Do keep treating flares of hand eczema with prescribed topical steroids (which can be applied once a day at home, ideally before bed). If hands are sore from the school day, apply an ointment emollient before bed and wear cotton gloves overnight to re-hydrate and restore the skin, ready for school the next day.
If you encounter difficulties with the school, we have an information sheet here that you can print out to show the school. This describes the impact hand eczema can have on children, and explains how schools can support the medical needs of children with eczema, allowing them to fully participate in school life.