About skin infections and eczema

Skin infections are common in people with eczema and it is likely that at some point you will experience either a bacterial, fungal or viral infection. All of these infections require intervention to clear them up as they do not improve on their own. The quicker the infection is recognised and the sooner treatment is started, the better the response to treatment. Preventing infection is also important – from simple hand washing before applying your creams to more sophisticated methods using antiseptics.

When you have eczema, the top layer of the skin (the epidermis) is often damaged. This damage is often clearly visible to the naked eye, appearing as cracks and areas opened up by scratching. There is also less protection within the skin, which you cannot see. These alterations in the barrier function of the skin increase the potential for skin infection. These infections are often described as secondary infections, which means they develop because of the underlying condition of eczema.

How can I tell if my skin is infected?

If you think your skin is infected, you should see your GP as soon as possible so that it can be assessed. Skin can be infected with bacteria, fungi or a virus. Bacterial infection is the most common.

Look out for one or more of the following signs of bacterial infection:

  • Eczema becomes suddenly worse, with redness, itching and soreness.
  • The skin is weepy with clear or yellow fluid.
  • The skin has blisters, or red/yellow pus spots appear.
  • You have a raised temperature, flu-like symptoms or swollen glands in the armpit, neck and groin.

How can I prevent infection?

  • Always wash your hands before applying topical creams.
  • Remember to decant emollients from any tubs you may be using – if you dip your fingers into a tub, it can easily become contaminated with bacteria. A metal dessert spoon is good for decanting emollient and washes well under the tap. If you are using pump handle dispensers for your emollients, you do not need to decant – you can just pump the emollient onto your hand (avoid touching the nozzle).
  • If you have eczema infected by Staph. aureus, or by fungal or viral infections, avoid sharing towels, bedding and clothing until the infection has cleared.
  • Some people with eczema suffer recurrent bacterial infections and require antibiotic treatment on several occasions. These people are often advised to use antiseptic washes or creams to reduce the amount of Staph. aureus on the skin. Commonly these antiseptics are triclosan, chlorhexidine gluconate or sodium hypochlorite. These antiseptics come combined with emollient preparations and can be used to wash with in the bath or as a leave-on preparation. One of the advantages of controlling infections with antiseptics is that they do not create or develop bacterial resistance.

For more information on skin infections and eczema, please see our Infections and eczema factsheet