​Eczema is an inflammatory skin condition that can sometimes lead to infection. This usually happens when the skin barrier — the outer layer that protects your body — is damaged. Scratching itchy skin can lead to open sores and cuts that let in bacteria, viruses, and fungi. Two common causes of eczema-related skin infections are staphylococcus (staph, a type of bacteria) and herpes simplex virus (which causes cold sores), but other microbes can be involved too.

People with all types of eczema, including atopic dermatitis and contact dermatitis, can get infections. Those with atopic dermatitis — the most common subtype of eczema — are especially at risk of bacterial and viral skin infections because large amounts of staph bacteria live on their skin.

One of the biggest risk factors for infected eczema is repeatedly scratching itchy areas. Rarely, eczema-related skin infections can cause more serious conditions, like eczema herpeticum, cellulitis, and even sepsis, which may require more intensive therapy and hospitalization. This article covers the signs of infected eczema, describes at-home treatments, and provides photos of what infected eczema looks like.

Symptoms of Infected Eczema

How can you tell if your eczema is infected? Spotting the signs early is important for protecting your skin and avoiding complications. Ask yourself these questions:

• Does the area look worse than my usual eczema?
• Is the skin more discolored or swollen than usual?
• Does it seem itchier or more painful?
• Are there any new lesions, like a pustule (blister containing pus) or crust?
• Do I feel unwell, perhaps with fever or chills?

Some of the most common signs of infected eczema include:

• Discolored skin
• Swelling
• Warm skin
• Tenderness
• Oozing
• Honey-colored crusting
• Pustules

In more serious cases of infected eczema, these symptoms also may be present:

• Fever
• Malaise (feeling unwell)
• New or changing rashes

Tell your healthcare provider if you suspect your eczema is infected, especially if you have a fever or changes in your rash.

Treatment for Infected Eczema

If your dermatology provider finds that your eczema is infected, they’ll likely recommend medicine to treat the infection. The treatment depends on the type of infection — bacterial, viral, or fungal.

Treatment may also include topical steroids (applied to the skin) to help reduce inflammatory symptoms and antihistamines to relieve itchiness. However, topical steroids should not be used alone if an infection is suspected or confirmed because they can worsen certain infections. If you’re not sure which treatment is right for you or you’re worried about a medication you’re using, talk to your dermatologist or another healthcare provider.

Treating Bacterial Infections

If your eczema becomes infected with staph, your doctor may prescribe antibiotics, either a cream or a pill, depending on how serious the infection is. Staph infections are grouped into two types:

• Methicillin-susceptible (MSSA) — Responds to more common antibiotics
• Methicillin-resistant (MRSA) — Has built up resistance to several commonly used antibiotics, so it’s harder to treat

For mild or localized infections, your doctor may recommend topical antibiotics like mupirocin ointment or antiseptics like diluted bleach baths (discussed below). If the infection is more widespread — especially if there’s pus or yellow crusting — you may need oral antibiotics (taken by mouth).

MSSA infections often respond to treatment with penicillins like dicloxacillin or cephalexin. If you’re allergic to penicillin, your doctor might use erythromycin instead. MRSA infections typically require other first-line options like doxycycline, clindamycin, or trimethoprim-sulfamethoxazole. If a staph infection goes untreated and spreads deeper into the skin, it can cause cellulitis. This serious infection may require a hospital stay and IV antibiotics.

Treating Viral Infections

If you have an infection caused by a virus such as the herpes simplex virus, you may be prescribed an antiviral such as valacyclovir or acyclovir. These medications are helpful if your doctor determines you have eczema herpeticum, which could be accompanied by a blistering rash, fever, and fatigue (persistent exhaustion that doesn’t get better with rest).

Treating Fungal Infections

Fungal infections such as ringworm typically require antifungal medications.

Prevention of Infected Eczema

The best way to prevent infected eczema is by working closely with your healthcare provider to build a personalized eczema treatment plan. People with poorly controlled eczema (particularly atopic dermatitis) are more likely to develop skin infections. Sticking to your treatment plan — including using moisturizers, lotions, and emollients — is an important foundation for preventing eczema-related skin infections. For best results, be sure to use any prescription medicines as your healthcare provider recommends.

Avoid Scratching

By avoiding scratching, you can reduce damage to your skin barrier and decrease your skin’s susceptibility to infection. Breaking the itch-scratch cycle is tough, but it’s an important step to help protect your skin. Here are some helpful strategies:

• Take antihistamines if your doctor recommends them — they can help ease the itch.
• Keep nails short to reduce skin damage if scratching happens.
• Wear loose, soft clothing, like cotton, to avoid irritating your skin.
• Try cool compresses, lukewarm showers, or colloidal oatmeal baths to soothe itching.
• Identify and manage your eczema triggers, like allergens, stress, or irritants, to prevent flare-ups that lead to more scratching.

Keep Skin Moisturized

Keeping your skin well hydrated is a mainstay to protect your skin barrier and prevent infections. One MyEczemaTeam member noted that when using a humidifier at night, they “noticed a difference immediately.” Other MyEczemaTeam members have reported that moisturizing regularly helped them interrupt the itch-scratch cycle. Some shared that using home remedies, like aloe vera and shea butter, helped soothe their skin and reduced irritation.

Try Bleach Baths

A bleach bath might help reduce symptoms of chronic eczema and lower your risk of infection. Bleach helps kill bacteria that thrive on eczema-prone skin, reducing the likelihood of infections.

To take a bleach bath, add about a quarter cup of unscented household bleach to a full bathtub of water. Soak for about 10 minutes, rinse off with clean water, and moisturize immediately afterward.

One MyEczemaTeam member noted that they “found taking bleach baths very helpful,” especially when followed by moisturizer. However, bleach baths may not work for everyone. These baths can sometimes dry out the skin or cause irritation. Always check with your dermatologist first to see if this treatment is right for you.

Talk With Others Who Understand

On MyEczemaTeam, the social network for people with eczema and their loved ones, more than 54,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Has your eczema become infected? What have you used to treat it? Have you tried any strategies to prevent future infections? Share your experience in the comments below, or start a conversation by posting on your Activities page.