Table of ContentsView AllTable of ContentsEczema/Skin Infections: ConnectionTypes of InfectionComplicationsPrevention Tips
Table of ContentsView All
View All
Table of Contents
Eczema/Skin Infections: Connection
Types of Infection
Complications
Prevention Tips
People witheczema(atopic dermatitis) are more susceptible toskin infectionsbecause the inflammatory disease compromises the barrier function of the skin.This allows disease-causing microorganisms like bacteria, fungi, and viruses to enter breaks in the skin and establish an infection in underlying tissues.
These infections, referred to assecondary skin infections, are common with eczema. They often develop with there is there there is a severe flare-up of symptoms. In very rare instances, the infection can spread into the bloodstream and cause potentially life-threatening complications likecellulitisandsepsis.
This article describes the relationship between eczema and skin infections. It explains what types of infections can occur, how they are treated, and what you can do to prevent them.
USA300 Strain ofStaphylococcus aureusBacteria.RML/NIAID
Relationship Between Eczema and Skin Infections
Eczema is achronic(long-term)inflammatorycondition that causes itchy, red, swollen, and cracked skin. Although eczema can occur at any age, it typically starts in early childhood.
In infants, eczema can cause a widespread rash covering the face and most of the body. In older kids, the rash is mainly seen in skin folds of the knee, elbow, and neck, while adults most often experience eczema on the hands and feet.
Common signs and symptoms of eczema include:
Type of Eczema Skin Infections
Bacteria are the most common cause of secondary skin infections in people with eczema. However, fungal and viral infections can often develop for slightly different reasons.
Bacterial Causes
By far the most common cause of secondary skin infections in people with eczema is a bacteria calledStaphylococcus aureus.The bacteria commonly reside on the skin and in the nose and can easily establish an infection when introduced into broken skin.
Around 80% of people with eczema will develop a secondary “staph” infection during their lifetime, compared to only 10% of the general population.
Severe infections are possible withmethicillin-resistantStaphylococcus aureus(MRSA), a bacteria most commonly acquired in hospitals, MRSA infections are resistant to antibiotics and can lead to severe infections such asboilsandabscesses.
What to Know About Bacterial Skin Infections
Fungal Causes
Fungal skin infections are less common than bacterial ones in people with eczema. When they occur, they are most commonly associated with:
Immunosuppressant drugslike Rinvoq (upadacitinib) sometimes used in people with eczema can also promote fungal growth, particularly with long-term use.
Candida albicansAn irregular red, growing skin rash mainly in skin folds like the groin, buttocks, or between the fingers and toesIntense itchingOozing and crustingDarkening of the skinThickening of the skinTinea corporisA scaly, ring-shaped rash typically on the buttocks, trunk, arms, and legsSlightly raised, expanding ringsA clear or scaly area inside the ring,Intense itchingFissure and peeling
Candida albicansAn irregular red, growing skin rash mainly in skin folds like the groin, buttocks, or between the fingers and toesIntense itchingOozing and crustingDarkening of the skinThickening of the skin
An irregular red, growing skin rash mainly in skin folds like the groin, buttocks, or between the fingers and toes
Intense itching
Oozing and crusting
Darkening of the skin
Thickening of the skin
Tinea corporisA scaly, ring-shaped rash typically on the buttocks, trunk, arms, and legsSlightly raised, expanding ringsA clear or scaly area inside the ring,Intense itchingFissure and peeling
A scaly, ring-shaped rash typically on the buttocks, trunk, arms, and legs
Slightly raised, expanding rings
A clear or scaly area inside the ring,
Fissure and peeling
Fungal skin infections are treated withtopical antifungal drugs. Some of the more common options are nystatin, clotrimazole, ketoconazole, oxiconazole, or econazole. Only on rare occasions areoral antifungalsused.
Interestingly, symptoms of eczema often improve with antifungal treatment.
How to Treat Fungal Skin Infections
Viral Causes
Symptoms of eczema herpeticum include:
Eczema herpeticum is a potentially serious condition affecting less than 3% of people with eczema, typically infants and children.
Mild cases can be treated with oralantiviralslikeacyclovir or valacyclovirfor seven to 21 days. Severe cases may require hospitalization with intravenous acyclovir.
How to Identify a Herpes Rash
Possible Complications
One of the biggest concerns with eczema-related skin infections is the risk of disseminated disease. This is when a bacteria, fungus, or virus enters the bloodstream and affects other organ systems.
With untreatedStaphylococcus aureusor MRSA, dissemination can lead to potentially serious complications like:
With sepsis, a person may experience severe inflammation of the heart (endocarditis) or brain (encephalitis), causing permanent organ damage and even death.
Disseminated fungal infections are less common and are mainly confined to people who are severelyimmunocompromised, like organ transplant recipients or people with untreatedadvanced HIV.
Eczema herpeticum, on the other hand, is a condition that can easily disseminate if left untreated. This can lead to encephalitis, secondary bacterial sepsis, andmeningitis(inflammation of the protective tissues surrounding the brain and spinal cord).
How to Prevent Secondary Skin Infections With Eczema
Not every secondary skin infection can be prevented if you have eczema, but there are plenty of things you can do to reduce the risk.
Here are some tips that can help:
How Eczema Is Treated
Summary
Secondary skin infections frequently affect people with eczema (atopic dermatitis). They are most commonly associated with bacteria likeStaphylococcus aureusand MRSA, both of which are treated with antibiotics.
Severe secondary skin infections can lead to complications like cellulitis, encephalitis, meningitis, endocarditis, and sepsis if left untreated
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wang V, Boguniewicz J, Boguniewicz M, Ong PY.The infectious complications of atopic dermatitis.Ann Allergy Asthma Immunol. 2021 Jan;126(1):3–12. doi:10.1016/j.anai.2020.08.002National Eczema Society.Skin infections and eczema.Thomsen SF.Atopic dermatitis: natural history, diagnosis, and treatment.ISRN Allergy. 2014;2014:354250. doi:10.1155/2014/354250Avena-Woods C.Overview of atopic dermatitis.Am J Manag Care. 2017;23(8 Suppl): S115-S123.Kim BE, Leung DYM.Significance of skin barrier dysfunction in atopic dermatitis.Allergy Asthma Immunol Res. 2018;10(3):207-15. doi:10.4168/aair.2018.10.3.207Alexander H, Paller AS, Traidi-Hoffmann C, et al.The role of bacterial skin infections in atopic dermatitis: expert statement and review from the International Eczema Council Skin Infection Group.Br J Dermatol.2020 Jun;182(6):1331–1342. doi:10.1111/bjd.18643National Eczema Foundation.Staph & eczema: a skin-duo you need to know about.Taufort EH, Jemec GBE, Hay RJ, Saunte DML.Cutaneous candidiasis - an evidence-based review of topical and systemic treatments to inform clinical practice.J Eur Acad Dermatol Venereol. 2019 Oct;33(10):1863-1873. doi:10.1111/jdv.15782Fleischmann R, Mysler E, Bessette L, et al.Long-term safety and efficacy of upadacitinib or adalimumab in patients with rheumatoid arthritis: results through 3 years from the SELECT-COMPARE study.RMD Open.2022;8(1):e002012. doi:10.1136/rmdopen-2021-002012Turner SA, Butler G.The Candida pathogenic species complex.Cold Spring Harb Perspect Med. 2014;4(9):a019778. doi:10.1101/cshperspect.a019778Centers for Disease Control and Prevention.About ringworm.Kalra MG, Higgins KE, Kinney BS.Intertrigo and secondary skin infections.Am Fam Physician.2014 Apr 1;89(7):569-73.Choi Y, Park KHY, Han HS, Lee MK, Seo SJ.Comparative analysis of cutaneous fungi in atopic dermatitis patients and healthy individuals.Ann Dermatol.2022 Apr;34(2):118–124. doi:10.5021/ad.2022.34.2.118American Academy of Dermatology Association.Herpes simplex: overview.National Eczema Association.Eczema herpeticum.Riley MMS.Invasive fungal infections among immunocompromised patients in critical care settings: infection prevention risk mitigation.Crit Care Nurs Clin North Am. 2021 Dec;33(4):395-405. doi:10.1016/j.cnc.2021.07.002Olabi B, Williams HC.Evidence-based management of eczema: five things that should be done more and five things that should be dropped.Curr Opin Allergy Clin Immunol. 2021 Aug 1;21(4):386-393. doi:10.1097/ACI.0000000000000750Additional ReadingAAAAI/ACAAI JTF Atopic Dermatitis Guideline Panel, Chu DK, Schneider L, et al.Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations.Ann Allergy Asthma Immunol. 2024;132(3):274-312. doi:10.1016/j.anai.2023.11.009
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wang V, Boguniewicz J, Boguniewicz M, Ong PY.The infectious complications of atopic dermatitis.Ann Allergy Asthma Immunol. 2021 Jan;126(1):3–12. doi:10.1016/j.anai.2020.08.002National Eczema Society.Skin infections and eczema.Thomsen SF.Atopic dermatitis: natural history, diagnosis, and treatment.ISRN Allergy. 2014;2014:354250. doi:10.1155/2014/354250Avena-Woods C.Overview of atopic dermatitis.Am J Manag Care. 2017;23(8 Suppl): S115-S123.Kim BE, Leung DYM.Significance of skin barrier dysfunction in atopic dermatitis.Allergy Asthma Immunol Res. 2018;10(3):207-15. doi:10.4168/aair.2018.10.3.207Alexander H, Paller AS, Traidi-Hoffmann C, et al.The role of bacterial skin infections in atopic dermatitis: expert statement and review from the International Eczema Council Skin Infection Group.Br J Dermatol.2020 Jun;182(6):1331–1342. doi:10.1111/bjd.18643National Eczema Foundation.Staph & eczema: a skin-duo you need to know about.Taufort EH, Jemec GBE, Hay RJ, Saunte DML.Cutaneous candidiasis - an evidence-based review of topical and systemic treatments to inform clinical practice.J Eur Acad Dermatol Venereol. 2019 Oct;33(10):1863-1873. doi:10.1111/jdv.15782Fleischmann R, Mysler E, Bessette L, et al.Long-term safety and efficacy of upadacitinib or adalimumab in patients with rheumatoid arthritis: results through 3 years from the SELECT-COMPARE study.RMD Open.2022;8(1):e002012. doi:10.1136/rmdopen-2021-002012Turner SA, Butler G.The Candida pathogenic species complex.Cold Spring Harb Perspect Med. 2014;4(9):a019778. doi:10.1101/cshperspect.a019778Centers for Disease Control and Prevention.About ringworm.Kalra MG, Higgins KE, Kinney BS.Intertrigo and secondary skin infections.Am Fam Physician.2014 Apr 1;89(7):569-73.Choi Y, Park KHY, Han HS, Lee MK, Seo SJ.Comparative analysis of cutaneous fungi in atopic dermatitis patients and healthy individuals.Ann Dermatol.2022 Apr;34(2):118–124. doi:10.5021/ad.2022.34.2.118American Academy of Dermatology Association.Herpes simplex: overview.National Eczema Association.Eczema herpeticum.Riley MMS.Invasive fungal infections among immunocompromised patients in critical care settings: infection prevention risk mitigation.Crit Care Nurs Clin North Am. 2021 Dec;33(4):395-405. doi:10.1016/j.cnc.2021.07.002Olabi B, Williams HC.Evidence-based management of eczema: five things that should be done more and five things that should be dropped.Curr Opin Allergy Clin Immunol. 2021 Aug 1;21(4):386-393. doi:10.1097/ACI.0000000000000750Additional ReadingAAAAI/ACAAI JTF Atopic Dermatitis Guideline Panel, Chu DK, Schneider L, et al.Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations.Ann Allergy Asthma Immunol. 2024;132(3):274-312. doi:10.1016/j.anai.2023.11.009
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Wang V, Boguniewicz J, Boguniewicz M, Ong PY.The infectious complications of atopic dermatitis.Ann Allergy Asthma Immunol. 2021 Jan;126(1):3–12. doi:10.1016/j.anai.2020.08.002National Eczema Society.Skin infections and eczema.Thomsen SF.Atopic dermatitis: natural history, diagnosis, and treatment.ISRN Allergy. 2014;2014:354250. doi:10.1155/2014/354250Avena-Woods C.Overview of atopic dermatitis.Am J Manag Care. 2017;23(8 Suppl): S115-S123.Kim BE, Leung DYM.Significance of skin barrier dysfunction in atopic dermatitis.Allergy Asthma Immunol Res. 2018;10(3):207-15. doi:10.4168/aair.2018.10.3.207Alexander H, Paller AS, Traidi-Hoffmann C, et al.The role of bacterial skin infections in atopic dermatitis: expert statement and review from the International Eczema Council Skin Infection Group.Br J Dermatol.2020 Jun;182(6):1331–1342. doi:10.1111/bjd.18643National Eczema Foundation.Staph & eczema: a skin-duo you need to know about.Taufort EH, Jemec GBE, Hay RJ, Saunte DML.Cutaneous candidiasis - an evidence-based review of topical and systemic treatments to inform clinical practice.J Eur Acad Dermatol Venereol. 2019 Oct;33(10):1863-1873. doi:10.1111/jdv.15782Fleischmann R, Mysler E, Bessette L, et al.Long-term safety and efficacy of upadacitinib or adalimumab in patients with rheumatoid arthritis: results through 3 years from the SELECT-COMPARE study.RMD Open.2022;8(1):e002012. doi:10.1136/rmdopen-2021-002012Turner SA, Butler G.The Candida pathogenic species complex.Cold Spring Harb Perspect Med. 2014;4(9):a019778. doi:10.1101/cshperspect.a019778Centers for Disease Control and Prevention.About ringworm.Kalra MG, Higgins KE, Kinney BS.Intertrigo and secondary skin infections.Am Fam Physician.2014 Apr 1;89(7):569-73.Choi Y, Park KHY, Han HS, Lee MK, Seo SJ.Comparative analysis of cutaneous fungi in atopic dermatitis patients and healthy individuals.Ann Dermatol.2022 Apr;34(2):118–124. doi:10.5021/ad.2022.34.2.118American Academy of Dermatology Association.Herpes simplex: overview.National Eczema Association.Eczema herpeticum.Riley MMS.Invasive fungal infections among immunocompromised patients in critical care settings: infection prevention risk mitigation.Crit Care Nurs Clin North Am. 2021 Dec;33(4):395-405. doi:10.1016/j.cnc.2021.07.002Olabi B, Williams HC.Evidence-based management of eczema: five things that should be done more and five things that should be dropped.Curr Opin Allergy Clin Immunol. 2021 Aug 1;21(4):386-393. doi:10.1097/ACI.0000000000000750
Wang V, Boguniewicz J, Boguniewicz M, Ong PY.The infectious complications of atopic dermatitis.Ann Allergy Asthma Immunol. 2021 Jan;126(1):3–12. doi:10.1016/j.anai.2020.08.002
National Eczema Society.Skin infections and eczema.
Thomsen SF.Atopic dermatitis: natural history, diagnosis, and treatment.ISRN Allergy. 2014;2014:354250. doi:10.1155/2014/354250
Avena-Woods C.Overview of atopic dermatitis.Am J Manag Care. 2017;23(8 Suppl): S115-S123.
Kim BE, Leung DYM.Significance of skin barrier dysfunction in atopic dermatitis.Allergy Asthma Immunol Res. 2018;10(3):207-15. doi:10.4168/aair.2018.10.3.207
Alexander H, Paller AS, Traidi-Hoffmann C, et al.The role of bacterial skin infections in atopic dermatitis: expert statement and review from the International Eczema Council Skin Infection Group.Br J Dermatol.2020 Jun;182(6):1331–1342. doi:10.1111/bjd.18643
National Eczema Foundation.Staph & eczema: a skin-duo you need to know about.
Taufort EH, Jemec GBE, Hay RJ, Saunte DML.Cutaneous candidiasis - an evidence-based review of topical and systemic treatments to inform clinical practice.J Eur Acad Dermatol Venereol. 2019 Oct;33(10):1863-1873. doi:10.1111/jdv.15782
Fleischmann R, Mysler E, Bessette L, et al.Long-term safety and efficacy of upadacitinib or adalimumab in patients with rheumatoid arthritis: results through 3 years from the SELECT-COMPARE study.RMD Open.2022;8(1):e002012. doi:10.1136/rmdopen-2021-002012
Turner SA, Butler G.The Candida pathogenic species complex.Cold Spring Harb Perspect Med. 2014;4(9):a019778. doi:10.1101/cshperspect.a019778
Centers for Disease Control and Prevention.About ringworm.
Kalra MG, Higgins KE, Kinney BS.Intertrigo and secondary skin infections.Am Fam Physician.2014 Apr 1;89(7):569-73.
Choi Y, Park KHY, Han HS, Lee MK, Seo SJ.Comparative analysis of cutaneous fungi in atopic dermatitis patients and healthy individuals.Ann Dermatol.2022 Apr;34(2):118–124. doi:10.5021/ad.2022.34.2.118
American Academy of Dermatology Association.Herpes simplex: overview.
National Eczema Association.Eczema herpeticum.
Riley MMS.Invasive fungal infections among immunocompromised patients in critical care settings: infection prevention risk mitigation.Crit Care Nurs Clin North Am. 2021 Dec;33(4):395-405. doi:10.1016/j.cnc.2021.07.002
Olabi B, Williams HC.Evidence-based management of eczema: five things that should be done more and five things that should be dropped.Curr Opin Allergy Clin Immunol. 2021 Aug 1;21(4):386-393. doi:10.1097/ACI.0000000000000750
AAAAI/ACAAI JTF Atopic Dermatitis Guideline Panel, Chu DK, Schneider L, et al.Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations.Ann Allergy Asthma Immunol. 2024;132(3):274-312. doi:10.1016/j.anai.2023.11.009
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