How to Prevent Skin Infections When You Have Eczema

Eczema can be challenging enough without the fear of a skin infection. Maybe you’ve heard horror stories from other eczema sufferers, experienced an infection yourself, or just know that those with eczema experience higher rates of skin infection. 

But despite this, Dr. Rachel Day, MD, Lead Dermatologist at Zest, says the outlook is positive: eczema does make your skin more vulnerable to infection, but you can prevent them with proper education, precautions, and a consistent eczema management plan.  

What is an eczema infection?

Eczema itself is not an infection, but it can make you more likely to develop one. Why? 

A core characteristic of eczema is a weakened skin barrier, the outer layer of skin that is supposed to protect you from outside irritants. “The skin barrier is your first line of defense, so when it’s broken, infections have a portal of entry,” says Dr. Day. 

An infection that develops because of the underlying condition of eczema is often referred to as a secondary infection. And unfortunately, in a vicious cycle, a secondary infection can aggravate eczema and cause a flare. 

Types of skin infections

• Bacterial infections are the most common secondary infection. Specifically, staph (staphylococcus aureus) infections impact those with eczema at much higher rates than the general population. The presence of staph bacteria doesn’t always lead to infection, but even still, “staph is always pathologic,” says Dr. Day, “just the presence of it can worsen eczema.” Strep (group A streptococcus) is another common bacterial skin infection. These infections aren’t usually too serious, but you should still consult with a doctor for treatment.
• Fungal infections of the skin most often result from either candida, a yeast that flourishes in warm, moist parts of the body, like the groin or armpit, and dermophytes, which lead to ringworm. Fungi naturally exists on your body, but when you have a weakened immune system, they more easily grow out of control. Like bacterial infections, fungal infections aren’t usually dire, but again, you should consult with a doctor to ensure it’s promptly treated.
• Viral infections in those with eczema can occur in the form of eczema herpeticum, a form of the herpes virus. In most people, this would just be a cold sore, but when you have eczema, the virus more easily spreads across the skin. With this infection, seeking immediate medical attention is vital. If you suspect you have eczema herpeticum, do not wait to see a doctor.

How to prevent an eczema infection

The best way to prevent a secondary infection is by keeping your eczema well-managed, Dr. Day says, since it’s the damaged skin barrier that allows infections to fester. 

By improving the resiliency of your skin barrier, you can reduce your risk. Here are Dr. Day’s recommended strategies for keeping your skin infection-free:

1. Practice good hygiene. Wash your hands before putting any products on your skin, avoid sharing razors, towels, clothing, or anything else that could carry bacteria, and frequently disinfect the items you touch the most, like your phone and keyboard. If you use a product that requires you to dip your fingers in it to get it out, like an emollient, try using a clean spoon to avoid transferring any bacteria from your fingers into the tub.
2. Protect broken skin. If you have any cracked or damaged skin, make sure to cover open wounds with sterile bandages, use antiseptic creams for minor cuts, and avoid public pools or hot tubs.
3. Maintain a consistent skincare routine. A consistent skincare routine is key to helping your skin build resiliency. Moisturize at least twice a day (and always after getting out of the shower) with a fragrance-free moisturizer, use liquid over bar soap since it hasn’t touched anything else (apply with your hands, though, not a loofah or washcloth), and turn down the heat of your showers (excessive heat can sap your skin of moisture, leaving it dry and vulnerable).
4. Avoid scratching. This can be difficult if you have itchy eczema rashes, but scratching can damage the skin barrier even more. Try to keep your nails short (to minimize damage when you do scratch), wear comfortable gloves at night to prevent unconscious scratching, and use anti-itch creams or oral antihistamines to relieve itchiness, as advised by your dermatologist.
5. Be proactive in treating eczema flares. Be sure to follow your dermatologist’s treatment plan as well as avoid any triggers you can, like stress, allergens, or alcohol, for example. If your treatment plan doesn’t feel feasible and you’re not able to consistently adhere to it, talk to your provider about making an approach that better fits your lifestyle.
6. Support your immune system. Your skin barrier is a function of your immune system, so boosting it can only benefit your skin health—not to mention your overall health. Eat a balanced diet rich in vitamins, minerals, and antioxidants, get enough sleep, manage stress through relaxation techniques or therapy, and stay hydrated.
7. Try a bleach bath. Add a quarter cup of bleach to a full bath. This amount is diluted enough that it won’t cause harm if it gets in your eyes or mouth. Bleach baths are especially recommended for those who are getting recurrent infections—particularly staph. “Diluted bleach is an antiseptic on the skin and has been shown to help reduce the burden of staph on the skin,” Dr. Day says.
8. Use another sodium hypochlorite product. Sodium hypochlorite is the main ingredient in bleach, but it can also be found in some skincare products like serums, sprays, and soaps, at a diluted level. Dr. Day recommends the brand Cln for a variety of sodium hypochlorite products.

Ready for help managing your eczema and keeping infections away? Book a free discovery call to learn how Zest can help with next-day appointments and 24/7 messaging support.

What are the signs and symptoms of an eczema infection?

Secondary infections related to eczema are preventable, but you should still know the signs. 

The sooner you can recognize and treat infections, the less havoc they can wreak on your skin. In the case of any infection, make sure to stay vigilant to signs of worsening, especially spreading redness or fever. These are signs you should seek immediate medical attention. 

Bacterial skin infection signs and symptoms 

• Increased redness, warmth, or swelling around eczema patches
• Sores or lesions
• Yellow or golden crusting on the skin
• Oozing or weeping sores
• Tenderness or pain
• Fever or chills (in severe cases)

Fungal skin infection signs and symptoms

• Irritation 
• Red, scaly, or itchy patches
• Well-defined borders between infected and unaffected skin
• Blisters or small bumps
• Itching

Viral skin infection signs and symptoms

• Clusters of painful blisters filled with clear or yellow fluid
• Rapidly spreading lesions
• Itching or tingling
• Fever, fatigue, or general malaise
• Swollen lymph nodes

From eczema flares to infections, we’re here to help every step of the way. Reach out today for personalized care and 24/7 support, from wherever you need it.