Infected Eczema: What to do?

Dermatitis, or eczema, is typically characterised by four distinct phases. Initially, red and warm patches appear, causing intense itching. A few hours later, small blisters emerge while the itching continues. Subsequently, small yellowish crusts form and fall off within a few days. Finally, the lesions, red and smooth, are covered with small flakes. These lesions may eventually disappear or persist in a chronic form accompanied by abnormal skin dryness.

In the majority of cases, eczema does not pose a health risk. Indeed, it is a disease that can significantly impact the daily lives of those who suffer from it, whether due to itching or the appearance of their skin, but it does not represent a life-threatening danger. However, there are instances where eczema can progress to a more severe form and become infected. This can occur when wounds open due to frantic scratching. As hands are not always clean, this promotes infection. Among the most common infections, we find:

• Herpes Simplex : An infection by the herpes virus can be suspected when the redness of eczema is accompanied by small bumps. An antiviral treatment is then necessary.

• The golden staphylococcus (Staphylococcus aureus): infections caused by this microbe exacerbate the spread of eczema and make it difficult to heal. Golden staphylococcus infections are recognised by the yellow oozing and crusts they cause. An antibiotic treatment is then prescribed.

• The Candida albicans: this fungus is responsible for superinfections that can exacerbate eczema. Oral intake or topical application of antifungal agents can help to eliminate it.

An infected eczema is not to be taken lightly and can lead to numerous complications, even hospitalisation in the most severe cases. To avoid reaching this stage, it is imperative to consult a dermatologist as soon as you notice that your eczema is itching more than usual, that the red patches are multiplying (generalised eczema), that they are changing colour or starting to ooze. Depending on the type of infection (bacterial, viral, fungal...), the doctor will be able to prescribe a suitable treatment. After the end of the infection, we recommend you to follow certain actions and precautions to avoid future complications.

• Adherence to medical recommendations : It is crucial to follow the dermatologist's prescriptions, whether these involve the topical application of creams or the oral intake of medications (antibiotics, antivirals...). Indeed, dermocorticoids sometimes inspire mistrust and are often applied in too small quantities or too late. For these to be fully effective and provide relief, it is necessary to use them from the outset of an eczema flare-up, when the itching begins to be felt and redness appears.

• Daily skin hydration: individuals suffering from eczema need to hydrate their skin very frequently. Indeed, their skin tends to be constantly dry (xerosis), due to a fragile skin barrier, which easily allows the evaporation of water from the skin. Therefore, it is recommended to apply at least once a day a emollient care. This can form a protective veil on the epidermis and compensate for the dysfunction of the skin's natural barrier, by limiting water loss.

• Avoid scratching as much as possible : it's challenging, but scratching often leads to infections as it opens up eczema lesions and exposes them to bacteria carried by the hands. To alleviate the itch, you can use thermal water or certain essential oils (such as tea tree, true lavender...). These ingredients possess soothing properties and reduce sensations of itching.

• GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).

• BORRADORI L. & al. Dermatologie et infections sexuellement transmissibles. Elsevier Masson (2017).