Eczema and Bacterial Infections

Medically Reviewed by Stephanie S. Gardner, MD on March 06, 2024
Written by Evan Starkman
6 min read

Think of your skin as a barrier. It’s typical for about 1,000 species of bacteria to live on it. Healthy skin keeps bacteria and other germs from getting inside your body.

If you or your child has eczema, though, there’s a higher chance that bacteria can get through the barrier and bring on an infection.

There are a couple of reasons for this. For one, the top layer of skin (called the epidermis) often gets damaged when you have eczema. You may have cracks or scratch marks. Plus, gaps between skin cells can open up below the surface, because your skin is less able to hold onto water.

Your skin is also more likely to have a type of bacteria called staph (Staphylococcus aureus) on it, compared to someone without eczema.

If you think you might have a bacterial infection, it’s important to see your dermatologist. Fast treatment can get rid of an infection and keep it from getting worse -- even if it’s a type of bug that’s resistant to some antibiotics.

Eczema is a skin condition that can bring on symptoms like:

Eczema isn’t caused by bacteria. The exact reason why people get this skin condition isn’t clear. Experts think a combination of your genes and triggers in your environment (like certain irritants, allergens, and stress) play a role.

People with eczema often have an immune system that overreacts to a trigger inside or outside the body. The immune system then makes too much inflammation in the skin, which is what causes the symptoms.

Your chances of having eczema go up if other people in your family have dermatitis (skin irritation). You’re also more likely to have eczema if you or family members have asthma, hay fever, or allergies.

Plus, researchers have found that some people with eczema have a mutation in the gene that makes filaggrin. That’s a protein that helps maintain the barrier on the top layer of your skin. Having less filaggrin can allow moisture to escape and bacteria to get in.

It’s common to get staph infections like these if you have eczema:

Boils. These are also called furuncles. They’re infections that start in your hair follicles. At first they usually look like reddish or purplish bumps, and they feel tender. The bumps get bigger and more painful as they fill with pus.

You can get boils anywhere on your skin, but they usually show up on body parts like the:

  • Face
  • Back of the neck
  • Armpits
  • Thighs
  • Buttocks

You can take these steps to treat a small boil at home:

  • Soak a clean washcloth in hot water. Make sure it’s not too hot, especially if you’re treating a child’s boil.
  • Once the cloth feels warm, gently hold it on the boil for 10 to 15 minutes.
  • Do that 3 to 4 times a day until the boil drains and heals.
  • Never squeeze or pierce a boil on your own, because that could spread the infection.
  • If your boil hurts, take ibuprofen or acetaminophen to ease the pain. Follow the directions on the bottle to choose the right dose.
  • Keep the area around the boil clean, and don’t touch or rub it.
  • If your boil bursts, place a sterile bandage or gauze over it while it heals.

If your boil is large or very painful, call your doctor. They may need to drain it for you or prescribe antibiotics to heal an infection that’s severe or keeps coming back.

Impetigo. This highly contagious infection can happen in eczema-affected skin that’s already open and “weepy,” meaning it’s oozing clear or straw-colored fluid. Impetigo can bring on honey-colored crusts that show up on the open areas of your skin, and the crusts can become painful and red.

Staph isn’t the only bacteria that can cause this infection. Strep (also called group A streptococcus) can bring on impetigo, too.

Your dermatologist can usually cure impetigo with an antibiotic that you put on your skin, like mupirocin or retapamulin.

Good skin care also helps clear up impetigo. Take these steps at home:

  • Soak your affected skin in warm water and soap. This is a gentle way to remove dirt and crusts.
  • Apply the medicine your dermatologist prescribed.
  • Cover the affected skin to help it heal and to avoid spreading the infection to someone else.

Cellulitis. This deep skin infection tends to be very painful and hurts to touch. It makes skin look red and swollen, and it could feel warm or hot if you touch it.

You can get cellulitis in any body part, but adults usually get it on their leg or foot. Children usually get it on their face or neck.

Severe cellulitis can bring on symptoms like:

The sooner you get treated, the better. Treatment can keep cellulitis from getting worse, and it could lower your chances of having a dangerous medical problem, like blood poisoning and severe pain.

Your doctor may prescribe one or more antibiotics that you take by mouth. Follow their instructions on how to take the medicine, and don’t stop taking it early.

Some people with a severe case of cellulitis, or cellulitis on the face, need to receive antibiotics through an IV. They usually stay in the hospital for a little over a week while they get treatment.

While you’re treating cellulitis, it’s also important to:

  • Cover affected skin to help it heal. If your doctor tells you to use special coverings or dressings, ask them to show you how to put them on and change them.
  • Get rest. This can help you heal and keep your cellulitis from getting worse.
  • Elevate your leg if cellulitis affects it. This eases swelling.
  • Keep following your eczema treatment plan while you recover from cellulitis.

 

If you think your child with eczema may have a bacterial skin infection, call the dermatologist. Tell them what your little one’s symptoms are. If your child is also running a fever, get medical help right away.

If you’ve been using techniques like wet-wrap therapy, occlusion (covering eczema with plastic), or “soak and smear” to help treat your child’s eczema, stop if the area looks infected. These techniques can make an infection worse, so don’t start using them again until the dermatologist tells you it’s OK.

Practice good habits like these:

Bathe as often as your dermatologist recommends. It helps remove bacteria from your skin and helps your skin heal.

Moisturize often. This quenches dry skin and makes it less likely to crack, which gives bacteria fewer ways to get in. Wash your hands well with soap and water before and after you moisturize.

Help your child moisturize safely. If your little one has eczema and you help them moisturize, don’t dip your fingers into their moisturizer. It could spread bacteria from their skin to the product, and you’ll need to throw it away if they get a skin infection. Instead, use moisturizer that comes in a bottle with a pump, or scoop out the moisturizer with a spoon instead of your fingers.

Ask your dermatologist about bleach baths. These might help if you or your child with eczema gets bacterial infections often. Ask the dermatologist exactly how much bleach to use in the bathwater.

If preventive steps like these aren’t helping, be sure to let the dermatologist know.