Infected Eczema in Children — Impetigo, Eczema Herpeticum and Red Flags

How to recognise infection early — and when to seek urgent medical care.

Children with eczema have a weaker skin barrier, and scratching can create tiny breaks that allow bacteria or viruses to enter. This can turn a regular flare into infected eczema, which often worsens quickly and needs prompt treatment.

This page explains:

• the common signs of bacterial infection (impetigo)
• the important (but less common) viral infections to watch for
• what you can do at home, and
• when to seek urgent help.

Infection prevention matters: see the daily routine, triggers, medications, wet wraps, and eczema baths.

Why infection is more common in eczema

Eczema skin is “leaky” and inflamed. Scratching damages the barrier further, making it easier for:

• bacteria (especially Staphylococcus aureus) to overgrow
• viruses (like herpes simplex) to enter through broken skin
• and sometimes yeast to contribute to inflammation. ^(1–3)

This is why infection control and barrier repair go together.

Bacterial infection: impetigo / infected eczema

What it can look like

Bacterial infection often causes:

• weeping or ooze
• yellow or “honey-coloured” crusts
• pimples/pustules or small pus bumps
• increased redness and swelling
• skin becoming more tender than usual
• flare worsening suddenly rather than gradually ^(1–3)

What to do

If it looks mild and localised:

• keep the area clean with gentle washing
• avoid picking crusts
• keep nails short
• continue moisturising around the area

If there is significant crusting, rapid spread, pain, fever, or your child seems unwell — it often needs medical review and may require prescription topical or oral antibiotics. ^(1–3)

Important: If your child’s eczema is frequently crusting or infected, prevention strategies can help — see our eczema bath recipe for children (sometimes bleach is used for infection-prone eczema). ^(1,4)

Viral infection: eczema herpeticum (urgent)

Eczema herpeticum is a serious viral infection caused by herpes simplex virus spreading into eczema-affected skin. It can become severe quickly and needs urgent medical assessment. ^(2,5)

Red flags for eczema herpeticum

Seek urgent care the same day if you see:

• clusters of painful blisters or small “punched-out” sores
• eczema suddenly becoming very painful (pain is a key clue)
• fever, lethargy, or child appears unwell
• rapidly spreading lesions
• involvement near the eyes ^(2,5)

Treatment usually requires antiviral medication promptly (e.g., aciclovir), and sometimes hospital assessment depending on severity. ^(2,5)

Molluscum and warts in eczema-prone skin

Children with eczema often get molluscum contagiosum and warts more easily because breaks in the skin barrier help viruses spread.

Molluscum bumps can trigger surrounding eczema (“molluscum dermatitis”) and lead to intense itch. ⁽⁶⁾

Warts can spread more quickly when children scratch or when skin is inflamed.

Related pages:

• Molluscum contagiosum
• Warts

What you can do at home (safe steps)

If you suspect infection:

• Do not wet wrap over oozing, crusting, or infected-looking skin unless you have a plan from your doctor. ^(1,2)
• Avoid harsh antiseptics or essential oils (they often irritate eczema)
• Keep the child cool, nails short, and reduce scratching
• Continue moisturising surrounding skin and follow your flare plan unless advised otherwise
• If you have recurrent infected flares, discuss infection prevention strategies. ^(1,4)

When to seek urgent care (use this as your checklist)

Seek urgent medical review if:

• your child has fever or seems unwell
• redness is spreading quickly or the skin is hot and painful
• there is significant pus, weeping, or crusting
• your child has painful blisters or eczema suddenly becomes very painful (possible eczema herpeticum)
• there is swelling or infection around the eyes
• your child is very young and infection is suspected
• you are worried — infection can escalate quickly in eczema ^(1–3,5)

Book an appointment

If your child has frequent infected flares, recurrent crusting, or you’re worried about what you’re seeing, we can assess the skin and build a simple written plan for:

• flare treatment
• infection prevention
• and when to escalate care.