Medicines for Eczema herpeticum

What it is

Eczema herpeticum is a potentially serious skin infection that can occur in people who have eczema (or certain other skin conditions), when the herpes simplex virus — the virus that causes cold sores — infects the eczema-affected skin. Because eczema damages the skin barrier, the virus can spread rapidly across the skin. It causes a rash of small, painful, fluid-filled or pus-filled blisters that often look "punched out" or crusted, spreading quickly over an area of eczema, along with the skin becoming very sore, and the person may feel unwell with a fever and feel generally poorly. It can affect children and adults with eczema. It is important to recognise because it can spread fast, become widespread, and occasionally cause serious complications, so it is treated as an emergency. It may follow contact with someone who has a cold sore, though not always. Prompt antiviral treatment is very effective.

How it is treated

Eczema herpeticum needs prompt medical assessment and treatment, usually urgently. The main treatment is antiviral medicine (which targets the herpes virus), started as soon as possible — often by mouth, or given into a vein in more severe or widespread cases, which may require hospital admission. Any bacterial infection on top is also treated, and the eczema itself is managed. Because the eyes can be affected, which is serious, urgent eye assessment is arranged if there is any concern about eye involvement. People with eczema are advised to be alert to the warning signs — a rapidly worsening, painful, blistering rash on eczema skin, especially with feeling unwell — and to seek prompt help. Avoiding close contact with active cold sores where possible, and good eczema control, may reduce the risk. With prompt antiviral treatment, most people recover well, but because it can become serious, early recognition is key. The essential message is that a rapidly spreading, painful, blistering rash in someone with eczema needs urgent medical attention.