Do you need antibiotics for weeping eczema?

Controlling the eczema itself remains important because inflamed, scratched skin can continue to ooze even without infection and is more vulnerable to further damage.

Fluid can leak from intensely inflamed or scratched eczema. Bacterial infection becomes more concerning when there is rapidly worsening eczema, increasing pain, warmth or swelling, pus, spreading redness, yellow-golden crusting, fever or feeling unwell.

Oozing can also accompany a flare or a reaction to a skin product, so appearance alone may not identify the cause. A clinician can assess the distribution, recent exposures and systemic symptoms before deciding whether an antibiotic is useful.

Gently cleanse away visible discharge with lukewarm water, pat rather than rub, keep fingernails short and use a clean non-stick dressing if clothing catches the skin. Separate towels and wash hands after applying treatment.

Continue prescribed eczema care unless the treating clinician tells you to stop, but avoid introducing fragranced products or someone else's creams. Use a prescribed antibiotic according to its directions and seek advice if symptoms worsen or fail to start settling within the expected timeframe given by the prescriber.

Request prompt assessment for spreading redness, increasing warmth, swelling or pain, extensive crusting, pus, fever, red streaks or marked tiredness. Rapid deterioration, confusion, faintness, breathing difficulty, or skin that becomes dusky or blistered needs emergency care.

Clusters of painful small blisters, punched-out sores, eye discomfort or eczema that suddenly becomes much more painful need urgent review because a viral eczema complication may require antiviral rather than antibacterial treatment.

Ask whether the weeping looks like a flare, contact reaction, bacterial infection or viral complication; which anti-inflammatory and moisturising treatments to use; how to dress the skin; and what change should trigger reassessment.