What are the risk factors for eczema herpeticum?

The skin barrier in atopic dermatitis can be dry, cracked, inflamed, or scratched, making it easier for viruses to enter and spread across damaged areas. Close contact with someone who has an active cold sore can provide a route for herpes simplex virus transmission. Risk may be greater during a flare, particularly when many areas are raw or excoriated. Eczema herpeticum can begin with clusters of painful, similar-looking blisters or small punched-out erosions rather than the usual itchy eczema pattern.

Avoid touching or sharing towels, lip products, razors, and other items with someone who has an active cold sore. Keep eczema treatment consistent as prescribed and protect open skin from scratching. If new painful blisters, crusted sores, or rapidly spreading erosions appear on eczema-affected skin, contact a clinician urgently the same day. Antiviral treatment may be needed, and delay can allow the infection to spread.

Seek urgent medical care for rapidly worsening painful blisters, punched-out sores, fever, unusual tiredness, swollen glands, or eye symptoms such as pain, light sensitivity, or blurred vision. Do not wait for a routine eczema appointment when these features occur. A clinician may need to distinguish eczema herpeticum from an ordinary flare, bacterial infection, or another blistering condition.

Ask how to recognise infection during your eczema flares, whether household cold-sore precautions are needed, which eczema medicines to continue during a suspected infection, and where to seek care outside normal clinic hours.