What causes eczema herpeticum?

When the skin barrier is disrupted by atopic dermatitis or another active eczema flare, herpes simplex virus can spread over the affected surface more readily than it would on intact skin. The infection may produce many similar-looking, painful, fluid-filled or crusted spots that can appear close together.

People may also feel unwell, with fever, tiredness, or tender lymph nodes. This is different from an ordinary eczema flare because the change can progress quickly and may involve the face or areas near the eyes.

Contact a clinician urgently if a rapidly spreading cluster of painful blisters or punched-out crusts develops on eczematous skin, especially with fever or feeling unwell. Avoid picking, sharing towels, or close skin contact with others until assessed, and wash hands after touching the area.

Do not rely on moisturiser or self-treatment alone. A clinician may examine the lesions and arrange prompt antiviral treatment when eczema herpeticum is suspected. Continue prescribed eczema care unless a clinician tells you to change it.

Seek same-day medical advice for rapidly spreading painful blisters, erosions, or crusts on eczema-affected skin. Go to urgent care immediately if the eye or eyelid is involved, vision changes, severe headache develops, or you feel markedly unwell. Early assessment is especially important for infants and people with reduced immunity.

Could this be eczema herpeticum rather than an eczema flare? Do I need antiviral treatment or testing? Which eczema medicines should I continue, and how can I reduce contact spread while the skin heals?