A rare and sometimes serious condition, eczema herpeticum causes symptoms that can lead to a medical emergency.
This article gives an overview of both eczema and herpes. It goes on to explore the causes, symptoms, and treatments for eczema herpeticum, the infection that happens when these two conditions meet.
What is eczema herpeticum?
Eczema herpeticum may lead to serious complications so it should be treated immediately by a healthcare professional.
Herpes does not cause serious health problems for someone with a healthy immune system. However, if an individual with eczema catches HSV-1 or HSV-2, they may develop eczema herpeticum.
Eczema herpeticum is a rare but serious complication, which can happen when skin that is affected by eczema comes into contact with the herpes virus. It is most often caused by contact with a cold sore (HSV-1) and usually occurs on the:
Symptoms of eczema herpeticum do not appear immediately after exposure to a cold sore or genital herpes. Usually, they show up 5 to 12 days afterward and may include:
- A rash that causes blisters: The blisters appear in a cluster and may cover a large area. They may break open and be itchy or painful, weep, bleed, or have pus or yellow fluid inside.
- Feeling unwell, swollen lymph nodes, fever, chills, and fatigue: These symptoms usually start as the rash appears.
Eczema herpeticum is a medical emergency because it can lead to serious complications. It can be fatal in rare cases. Complications may include:
- Long-term scarring from the blisters.
- A herpes infection in the cornea of the eye known as herpetic keratitis. If untreated, herpetic keratitis can lead to blindness.
- Organ failure and death if the virus spreads to the brain, lungs, and liver.
Eczema herpeticum can occur in people with any condition involving damaged skin, such as:
- contact dermatitis
- seborrheic dermatitis
It is most common in young children and infants. However, anyone with a less developed immune system may be more vulnerable to this infection.
What is eczema?
Eczema may come and go, dependent on aggravations, and certain triggers.
Eczema is a rash that causes dry, irritated, red, and itchy patches of skin. In most cases, eczema refers to atopic dermatitis, which is an allergic reaction that affects the skin.
Eczema may go through periods of healing, known as remission, where there are virtually no symptoms.
At other times, however, eczema may become aggravated, and thesymptoms worsen. This is known as a flare.
People with eczema are often advised to avoid triggers, or things that cause eczema flares. Triggers are different for each person and may include:
- certain detergents
- certain foods
- other irritants or allergens
In general, eczema can be bothersome but does not cause serious complications.
Most eczema flares heal without long-term problems. However, a common virus, the herpes simplex virus, can be serious and even fatal for people with eczema.
What is herpes simplex virus?
Herpes simplex viruses are commonly called "herpes." They spread from person to person and can cause painful or itchy blisters or open sores.
When sores or blisters appear, it is called a herpes outbreak. Many people have herpes but do not have outbreaks, so they are unaware that they have the virus.
The two most common types of herpes are:
- Herpes simplex virus type 1 (HSV-1): HSV-1 commonly causes cold sores, known as oral herpes. HSV-1 is very contagious, and many people get HSV-1 through non-sexual contact, such as kissing or sharing personal items like lip balm or utensils. An estimated 67 percent of people under age 50 have HSV-1, globally, according to the World Health Organisation. HSV-1 can spread through sexual contact from the mouth to the genitals, but it is not necessarily a sexually transmitted infection.
- Herpes simplex virus type 2 (HSV-2): HSV-2 spreads through sexual contact with an infected person. It can cause blisters on the genital area, known as genital herpes. It may also be spread to a baby during childbirth if the mother is infected.
HSV-1 and HSV-2 infections have no cure. Once a person is infected, the virus stays in their body for life.
A person with herpes is more likely to spread it to others when blisters are present. However, herpes can spread to another person, even when there are no symptoms.
Antiviral medicines reduce the number and severity of herpes outbreaks. But they cannot cure herpes or prevent it spreading from person to person.
Treatment and prevention
Eczema herpeticum is treated with antiviral medication, and it can lead to hospitalization. Bacteria do not cause eczema herpeticum, so it is not treated with antibiotics.
An ophthalmologist may need to examine suspected infections in the cornea of the eye. Early treatment is necessary to avoid serious health problems and to stop it spreading to vital organs.
The best way to prevent eczema herpeticum is to keep eczema symptoms under good control and to take measures to avoid catching HSV-1 or HSV-2.
The following tips may help:
Antiviral medication is used to treat eczema herpeticum.
Image credit: Sage Ross, 2014
- Know eczema triggers: Avoid them whenever possible.
- Moisturize skin after bathing and throughout the day, as needed: Avoid scratching the skin, as this may cause cracks or breaks that leave it vulnerable to infections.
- Use eczema medications as prescribed by a doctor: These may be oral as well as creams for the skin.
- Keep track of eczema symptoms: Always see a doctor if they worsen.
- Avoid catching a cold sore: Do not kiss people with active cold sores or share drinks, utensils, or personal items with them.
- Protect affected skin: Wash hands frequently and avoid touching areas affected by eczema, whenever possible.
- Avoid sexual contact with those who have genital herpes: Ask sexual partners if they have been tested for sexually transmitted diseases, including herpes.
- Use a latex condom during sex: This acts as a barrier against sexually transmitted infections, including herpes.
See a doctor right away if a blistery rash appears on the skin, especially if other symptoms such as fever are present. Parents of infants and young children should keep the child's eczema symptoms under control and see a doctor immediately if blisters appear.
Managing eczema is not only important for comfort, but also for preventing a serious skin infection. Keeping the skin healthy and unbroken helps the body keep out unwanted viruses and bacteria that can cause illness.