Eczema vaccinatum is a rare complication that can occur in people with eczema who have recently received the smallpox vaccination or had skin-to-skin contact with someone who has received the vaccine.

The live virus in the smallpox vaccine may trigger symptoms such as a fever in people with eczema and can cause serious infections.

The COVID-19 vaccines do not contain any of the live SARS-CoV-2 virus, so they do not cause eczema vaccinatum.

Some researchers have recorded cases of easily controlled eczema flare-ups in people who have received a COVID-19 vaccine, but they have not found the symptoms to be severe or dangerous.

This article discusses what eczema is, whether COVID-19 vaccines can cause it, and how to treat the condition.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on the COVID-19 pandemic.

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Eczema is a common condition that affects more than 31 million people in the United States. There are different types of the inflammatory skin condition. It can affect newborn babies or develop at any time in a person’s life.

People with eczema typically experience flare-ups, which are phases during which their symptoms worsen. These may last between days and weeks.

The symptoms of eczema may vary among individuals, and they can appear differently in different age groups. However, they almost always include itchy skin. Other symptoms typically include:

Someone with eczema can have all or a few of these symptoms, depending on the type of eczema. In people with dark skin, the affected areas may be purple, gray, or dark brown. In those with light skin, the discolored areas typically appear red.

Learn more about eczema on skin of color.

In general, researchers have found that a small number of people with eczema may experience a flare-up of symptoms after they receive each dose of a COVID-19 vaccine.

Most of the vaccines do not appear likely to cause eczema in people who do not have the condition. However, more research is necessary to confirm this, as studies have produced different findings.

The authors of a 2021 review suggest that people with atopic dermatitis, the most common type of eczema, should follow the same recommendations for COVID-19 vaccinations as for all other non-live vaccines. However, they also note that further research into the adverse effects of the COVID-19 vaccine on people with atopic dermatitis is necessary.

A 2022 case study notes that several people have reported dermatological side effects following their first injection of another type of COVID-19 vaccine — the Sputnik V vaccine. This vaccine employs the same mechanism of action as the Oxford-AstraZeneca vaccine.

The researchers report on the case of a 40-year-old woman with no history of eczema who experienced eczema lesions on her face, upper limbs, and chest after receiving her first dose of the Sputnik V vaccine. They also note that she experienced mild myalgia and a low grade fever.

A 2022 study with 480 participants found that 2.7% of people who were receiving treatment with dupilumab experienced exacerbated eczema symptoms after the COVID-19 vaccine.

Dupilumab is a medication that doctors may prescribe for the treatment of moderate to severe atopic dermatitis.

The study suggested that any of the COVID-19 vaccines may worsen eczema symptoms in a small percentage of people who are taking dupilumab. The flare-ups responded well to treatment with topical medications. The researchers do not know exactly how the vaccine and rashes are related.

A 2021 case study focused on two people who had a personal or family history of eczema and both reported generalized eczema symptoms after they received their COVID-19 vaccines. Neither person developed serious adverse symptoms after their second vaccine dose, and their eczema symptoms responded well to treatment.

The authors note that they do not know what the relationship is between the vaccines and eczema symptoms. They suggest that the vaccine may act as an environmental trigger in people who are genetically susceptible.

Overall, researchers consider the COVID-19 vaccines to be safe and well-tolerated. Large studies conclude that a very small percentage of people may experience a flare-up of eczema symptoms after a vaccine, but these symptoms are easily treatable and not likely to be severe.

Eczema should not prevent a person from receiving a safe and effective COVID-19 vaccine.

If a person experiences a flare-up of eczema symptoms following a vaccination, they should contact a doctor who can recommend or prescribe an appropriate treatment. A dermatologist or doctor may treat eczema with a combination of treatments.

Medications

Medications for eczema include prescription and over-the-counter (OTC) options, depending on the severity of the condition. They include:

  • Corticosteroids: A doctor may prescribe corticosteroid cream or ointment to help reduce skin inflammation.
  • Biologic medications: A doctor may inject a biologic medication, which blocks some functions of the immune system, to control eczema symptoms.
  • Janus kinase (JAK) inhibitors: A doctor may prescribe these for severe eczema. JAK inhibitors send messages to certain cells to prevent them from causing inflammation.
  • Calcineurin inhibitors: A person may apply these to the skin to prevent eczema flare-ups and reduce inflammation.
  • Phosphodiesterase-4 inhibitors: These may reduce inflammation.

Skin care

People with eczema should moisturize soon after bathing to keep the skin hydrated and prevent it from drying out.

A doctor may also recommend taking a diluted bleach bath twice weekly to help prevent skin infections. However, people should not attempt this without following a healthcare professional’s instructions.

Phototherapy

A dermatologist or doctor may recommend trying UV light therapy for eczema.

People with eczema may be at risk of complications when they receive vaccines that carry live viruses, such as the smallpox vaccine. These complications include eczema vaccinatum. However, COVID-19 vaccines are unlikely to cause severe skin reactions.

Large studies suggest that a small percentage of people with eczema may experience flare-ups following a COVID-19 vaccine. However, the symptoms often respond well to treatment, so this should not discourage people from getting the vaccination.

If someone does experience a flare-up of eczema symptoms following a vaccine, they should contact a doctor to receive treatment.