Do People With Atopic Dermatitis (Eczema) Get More Skin Infections?

Question: Do People With Atopic Dermatitis (Eczema) Get More Skin Infections?
Answer: Yes, people with atopic dermatitis are more prone to infections of the skin, particularly those of the viral, bacterial and fungal kind.

In people with atopic dermatitis, the immune system is more focused on allergies than fighting infections. This means that the skin has less infection-fighting chemicals, giving various bacteria -- especially Staphylococcus aureus -- any easier shot at colonizing.

Colonization and infection by Staphylococcus aureus causes various problems in people with atopic dermatitis. This bacterium not only causes skin infections, such as impetigo, but also produces bacterial toxins to which many people with atopic dermatitis are allergic. These bacterial toxins can worsen eczema, and treatment with antibiotics can improve symptoms in people with bacterial colonization even if there is no obvious skin infection.
Fungal infections, such as tinea and yeast infections, are also more common in people with atopic dermatitis. This may be partially due to the use of topical steroids, which can suppress the immune system of the skin, but it may also be because of the lack of special infection-fighting chemicals in the skin of people with atopic dermatitis. Treatment of fungal infections can improve the symptoms of atopic dermatitis.

Viral infections are also more common in people with atopic dermatitis. These infections can be on certain areas of the skin, such as is the case with herpes infections and molluscu contagiosum, but can also involve the entire body, as they are with eczema herpeticum. People with atopic dermatitis and severe herpes infections may require oral or intravenous antiviral medications to treat these infections.

Lastly, people with atopic skin are also more susceptible to infection, because the barrier function of atopic skin is compromised. This means that the disease itself causes breaks in the skin, where infection-causing microorganisms can enter.