Infected Dermatitis

Key points

• Honey-coloured crust, pustules, spreading redness, warmth and fever support infection more than itch or weeping alone.
• Treatment must still control the underlying dermatitis and restore the skin barrier.
• Repeated topical antibiotic use can drive resistance and should not become routine flare treatment.

An antibiotic or steroid combination listing cannot confirm infection; severity, extent, recurrence and signs of systemic illness guide treatment.

How is infection distinguished from a flare?

Dermatitis itself can be red, cracked and weeping. Increasing pain, warmth, purulent discharge, pustules, rapid extension or fever makes bacterial infection more likely. Blistering or punched-out painful erosions can indicate eczema herpeticum, which needs urgent antiviral assessment.

What treatment may be used?

Limited local infection may sometimes use fusidic acid with an appropriate anti-inflammatory such as betamethasone. Widespread or systemic infection may need oral treatment. Emollients and trigger control remain important; see skin care for class context.

When to seek urgent care

Seek same-day care for fever, rapidly spreading redness, severe pain, facial or eye involvement, red streaks, marked illness, or grouped blisters and punched-out sores. Reduced immunity warrants earlier review.

Further reading

• Eczema: Symptoms, causes, types & treatment
• Atopic eczema - NHS