Eczema Herpeticum
HSV test

Eczema herpeticum (EH) is a painful blistering rash that is caused by the herpes simplex virus. It is more common in young children, and particularly in individuals who have atopic dermatitis. Because people with atopic dermatitis have dry and sensitive skin, they are at a greater risk for developing EH. However, it can still occur in people with any condition involving damaged skin.

Symptoms and Causes

HSV test

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 often caused by contact with a cold sore (HSV-1) or HSV-2 and usually occurs in the head, neck, and trunk.

The symptoms of EH do not immediately appear after exposure to a cold sore or genital herpes. They usually become visible 5 to 12 days after and these symptoms include:

  • Red, itchy rashes in the face and neck area
  • Clusters of small and painful fluid-filled blisters that can appear red, purplish, or black
  • High fever
  • Chills
  • Swollen lymph glands
  • General unwell feeling

Important Note: Eczema herpeticum is a medical emergency because it can lead to serious complications, and can be fatal in rare cases. Complications include long-term scarring from the blisters, a herpes infection the cornea of the eye called herpetic keratitis (which if not treated can lead to blindness), and organ failure.

What is herpes simplex virus?

eczema herpeticum

HSV or commonly called “herpes” spread from person to person and can cause painful blisters and open sores. The two most common types are HSV-1 and HSV-2. HSV-1 can spread through sexual contact from the mouth to the genitals, but is not necessarily a sexually transmitted infection. It is passed on normally through non-sexual contact such as kissing or sharing of personal items. HSV-2 on the other hand, is spread through sexual contact and cause blisters on the genital area, and can be spread to a baby during childbirth of the mother is infected.

Diagnosis and Treatment

Doctors can likely diagnose EH by is appearance, but they still may want to confirm their diagnosis with other tests because EH can resemble some bacterial infections like impetigo. An EH diagnosis can be confirmed by taking a smear of a blister to check for the virus. Some severe cases of EH may even require hospitalization. As for the treatment, once the diagnosis is confirmed, doctors will immediately prescribe antiviral medication. Because if left untreated, or not treated soon enough, it can lead to blindness especially if the lesions are near the eyes.


The best way to prevent EH is to keep eczema symptoms under control. The following tips may help:

  • Know your triggers and avoid them whenever possible
  • Moisturize skin after bathing and throughout the day as needed
  • Use eczema medications prescribed by a doctor
  • Always see a doctor when eczema symptoms worsen
  • Avoid catching a cold sore
  • Protect the affected areas of the skin with hypoallergenic clothing or 100% organic cotton clothes
  • Frequently wash your hands and avoid touching the areas of the skin affected by eczema
  • Avoid sexual contact with those who have genital herpes and ask sexual partners if they have been tested for sexually transmitted diseases, including herpes
  • Use latex condom during sex
  • See a doctor immediately, especially if other symptoms such as fever is present
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