Is eczema contagious? What can and cannot spread

Eczema is a group of skin conditions that make skin dry, itchy and inflamed. Only a doctor can confirm that a rash is eczema, and that matters for this question, because some rashes that look like eczema are infections that do spread. This guide explains why eczema itself cannot be caught, which infections on top of eczema can pass between people, and the signs that need a doctor quickly. For the condition as a whole, see the complete guide to eczema.

The short answer: you cannot catch eczema

Four major health sources give the same answer. The NHS says atopic eczema is not contagious, so you cannot catch it or spread it. The US National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) says atopic dermatitis cannot be spread from person to person. The American Academy of Dermatology (AAD) answers "No" to the question "Is atopic dermatitis contagious?" MedlinePlus, the health site of the US National Library of Medicine, says eczema in general is not contagious.

That means you cannot get eczema by touching someone's skin, by sharing a bed or a bath, by kissing, or from their clothes.

Why eczema cannot be passed on

Eczema comes from inside the body and from how the skin is built. NIAMS says genes, the immune system and the environment all play a part in atopic dermatitis. The outer layer of the skin lets water escape and lets irritants in, and an overactive immune system causes inflammation. None of these can move from one person to another by touch. The guide to what causes eczema explains each cause in more detail.

Eczema does often appear in several people in one family. The NHS says you are more likely to have atopic eczema if one or both of your parents have it, or if a close family member has asthma or hay fever. Family members share genes and often share a home, so they share the risk. Nobody passes eczema to anyone.

Contact dermatitis, another type of eczema, comes from a substance touching the skin, such as a soap, a metal or a cosmetic. The rash is a reaction to that substance. The person with the rash cannot pass the reaction to anyone else.

Why eczema can look contagious

Eczema can look like something you could catch. NIAMS says scratching leads to more redness, swelling, cracking, clear fluid leaking from the skin, crusting and scaling. Raw, weeping or crusted skin can worry other people.

Eczema can also seem to spread. NIAMS says symptoms can flare in several areas of the body at the same time, and can appear in the same places and in new places. The AAD says that while one area heals, flare-ups may start in other areas. In that case, the eczema is flaring in a new place.

Infections on top of eczema can spread

Skin with eczema gets infected more easily. The AAD says gaps in the outer layer of the skin let germs such as viruses and bacteria get inside, which can lead to an infection. MedlinePlus says people with atopic dermatitis may get infections easily. These infections are caused by germs, and germs can pass between people.

Staph bacteria and impetigo

The NHS lists staph infections among the things that make atopic eczema worse. The AAD says yellow or golden crusts on the skin often mean a staph infection, and that you should contact a doctor if you see them.

MedlinePlus describes impetigo, a skin infection caused by staph or strep bacteria. It says impetigo can spread to others: you can catch it from someone who has it if the fluid from their blisters touches an open area on your skin. MedlinePlus advises people with impetigo to use a clean washcloth and towel each time they wash, and not to share towels, clothing, razors or other personal items.

The cold sore virus and eczema herpeticum

The AAD describes eczema herpeticum as a serious infection caused by the herpes simplex virus, which causes cold sores. Symptoms include dome-shaped blisters and bumps, along with fever, tiredness and swollen glands. The AAD says that in babies, children and anyone with a weak immune system, eczema herpeticum can be life-threatening and needs immediate medical care.

MedlinePlus says herpes viruses spread most easily from people with an active outbreak or sore, and advises avoiding direct contact with herpes sores. It also says the virus can cause a widespread infection that may be life-threatening in people whose immune system is weakened, and it names atopic dermatitis as one cause of that weakness.

Molluscum contagiosum

The AAD says having atopic dermatitis increases the risk of molluscum contagiosum, a common viral infection that causes small bumps on the skin. MedlinePlus says the virus spreads through direct contact with the bumps and through objects such as towels, clothing or toys, and that people with severe eczema may have a fast-spreading case. MedlinePlus also says scratching spreads it to new areas of the same person's skin.

Warts

NIAMS lists viral skin infections, such as warts and cold sores, among the complications of atopic dermatitis.

Signs that eczema may be infected

The NHS says to ask for an urgent appointment, or to call NHS 111 in the UK, if you or your child have atopic eczema and:

• it is blistered, crusty, leaking fluid or has spots filled with pus
• it is painful, swollen or feels warm
• it suddenly gets worse or gets bigger
• you have a high temperature or feel unwell

The NHS says these can be signs that eczema is infected, or of eczema herpeticum, and that you may need treatment such as antibiotics. For discoid eczema, the NHS adds a yellow crust, a lot of oozing, and hot, swollen, tender skin around the patches as signs of infection.

Simple steps that lower the risk of spreading germs

You cannot spread eczema, but you can lower the chance of passing germs to your own skin or to someone else:

• Keep your moisturizer to yourself. The NHS says not to share your moisturizers with anyone else, and not to put your fingers into a pot. Use a spoon or a pump dispenser instead. The NHS says a clean spoon or spatula reduces the risk of infection from a contaminated pot.
• Do not share towels or razors. MedlinePlus gives this advice for both impetigo and molluscum.
• Keep nails short. The NHS advises short nails to help prevent damage to the skin from scratching, since broken skin lets germs in.
• Avoid cold sores. MedlinePlus advises avoiding direct contact with herpes sores. This matters most around babies and anyone with eczema.
• See a doctor early. The AAD says a doctor may prescribe a medicine that helps treat the infection as quickly as possible and prevent it from spreading. It also says that this medicine treats the infection and leaves the eczema itself to its usual treatment.

Being close to a baby or child with eczema

Holding, feeding, bathing and cuddling a baby with eczema is safe for everyone involved, because the eczema cannot pass to you, and you cannot give it to the baby. The risk runs the other way, from germs to the baby's skin. MedlinePlus says parents may spread the cold sore virus to their children during regular daily activities, and it advises avoiding direct contact with herpes sores. The AAD says eczema herpeticum can be life-threatening in babies and children. Anyone with an active cold sore should take care around a baby with eczema, and a baby whose eczema suddenly blisters or who develops a fever needs a doctor straight away.

One contact that people with eczema should avoid

NIAMS gives one specific warning about contact. It says anyone with atopic dermatitis should not receive a smallpox vaccine, because people with atopic dermatitis are more likely to develop a serious complication from it, even when their eczema is mild or not active. NIAMS also says people with atopic dermatitis should avoid being around others who have recently received that vaccine, and should talk to a doctor before anyone in their household receives it.

Talking to other people about eczema

Being asked whether eczema is "catching" can hurt. The AAD says some people feel ashamed when others see flare-ups on their skin, and that children with eczema may be bullied because their skin looks different. A short, clear answer helps: eczema is a skin condition that runs in families, and you cannot catch it.

If eczema affects your mood or sleep, a doctor can help with that too. The guide on how eczema is treated covers what a doctor may offer, and the guide to eczema flare-up triggers explains how infections and other triggers make eczema worse.