What emollient can be used for herpetic (herpes simplex virus) lesions around the eye in a child with atopic dermatitis (eczema)?

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Last updated: April 17, 2025View editorial policy

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From the Guidelines

For herpetic lesions around the eye in a child with eczema, petroleum jelly (Vaseline) is the recommended emollient, as it is non-irritating and fragrance-free, and can help maintain moisture and protect the skin barrier while the lesions heal. When applying petroleum jelly, it's essential to use a clean cotton swab for each application to prevent contamination and spread of the herpes virus 1. The child should also be evaluated by a healthcare provider, as oral antiviral medication may be necessary to treat the herpes infection, especially near the eye where complications can be serious. According to the most recent guidelines, topical corticosteroids should be avoided as they can potentiate HSV epithelial infections 1.

Some key considerations when treating herpetic lesions around the eye in a child with eczema include:

  • Applying a thin layer of petroleum jelly to the affected area 3-4 times daily
  • Using a clean cotton swab for each application to prevent contamination
  • Avoiding steroid creams that can worsen herpetic infections
  • Monitoring for signs of eye involvement, such as redness, pain, or vision changes, which require immediate medical attention
  • Considering oral antiviral medication, such as acyclovir, valacyclovir, or famciclovir, as prescribed by a healthcare provider 1.

It's also important to note that the management of atopic eczema involves allowing adequate time for explanation and discussion, and education regarding the application of topical preparations and the quantity to use is essential 1. However, in the context of herpetic lesions around the eye, the primary concern is preventing the spread of the infection and promoting healing, rather than managing the underlying eczema.

From the Research

Emollient Options for Herpetic Lesions around the Eye in Children with Eczema

There are no specific emollient options mentioned in the provided studies for herpetic lesions around the eye in children with eczema. However, the studies discuss the treatment and management of eczema herpeticum and herpetic ocular disease:

  • The use of systemic acyclovir and topical trifluridine has been shown to be effective in treating herpetic keratoconjunctivitis associated with eczema herpeticum 2.
  • Topical corticosteroids are a first-line treatment for eczema, but their long-term safety is a concern 3.
  • Patients with atopic dermatitis are at a higher risk of developing herpes simplex virus infections, including eczema herpeticum 4, 5, 6.

Considerations for Treatment

When considering treatment options for herpetic lesions around the eye in children with eczema, it is essential to:

  • Seek medical attention promptly to prevent the spread of the infection and potential complications 4.
  • Use antiviral medications, such as acyclovir, to treat the herpes simplex virus infection 2.
  • Avoid using topical corticosteroids without consulting a healthcare professional, as they may have long-term safety concerns 3.
  • Be aware of the increased risk of herpesvirus infections, serious infections, and opportunistic infections in patients with atopic dermatitis 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Treatment of ocular disease in eczema herpeticum.

American journal of ophthalmology, 1990

Research

Fifteen-minute consultation: eczema herpeticum in a child.

Archives of disease in childhood. Education and practice edition, 2015

Research

Eczema Herpeticum: Clinical and Pathophysiological Aspects.

Clinical reviews in allergy & immunology, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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