“Healthy skin acts as a protective barrier that helps keep viruses, bacteria, and other irritants out,” says Jody A. Levine, MD, a pediatric dermatologist in New York City. “In children with atopic dermatitis, that barrier is disrupted, leaving tiny cracks in the skin that make it easier for germs to enter.”
Though a cold sore can also be harmful to adults with moderate-to-severe eczema, children with the same type of atopic dermatitis are even more at risk when exposed to HSV-1.
That’s partly because children have developing immune systems and thinner skin barriers than adults, so they’re already at a higher risk of catching viruses and getting infections.
“If a child with eczema is exposed to HSV-1, the virus can spread rapidly through areas where the skin barrier is damaged,” says Dr. Levine. “Instead of remaining confined to a small cold sore on the lip, it can infect large areas of skin.”
In short, “Children with moderate-to-severe eczema are at the greatest risk, because they have more extensive barrier disruption,” says Levine.
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