Fucibet Cream

• Infected eczema or dermatitis — the main use, where there is weeping, golden crusting or a sudden worsening
• Infected contact dermatitis
• Other inflammatory skin conditions with secondary bacterial infection

It is not for eczema without infection — that needs a steroid and emollients, without the antibiotic. And it is not for infection without inflammation, which needs the antibiotic alone.

• Apply thinly, twice daily
• For up to two weeks — and not longer without review
• Apply to the affected area only, not to unaffected skin around it
• Keep using emollients alongside, generously and separately

The fingertip unit

One fingertip unit — from the tip of an adult index finger to the first crease — covers about two adult palms of skin. Most people apply far more than they need, and a small tube should last a two-week course comfortably.

Order of application

Emollient first, wait twenty minutes or so, then the steroid — or the other way round, provided they are not applied simultaneously, which dilutes both.

No significant systemic drug interactions from normal topical use on a limited area.

No routine blood monitoring is needed.

What requires active monitoring is duration and repetition. Two weeks is the ceiling, and repeat prescriptions without review are the mechanism by which people accumulate months of potent steroid and antibiotic on the same patch of skin.

Where infected eczema keeps returning, the question is why the eczema is not controlled between flares — which is nearly always about emollient use, and occasionally about something else entirely.

Fucibet is prescription-only and modestly priced as a generic. On a private prescription it costs somewhat more than the England NHS prescription charge. NHS prescriptions are free in Wales.

What matters more than the tube

Emollients — available cheaply over the counter, and in large quantities on NHS prescription. Used generously and daily, they do more to prevent infected eczema than any short course of Fucibet treats. This is the least glamorous and most effective thing on the page.

Cheaper components

• Hydrocortisone 1% is over the counter for mild eczema, though it is far milder than betamethasone
• Antiseptic emollients and bath additives can reduce staphylococcal load without antibiotics

Where paying is justified

A genuine infected flare that needs settling quickly, and a proper review of why flares keep becoming infected — which usually has a fixable answer.

Stop at two weeks. Once the infection has settled, step down to a plain steroid of appropriate potency, then to emollients alone. Continuing the antibiotic component beyond the infection serves no purpose and drives resistance.

If it has not worked

• It was viral — particularly eczema herpeticum, which worsens on steroid
• It was fungal — the steroid masked and spread it
• Fusidic acid resistance, which is common enough in the UK to be a realistic explanation
• Allergy to fusidic acid itself
• The eczema is simply not controlled, and needs a proper maintenance plan rather than repeated rescue treatment

Alternatives

• A plain topical steroid plus emollients — for eczema without infection, which is most of it
• Oral flucloxacillin — for extensive infected eczema
• Antiseptic emollients or bath additives — to reduce bacterial load without antibiotics
• Tacrolimus or pimecrolimus — steroid-free, useful for the face and folds

How do I know my eczema is infected?

Weeping, golden-yellow crusting, small pustules, increasing pain, or a sudden marked worsening — sometimes with fever or feeling unwell.

Ordinary eczema is itchy, dry and red. Infected eczema is wet, crusted and sore, and the change is usually noticeable.

How long can I use it?

Two weeks maximum without review. Both components have reasons for a short course — the steroid thins skin, the antibiotic drives resistance.

Can I use it on my face?

Not without being told to. Betamethasone is potent and facial skin is thin. Steroid-induced rosacea and perioral dermatitis are genuinely difficult to treat afterwards.

Will it thin my skin?

Not from a two-week course used correctly. Thinning comes from potent steroids used continuously for months, or on thin skin.

Being too frightened to use enough is its own problem — undertreated eczema stays itchy, gets scratched, and becomes infected again.

Why can I not have it on repeat?

Because continuous use causes skin changes that do not reverse, and because repeated fusidic acid drives resistance. If you need it often, the real problem is that the eczema is not controlled between flares — and that is worth solving properly.

Do I still need my moisturiser?

Yes, and it matters more than the steroid over a year. Emollients used generously every day are what keep the skin barrier intact, which is what stops the flares that become infected.

My eczema suddenly became very painful with little blisters. What is that?

Seek advice today. Painful clustered punched-out sores on eczematous skin, particularly with feeling unwell, can be eczema herpeticum — a herpes infection needing antiviral treatment. A potent steroid makes it worse, so this is one to act on rather than treat.