We’ve previously mentioned the effect of hand washing disrupting the resident skin microflora. Maintaining the skin microflora and barrier is an important component of skin health for preventing both dermatitis and infection. Hand washing or use of hand sanitizer is of paramount importance and effective in infection control for COVID-19. To maintain skin health and the skin barrier, applying lotion or cream after hand washing is recommended. It is recommended to avoid scrubbing hands while washing, since this causes breaks in the skin. Using water that is too hot is not recommended as it can inflame the skin further and disrupt the skin barrier.
Wearing gloves, if possible, is recommended when using household disinfectant products to further decrease skin irritation, barrier disruption, and risk of contact dermatitis. I have found hand emollients that contain ceramides or ingredients higher in omega 6 fatty acids, such as borage seed oil or other oils high in linoleic acid content, to be helpful. In addition to improving the skin barrier, emollients and perhaps those with topical pre- or probiotics, may help restore the skin microflora, potentially improving infection control further. Application of hand moisturizer each time after hand washing to maintain better infection control and barrier protection was also recommended by the recent consensus statement of Chinese experts on protection of skin and mucous membrane barrier for health care workers fighting against COVID-19.
We and our patients have remarked how it seems like our hands have aged 20-50 years in the previous 2 weeks. No one is complaining, everyone understands that protecting themselves and others against a potentially lethal virus is paramount. Maintaining skin health is of secondary concern, but maintaining healthy skin may also protect the skin barrier, another important component of potential infection control.
Dr. Wesley and Dr. Talakoub are cocontributors to this column. Dr. Wesley practices dermatology in Beverly Hills, Calif. Dr. Talakoub is in private practice in McLean, Va. This month’s column is by Dr. Wesley. They had no relevant disclosures. Write to them at dermnews@mdedge.com.
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