Keeping Your Hands Protected During the COVID-19 Pandemic

The best way to protect yourself during this COVID-19 pandemic: wash your hands for at least 20 seconds with soap anytime you touch your face or any public surface. According to a study published in the New England Journal of Medicine, SARS-CoV-2, the virus that causes COVID-19, travels through the air and can live on plastic surfaces for up to 72 hours, stainless steel up to 48 hours, cardboard up to 24 hours, and copper up to 4 hours.

So washing your hands is the key factor in protecting yourself. But how do you protect your hands from the frequent and prolonged hand washing? Hand dermatitis is a term used to encompass a broad category of rashes that can occur on the skin of the hand. In my experience, I see this commonly with irritant exposures and eczema. Eczemas can be induced from over drying the skin. This can lead to subsequent inflammation. Irritants exacerbate and accelerate this drying and inflammation process. Irritants include detergents, alcohol, astringents, amongst other agents.

1. Wash with cool water

Hot water strips more of our natural oils from the skin. It is also more likely to trigger subsequent itch in the skin.

2. Use a gentle skin cleanser when possible

This may not be available in everyone’s clinic or home, but it’s important to note that certain soaps are harsher than others. Soaps designed for sensitive skin types are less damaging to the skin. Dish soap is not recommended for direct use on the skin.

3. Don’t use alcohol or hand sanitizer immediately after washing your hands

The skin is clean after washing. Adding alcohol or hand sanitizer to clean damp skin can cause irritation.

4. Avoid unnecessary scrubbing of your hands or excessively rubbing them dry with a towel

• Avoid chemical or mechanical skin exfoliants at this time.
• Rough mechanical friction dislodges the protective barrier of the skin and causes microdamage. People in certain fields, such as surgical fields, need to perform surgical scrubs. However; for those of us who aren’t performing surgical procedures, a simple lathering technique is all that’s needed. Click here for a hand-washing tutorial video from the World Health Organization.
• Pat your hands dry. Be careful to dry off areas that may trap excessive moisture (ie, beneath wedding bands or in finger web creases)

5. Repair your skin between washes and at night

If you can tolerate it, I recommend a greasy, bland emollient at night. Consider petrolatum-based ointments for some heavy hitting. If you are unable to tolerate this, consider thick, bland hand creams. Creams are thicker than lotions. Bland products typically lack noticeable fragrances or excess active ingredients or additives.

Moisturize after washing your hands. Many national brands have appropriate hand creams. Consider using a hand cream containing dimethicone between washes. Dimethicone is a silicone derivative and provides a “barrier” between your skin and the environment. Although this won’t provide additional protection from germs, it protects the skin from lipid stripping due to detergents in soaps. Instead, those soaps will strip the dimethicone.

6. Wear gloves when handling disinfectant wipes and chemicals

These chemicals can include irritants that should not be left on the skin. The simplest way to avoid getting these irritants on your skin is to use gloves when handling these products. Also, reference the product labels for appropriate skin precautions.

7. Healthcare providers need to practice additional precautions

• Avoid excessive wetness (maceration) from occurring due to sweat trapping in medical gloves.
• Also, medical facility sanitizers and soaps can be linked to occupational-related dermatitis in some individuals, but not others. If this occurs, your manager can help you obtain an alternative hand sanitizer or soap.

If you notice persistent skin irritation or rash despite these measures, contact your dermatologist to rule out other causes of hand dermatitis.