Frequent hand washing, dry hands, and emollients
As lockdown eases, hand washing is now more important than ever. Many of you may be noticing the skin on your hands is getting dry with some of you developing dry skin conditions like dermatitis or eczema. This post explains why, and what can be done.
Dry skin from hand washing
Washing your hands is the best way of removing microbes from your skin, before they can be passed to another surface, or someone else. Most hand soaps have ingredients called surfactants which break down oils, helping lift dirt and microbes from the skin so they can be rinsed off with water.
Your skin naturally has some bacteria that help keep it healthy [1]. It also has natural oils and moisturising factors between skin cells which help form a barrier to retain water and keep skin hydrated. Repeat washing removes the bacteria, oils and moisturising factors that support your skin. This leads to skin dryness, and compromises the barrier of the skin, allowing further moisture loss [2]. A compromised skin barrier can also allow irritants in, which can start reactions like dermatitis and eczema [3].
Frequent handwashing with soap strips off the natural protective layer of skin which makes the hands dry and prone to cracks. This can lead to eczema and dermatitis. - Dr. Anton Alexandroff, Consultant Dermatologist
Dry skin from alcohol gel
While not the first choice for removing microbes, alcohol gels are a popular stop-gap measure to inactivate microbes on the skin.
Once again, the issue is that alcohol gel doesn’t differentiate. It disrupts the natural bacteria your skin relies on, and your skin cells directly, along with the bacteria and viruses you want it to. Similar to hand soaps, some hand gels contain other antimicrobial ingredients to help them function better, and some of these have been reported to cause irritation or contact dermatitis, particularly on skin that is already dry and damaged [4].
What to do
Washing our hands regularly and thoroughly is essential, not optional. We all have a responsibility to help control the spread of coronavirus.
Epaderm is an emollient designed by dermatologists to treat dry skin conditions and eczema. They create a barrier which aids moisture retention within the skin. Epaderm is gentle on the skin, and is free from many ingredients such as fragrances and sodium lauryl sulphate. Fragrances and sodium lauryl sulphate have been associated with skin irritation and dermatitis [5].
By regularly moisturising your hands throughout the day, it will help to restore all protective layers that are lost during hand washing. – Dr. Anton Alexandroff
Epaderm is available as a cream for regular use during the day. It has been shown to improve skin hydration in two weeks.
Epaderm is also available as an ointment. This is a greasier formulation with fewer ingredients. The British Association of Dermatologists suggests using an ointment at night, under cotton gloves to stop bedclothes getting greasy [6].
Epaderm is available from major pharmacies, or if you’re not able to visit one at the moment, online from Amazon.co.uk
References:
[1] D. Peroni, G. Nuzzi, I. Trambusti, M. Di Cicco and P. Comberiati, “Microbiome Composition and Its Impact on the Development of Allergic Diseases,” Frontiers of Immunology, vol. 23, no. 11, 2020.
[2] D. Voegeli, “The effect of washing and drying practices on skin barrier function,” vol. 35, no. 1, 2008.
[3] C. Shen, M. Zhao, Z. Jia, J. Zhang, L. Jiao and L. Ma, “Skin Ceramide Profile in Children With Atopic Dermatitis.,” vol. 29, no. 4, 2018.
[4] L. Campbell and M. Zirwas, “Triclosan,” vol. 17, no. 4, 2006.
[5] F. Kartono and H. Maibach, “Irritants in combination with a synergistic or additive effect on the skin response: an overview of tandem irritation studies,” vol. 54, no. 6, 2006.
[6] British Association of Dermatologists, “Patient information leaflet: How to care for the skin of your hands,” 09 2019. [Online]. Available: https://www.bad.org.uk/shared/get-file.ashx?id=3776&itemtype=document. [Accessed 05 2020].
