Your skin plays an important role as a barrier to infectious microbes. We know that skin-to-skin contact is a major culprit in the transmission of contagious disease causing organisms, and that hand washing is our No. 1 defense in the fight against spreading hospital-acquired infection. But there's a catch: frequent exposure to soap, water and alcohol-based sanitizers can mess with your skin integrity. We're talking red, dry, cracked, itchy, irritated hands. A study published in the International Journal of Cosmetic Science found that a major deterrent for hand-washing compliance is concern for uncomfortable irritant dermatitis. And 69% of nurses surveyed reported a history of skin irritation related to repeated hand washing.
What happens to hands when you wash them?
Frequent exposure to soap/surfactant cleansers (common in healthcare) and water has significant affects on skin structure and function, including increased permeability and inflammation. Despite common misconception, alcohol-based sanitizers aren't necessarily more drying to the skin than soap and water, although they can sting and irritation may be variable depending on the formula used. The authors of the study estimate that the average healthcare worker washes his or her hands between 100 and 140 times over a span of 3 or 4 12-hour shifts! Cold/dry climates can worsen the problem, with significantly more irritation, cracking and erythema.
Lotion Up
The best way to counteract chronic skin dryness is chronic lotion application. It's important to note that petroleum- and mineral-based lotions can potentially compromise the integrity of protective gloves. This study compared two hand creams: CleanCare Amino+Derm Everday Emulsion and MedLine Remedy. There was a greater degree of improvement for those subjects who used Remedy, which contains linoleic, a fatty acid involved in the repair of the epidermis. It also contains water-soluble amino acids that the literature suggests may help aid in skin hydration.
Yeow! Cracked Skin
Cracked and split skin can be painful and limiting. Subjects in this study who had visibly cracked skin applied an over-the-counter hand damage cream (O'Keeffe's Working Hands) 2-3 times daily for 10 days. Improvements were noted in all subjects and documented with high-resolution photos. The researchers call attention to the need for a controlled investigation to compare efficacy of various treatments for cracked skin.
More is Better
Whatever lotion or cream you choose, apply as often as possible for best results. When you're not at work, use a hand moisturizer even more frequently and try to decrease your hands' water exposure. Here is a list of hand creams and lotions that have been shown to be effective in the treatment of irritant dermatitis.
- Lubriderm
- Hand Sense
- Barrier creams
- Locobase Repair
- Remedy
- Clean Care Amino + Derm
- O'Keeffe's Working Hands
