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Hand hygiene products fall into the categories of soap (a fatty acid salt with cleansing properties and a pH between 9 and10), synthetic detergents, antiseptic cleansers, and alcohol-based hand sanitizers. Detergents are the harshest on skin barrier function, eroding the lipid barrier of the stratum corneum and leading to increased transepidermal water loss and penetration of irritants and allergens. Alcohol-based hand sanitizers have fewer lipid-dissolving effects. The temperature of water used for cleansing does not affect microbe removal, so use cold or lukewarm water to prevent skin irritation. Use moisturizer devoid of common allergens and fragrance after washing. Avoid donning gloves when hands are still wet, as this potentially traps irritating ingredients on the skin.
Hand hygiene is essential for reducing SARS-CoV-2 transmission, but its increase may also lead to elevated incidence of irritant and allergic contact dermatitis. Alcohol-based hand sanitizers with moisturizers have the least sensitizing and irritancy potential compared with soaps and synthetic detergents.
– Margaret Hammond, MD
This abstract is available on the publisher's site.
The recent coronavirus 2019 (COVID-19) pandemic has resulted in increased hand hygiene and hand cleansing awareness. To prevent virus transmission, the Center for Disease Control (CDC) recommends frequent hand washing with soap and water. Hand hygiene products are available in a variety of forms and while each of these formulations may be effective against COVID-19, they may also alter skin barrier integrity and function. As health care workers and the general population focus on stringent hand hygiene, the American Contact Dermatitis Society (ACDS) anticipates an increase in both irritant contact and allergic contact hand dermatitis. Alcohol-based hand sanitizers with moisturizers have the least sensitizing and irritancy potential when compared to soaps and synthetic detergents. This article provides an overview of the most frequently used hand hygiene products and their associations with contact dermatitis as well as recommendations from the ACDS on how to treat and prevent further dermatitis.