Manage Skin Irritation Due to Handwashing and PPE

COVID-19 will put focus on how to manage skin irritation from handwashing and personal protective equipment (masks, etc).

Start with good skin care...especially for your hands, face, and behind the ears.

Stick with fragrance- and dye-free soaps, sanitizers, and moisturizers. Be aware that "unscented" products are NOT "fragrance-free"...they often have irritating additives to MASK scents.

Wash with mild soap (Cetaphil, etc) and lukewarm water...since hot water worsens dermatitis. Pat your skin dry, don't rub it.

Clear up the misconception that alcohol-based hand sanitizer is more irritating than handwashing.

Sanitizer may sting...but it doesn't strip away natural oils as much as soap and water. Use sanitizer to clean your hands if they're dry and itchy...and not visibly dirty.

Apply moisturizer regularly if possible, especially after washing while skin is damp. This doesn't negate cleansing effects.

But ensure hands are DRY after using sanitizer before applying avoid trapping alcohol in the skin.

Keep in mind, moisturizer should be absorbed...and skin should be dry...before donning gloves and masks.

Evaluate other skin-protecting strategies...especially if you wear personal protective equipment for most of your shift.

For example, consider a barrier cream or wipe to limit moisture damage or friction on the nose, cheeks, etc...or a wound dressing (DuoDerm, etc) to protect areas of pressure or aggravated skin.

But check your hospital policy first.

For instance, you'll likely need to get your N95 mask refitted if wearing a dressing underneath...or avoid touching your N95 mask with cream on your hands if reusing it.

Review our chart, PPE-Related Skin Irritation: Prevention and Treatment, for more practical advice.

Key References

  • J Am Acad Dermatol Published online May 13, 2020; doi:10.1016/j.jaad.2020.05.032
  • J Am Acad Dermatol Published online Apr 21, 2020; doi:10.1016/j.jaad.2020.04.068
  • J Am Acad Dermatol Published online Apr 16, 2020; doi:10.1016/j.jaad.2020.04.047
  • (6-1-20)
Hospital Pharmacist's Letter. June 2020, No. 360605

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