Good Hand Hygiene Can Mean Dry Skin Here’s Help

Frequent handwashing has always been important. But with the emergence of COVID-19, it’s getting more attention now than ever before.

That’s a good thing. Washing your hands is among the simplest and most effective ways to remove bacteria, viruses and other disease-causing pathogens and prevent the spread of many different kinds of illnesses.

But, the more you wash your hands, the more likely you are to experience dry skin and irritation. The good news: following a careful regimen can keep your skin healthy—and prevent dryness before it causes bigger problems.

Battling Dryness

With the current pandemic spurring so much handwashing, our hands are under assault. Dermatologists are seeing an increase in new cases of dry, red, itchy, inflamed skin—a form of eczema known as contact dermatitis.

We’re also using hand sanitizer at record levels. Almost all hand sanitizers include alcohol as the active ingredient. Alcohol is an effective germicide, but it can irritate dry, cracked and damaged skin, making it even worse.

It’s a bit of a vicious circle. We clean the hands. That removes the protective oils that hold in moisture. As moisture wicks away, the tissue shrinks and tiny cracks form. It’s the same process that causes earth to crack when the weather is hot and dry.

Once the skin begins to crack, it sets up the potential for more irritation and even infection. Cracks can bleed or ooze, becoming a virtual Petri dish where bacteria thrive, especially between the fingers.

Moisturize to Protect

Proper moisturizing is the best way to prevent contact dermatitis caused by soap, sanitizer and other irritants. It’s so important, I carry both hand sanitizer and moisturizer as I go about my day. Anytime I wash my hands or use sanitizer, I apply a moisturizer.

Wash your hands the way healthcare workers do; lather up and rub all of the surfaces for at least 20 seconds. Then dry your hands thoroughly, preferably with paper towels. If you leave your hands wet, water remaining on the surface can actually wick away more water from beneath the surface as it evaporates—making dryness worse.

When your hands are clean and dry, apply a moisturizer, preferably free of fragrances. Besides removing natural oils, soap and sanitizer can also strip away the moisturizer you applied earlier. So it’s important to moisturize every time you clean your hands. This is the single most important thing you can do to prevent dryness and irritation. It can even help prevent fingernail dryness.

When to Sanitize

Hand sanitizers are convenient for killing germs. But they only work on clean hands. If your hands are soiled—from dusting, cleaning, doing food prep, working in your garden or on your car—you’ll want to make sure you wash them. Sanitizer alone can’t do the job.

When Irritation Means Something Serious

Contact dermatitis from frequent handwashing is a common complaint, and managing it is most often straightforward. However, red, dry, irritated, broken or weeping skin on the hands can also be a symptom of more serious conditions, including atopic dermatitis, eczema, psoriasis and allergic contact dermatitis, among others.

Seek medical attention if your hands continue to be dry, irritated or painful, even after you adopt a good regimen with mild soap and frequent moisturizing.

If It Feels Good, Use It

Everyone is unique. What irritates one person’s skin may feel fine to another. If you use a product that causes discomfort, a reaction or just doesn’t work, try something else.

Check the label. Generally speaking, the fewer ingredients, the better. I recommend unscented products whenever possible.

Hand sanitizers are mostly alcohol. But they can contain other ingredients that might irritate—for example, perfumes and acrylates, the chemicals used to make super glue and artificial fingernail products. My advice: if the sanitizer burns, stings, or does not feel good on your hands, try another. That’s easier said than done in an era of limited inventory, but it’s something to keep in mind.

For cleansers and moisturizers, the brands I like are mild and without potentially troublesome ingredients, including CeraVe®, Cetaphil®, Vanicream™, Aveeno®, Olay®, and Eucerin®. Most Dove soaps contain petroleum jelly, so they tend to be less drying, and fragrance-free varieties are available. A lot of store brands are okay, too. It’s all about what works for you.

These recommendations are not product endorsements but are based on what has worked for me and my patients over the years.

Healthy Habits, Healthy Skin

Beyond moisturizing, you can do more to keep the skin healthy, on the hands and everywhere else. Here are some tips:

• Excessively hot water can irritate the skin. Cool or warm water is just as effective for handwashing.
• If you know you will come in contact with harsh chemicals, like bleach or other cleaning products, wear gloves. And be sure to choose gloves that will stand up to the threat. Some chemicals will eat through thin nitrile or vinyl gloves, so you must choose carefully. If the inside of your gloves get wet, wash your hands, dry them, and put on a dry pair.
• Avoid anything you know your body doesn’t tolerate well. You may be sensitive to latex or lanolin, for example, so keep a sharp eye out for them.
• Hydration is important for health overall. Everyone’s daily needs are a little different but listen to your body and drink when you’re thirsty. Be aware that alcohol and caffeine can stimulate the kidneys and cause you to lose water more quickly, so always include non-caffeinated, non-alcoholic beverages in your daily routine.
• A balanced diet is important for the skin. A normal, varied diet, adjusted for intolerance and food allergies, helps boost overall health.
• If you don’t spend any time in the sun, you may not be getting enough vitamin D. This is especially true for those with darker complexions, who need more sun exposure time to make enough of it. To maintain healthy blood levels, aim to get 15–20 minutes of midday sunlight several times per week. People with darker skin and those living in areas with less daylight may need a little more than this. Your exposure time should depend on how sensitive your skin is to sunlight. Make sure to stop before any redness or burning develops, as that means your skin is getting damaged.
• Exercise, too, plays a role. It’s common sense, really. The skin is a complex system that depends on all the same factors as other organs and structures of the body. The more fit you are, the more fit your skin can be, too. Remember to use sunscreen if your fitness regimen involves outdoor activities.

At MedStar Washington Hospital Center, we treat a wide range of skin conditions, from common to rare, and are happy to offer the convenience of video visits to address your needs. Our dermatologists’ mission is to help you maintain happy, healthy skin for your entire life.