COVID-19: Does overuse of hand sanitisers and too much hand washing cause skin allergies?

Dubai: Too much emphasis on hand-washing protocol and use of hand sanitisers all too frequently to keep COVID-19 at bay have seen a surge in skin allergies, according to dermatologists and skin specialists in Dubai.

Most dermatologists feel that in the past nine months, more hand sanitisers and hand washes have been used by people in comparison to what was the regular consumption for the past ten years.

Dr Fiona Cowie, aesthetician and specialist in family medicine at the Dermalese Clinic, Al Wasl, Dubai, said: “Hand hygiene is one of the basic pillars of COVID-19 prevention protocol. People have been advised to wash their hands once every hour for a minimum of two minutes and in addition, people have been using hand sanitisers — not only as an alternative where hand-washing facility is not available, but also after washing their hands. The soap helps dissolve all the natural moisture and lipids of the skin and the sanitiser, with a high percentage of alcohol content, then completely dries of the skin.

Frequent rubbing and washing and drying irritate and split the skin surface, giving a free run to the chemicals to enter through the cracks, which further aggravates the problem.”

Surge in skin allergies

Dr Nameer Abdul Majeed, specialist dermatologist at Aster Clinic, Al Qusais, told Gulf News: “Ever since the onset of the COVID-19 pandemic, we have seen a rise in hand-skin related issues among common people. Earlier, it was only health-care workers like doctors and nurses who frequently had to wash, disinfect and sanitise their hands and wear gloves who suffered from contact dermatitis. Now we have members of the public suffering from the same problem.”

Elaborating on the kind of complaints that people are coming in with, Dr Abdul Majeed further said: “They come in with two types of skin reactions to hand hygiene. The first is symptoms of dryness, irritation, itching and even cracks and minor bleed, which is part of the contact dermatitis symptoms. Then we have patients with skin allergies developed from the constituents of common hand sanitisers. It’s the high percentage of alcohol, the kind of fragrance used and the paraben in commonly-available sanitisers that are triggering this kind of allergic dermatitis.

“In fact, the World Health Organisation has issued guidelines on how to handle such skin allergies in its Multimodal Hand Hygiene Improvement Strategy toolkit."

What do hand sanitisers contain?

Dr Cowie explained how people are developing bacterial resistance owing to the indiscriminate use of hand sanitisers. Many of the common hand sanitisers available in the market contain a high level of alcohol, which strips the skin of moisture. In addition, sanitisers also contain paraben, paraffin for longer shelf life and phthalates for strong fragrances. These aggravate the skin and trigger allergies. Some sanitisers also contain trichlosan and tricholocarbon. These chemicals make the bacteria on the hands antibiotic resistant. These must be avoided as they make the skin prone to secondary bacterial infections when there is a crack and one keeps picking on it. When a person has a crack in the skin and the chemical seeps through it, it can trigger secondary bacterial infections.”

The problem gets worse for people with existing eczema and contact dermatitis issues. Frequent hand washing and use of hand sanitisers aggravate the condition. Both doctors advise that while it would be difficult to avoid this protocol, there is need to follow certain precautions to keep the skin on your hands moisuturised and infection free.

How to hand wash, sanitise and still keep the skin healthy?

• Choose a good sanitiser that contains alcohol only upto the permissible limits, but has no tricholosan trichlocarbon, phthalate and paraben.

• As far as possible, prefer to wash hands with water and a mild mositurising soap that is PH balanced and is hypoallergenic (contains no artificial fragrance), instead of using hand sanitiisers.

• Use a sanitiser only when hand-washing facility is not available.

• While washing hands, make sure to gently pat dry them after the wash and use a lipid-rich, hypoallergenic moisturiser to replenish the skin that has been stripped off its natural oils due to the frequent hand washing and use of sanitisers.

• For people in the food and health industry, it may be preferable to wear gloves and use hand sanitsers on the glove instead of directly on the hand. Change the glove frequently to air the skin and avoid any build-up of bacteria.

• If the skin on your hand is cracked, do not pick on it as it could lead to secondary bacterial infection. Keep it open and dry and try and avoid any social contact. Opt to work from home, until the skin heals so that it helps minimise the use of any hand sanitisers.

• At night, take time to indulge in some hand-care routine. Clean your hands and use a long-lasting moisturiser that can help repair the damage through the night.

• Consult a dermatologist if you suffer from an outbreak of allergic or contact dermatitis for successful management of the condition.

Source: Dr Nameer Abdul Majeed and Dr Fiona Cowie