If you’re like most people trying to do their part in the midst of the COVID-19 outbreak, you’re washing your hands diligently with soap and water many times a day. Excellent hand hygiene is one essential public health measure to help stop the spread of the novel coronavirus. Unfortunately, additional handwashing can result in dry skin and hand dermatitis, a rash that can manifest as red, itchy, cracked, or sore skin. People who have a history of eczema or who are prone to dry skin may be even more likely to develop dry, chapped hands during this pandemic.
What’s happening to your hands?
Intact skin acts as a protective barrier. Frequent exposure to water and the use of oil-stripping soaps and drying alcohol found in hand sanitizers diminish the healthy fatty compounds in the top layer of the skin. The result is an impaired skin barrier. In addition to the irritation and discomfort of dry hands, cracks and breaks in skin could lead to an increased risk of superficial skin infections.
How can you combat dry skin on your hands?
Dry hands may seem like a small price to pay for public health in the present time, but there are some preventive measures you can follow to combat dry skin.
Take these three steps when washing hands:
- Wash hands with cool or lukewarm water and soap for at least 20 seconds, washing thoroughly between your fingers and around your nails (see handwashing video). Per the CDC recommendation backed by multiple scientific studies, water temperature does not appear to affect elimination of germs. Extremely hot water can be more damaging and drying to skin. Consider keeping nails trimmed short to avoid trapping debris and germs.
- Pat hands dry lightly with a clean towel. Avoid wringing or rough rubbing.
- While skin is still slightly damp, apply a thick moisturizer to lock in moisture immediately and restore the skin’s barrier. Helpful ingredients to look for on moisturizer labels are petrolatum, mineral oil, ceramides, and/or glycerin. As a general rule, products packaged in a jar or squeeze tube are thicker in consistency, and therefore more moisturizing. For very dry skin, we recommend avoiding lotions in a pump bottle because these are typically thinner and contain more water.
Does the type of soap you use matter?
Any soap will do the job as long as proper handwashing technique is used. The reason lies in the chemistry behind soap. Soap is a surfactant, a type of compound that forms micelles (little balls of soap molecules that grab and trap dirt, oil, and germs). Soap also has the ability to dissolve lipids (fats). This enables soap to break down the outer envelope of certain viruses, including this coronavirus. So, using soap to wash hands helps in two ways: it loosens the grip between the skin and the virus, and it helps break apart the bonds that hold the virus together.
Any soap product that has these properties, including traditional soap, moisturizing soap, dish soap, or “natural” soap will work the same way. Soaps containing moisturizing ingredients may be less harsh or drying to skin. Examples of such ingredients include glycerin, ceramides, and hyaluronic acid. For those who like opting for natural products, look for soaps containing avocado oil, shea butter, coconut oil, or jojoba oil, which are also good moisturizing ingredients.
Many soaps contain ingredients that can trigger contact dermatitis. For most people, this is not a problem, but it’s important to consider if you have sensitive skin, eczema, or a history of allergies to cosmeceutical products. If sensitive skin is an issue, try to use mild soaps. Common contact allergens to avoid in soaps are fragrance, methylisothiazolinone, methylchloroisothiazolinone, cocamidopropyl betaine, and Balsam of Peru.
If soap and water are unavailable, the CDC recommends using alcohol-based hand sanitizers (check the label for at least 60% ethanol or 70% isopropanol alcohol). After using hand sanitizer to clean your hands, wait for the product to dry completely before applying a moisturizer.
One more step at bedtime
At bedtime, consider escalating to an even more moisturizing product, such as a heavy ointment. A great option is plain petroleum jelly, which is thick and occlusive, excellent for locking in moisture, and does not contain additional ingredients that could irritate skin. For extreme cases, layering this under white cotton gloves at night can help further seal in moisture.
If you develop dermatitis or severely dry, irritated skin, you may need an evaluation by a dermatologist and prescription medications. Many dermatology practices are continuing to offer patient visits via telemedicine.