As the coronavirus pandemic continues to spread, health officials, including those at the Center for Disease Control and Prevention (CDC), emphasize the need to wash one’s hands regularly. They state that proper handwashing is the most effective way of preventing the spread of COVID-19. 

Their advice is to scrub the hands with soap and water for at least 20 seconds. They also say to use alcohol-based sanitizers that contain a minimum of 60% alcohol when soap and running water are not available.

Here is a link to a CDC video showing proper hand-washing technique: https://youtu.be/d914EnpU4Fo

Handwashing is likely one of the most cost-effective ways to prevent the spread of many germs and viruses, including the coronavirus. But how does all of that scrubbing affect the skin on your hands?

Unfortunately, it can cause extremely dry skin. It can even exacerbate certain skin conditions, like hand eczema.
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Hand eczema is more than dry skin

Hand eczema is also known as hand dermatitis. It is more than just dry skin, although dry skin may be the first sign of hand dermatitis. Hand eczema, unlike dry skin, is also associated with an inflammatory response. It is common, affecting nearly 10% of the U.S. population.

Photo of hand eczema is compliments of American Academy of Dermatology (AAD) National Library of Dermatologic Teaching Slides (supplied by the author)

This condition is most prevalent amongst people in certain professions, such as:

• hairdressers
• food handlers
• healthcare workers 
• mechanics

It can affect anyone whose work is associated with an increase in contact with water, allergens, and irritants.

Now, with the expected increase in the number and duration of hand washes as people try to comply with public health recommendations related to coronavirus, we may see an increased incidence of hand dermatitis.

How does over-washing cause dry skin and exacerbate hand eczema? 

The outermost layer of skin, the stratum corneum, is responsible for maintaining appropriate water content of skin. The skin cells in these superficial layers contain water-soluble compounds that absorb water from the lower layers of skin.

In addition, each of these cells is surrounded by lipids. These fats provide a waterproofing that prevents water from evaporating from the skin into the environment. Excessive water and cleanser exposure may rid the skin of this protective lipid barrier. 

In addition, alcohol – the solvent in most hand sanitizers –  is an irritant and may initiate an inflammatory response. Either way, a disruption of the skin’s natural water barrier system leads to skin dryness and cracking which may lead to more water loss through the skin. This sets up a vicious cycle that can lead to a worsening of the condition.

Dry hands are no fun

Hand eczema is not contagious, however, the symptoms may be extremely uncomfortable. They may also prevent individuals from performing their jobs.

Here are some of the symptoms of dry skin and hand eczema:

• Symptoms of Dry Skin 

  • • Dry flaky skin on the hands with no or minimal redness.
    • Minimal itching.
    • Slight peeling or scaling.
    • Small cracks or fine lines.

• Symptoms of Hand Eczema

• • • Redness of the skin and frequent itching.
    • Dry patches.
    • Irritated patches of red or brown skin.
    • Flaking or scaling skin that may itch.
    • Cracks in the skin that may bleed.
    • Inflamed patches that may weep or burn.
    • Areas with crust or pus.

What is the best way to treat dry skin? 

Moisturizers are the key to treatment. You should apply a moisturizer frequently and especially after every hand wash. Look for moisturizers that contain occlusive ingredients, such as

• petrolatum,
• mineral oil,
• dimethicone, or
• cyclomethicone

These ingredients create a barrier to water loss. This allows the skin to renew its water barrier function.

You should also wear protective gloves when outdoors in cold temperatures and low humidity.

What is the treatment for hand eczema?

The best treatment for hand eczema is avoiding the cause. If the trigger is a particular food allergen or chemical, avoid that trigger if possible.

Your dermatologist or allergist may be able to determine the exact cause of the irritation with a “patch test.”

Here is a list of treatment to try:

• Topical corticosteroid creams and ointments are often effective at decreasing inflammation.
• Antibiotic therapy, either topical or systemic may be warranted if an infection is evident.
• Phototherapy with ultraviolet light may be effective.
• Topical calcineurin inhibitors like tacrolimus may improve hand eczema.
• Oral immunosuppressant therapy may be helpful for the severest of cases.

Proper handwashing if you have dry skin and/or hand eczema

Here are some tips to help avoid dry skin or hand eczema during this period when frequent and longer duration hand washes are recommended:

• Only use lukewarm water.
• Only use fragrance-free cleansers as fragrance may trigger eczema.
• Select mild soap-free cleansers to protect the lipid barrier.
• After blotting the skin dry, apply a well-formulated occlusive moisturizer.
• Avoid antibacterial cleansers and harsh soap that may exacerbate eczema.

Only use waterless antibacterial cleansers that contain harsh solvents like alcohol when necessary. Washing with water and a mild cleanser is more effective at removing germs than alcohol-based sanitizers. 

Related content: Stop Wasting Your Money on These Skincare Products

The bottom line for handwashing in the age of coronavirus

Proper handwashing is an essential step to protect yourself and prevent the spread of infectious agents, such as coronavirus. It can, however, lead to dry skin and hand eczema. Both of these conditions can be avoided or minimized by proper handwashing and the use of effective moisturizers.

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Fayne Frey, MD

Website: https://FryFace.com/

Fayne Frey, M.D., is a board-certified clinical and surgical dermatologist practicing in West Nyack, New York, where she specializes in the diagnosis and treatment of skin cancer. She is a nationally recognized expert in the effectiveness and formulation of over-the-counter skincare products.

She is a frequent speaker in many venues where she captivates audiences with her wry observations regarding the skincare industry. She has consulted for numerous media outlets, including NBC, USA Today, and, the Huffington Post. and has also shared her expertise on both cable and major TV outlets.

Dr. Frey is the Founder of FryFace.com, an educational skincare information and product selection service website that clarifies and simplifies the overwhelming choice of effective, safe and affordable products encountered in the skincare aisles.

Dr. Frey is a graduate of the Weill Cornell Medical College and is a fellow of both the American Academy of Dermatology and the American Society for Dermatologic Surgery.

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