Assessment of hand hygiene strategies on skin barrier function during COVID‐19 pandemic: A randomized clinical trial

Abstract

Introduction Coronavirus disease 2019 (COVID‐19) has increased the frequency of handwashing. There is scarce evidence regarding the impact of different hand hygiene procedures on skin barrier function in clinical practice. Objective To compare the impact on skin barrier function of different hand hygiene measures in healthcare workers in daily practice. Methods A randomized controlled clinical trial was conducted. Participants were randomized to sanitize their hands with water and soap, alcohol‐based hand sanitizers (ABHSs), or disinfectant wipes during their 8‐hour working shift. Epidermal barrier functional parameters, such as transepidermal water loss (TEWL), and the microbial load were assessed before and immediately after the working day. Tolerance and acceptability of each product were recorded after work. Results Sixty‐two participants were included and 20, 21, and 21 were randomized to use water and soap, ABHS, and disinfectant wipes, respectively. After the 8‐hour shift, TEWL increase was higher with disinfectant wipes than with soaps or ABHS (+5.45 vs +3.87 vs −1.46 g h−1 m−2, respectively; P = .023). Bacteria and fungi colony‐forming unit (CFU) count reductions were lower for the water and soap group than for ABHS and disinfectant wipes. Disinfectant wipes were considered more difficult to use (P = .013) compared with water and soap and ABHS. Conclusion Daily hand hygiene with ABHS showed the lowest rates of skin barrier disruption and the highest reduction of CFU.

Water, soap, and hand‐disinfectant exposure during the COVID‐19 pandemic and self‐reported hand eczema in frontline workers: A cross‐sectional study

“…For example, the prevention of irritant contact dermatitis is possible by incorporating alcohol-based hand sanitisers with emollients into the hygiene practices as an alternative to hand washing with water and soap. 5,9,[26][27][28] Furthermore, moisturisers should be used regularly after use of soap and water as a preventive measure to hand dermatitis. 9,27,29 Although skin protection programmes and guidelines for the prevention of HE have been in place for over a decade, 2 moisturisers are frequently used as a therapeutic rather than as a preventive measure.…”

“…The strain from hand hygiene practices and wet work can be prevented in different ways. For example, the prevention of irritant contact dermatitis is possible by incorporating alcohol‐based hand sanitisers with emollients into the hygiene practices as an alternative to hand washing with water and soap 5,9,26–28 . Furthermore, moisturisers should be used regularly after use of soap and water as a preventive measure to hand dermatitis 9,27,29 .…”

Effect of availability and COVID-19 vaccination on food shopping and consumption behaviors among Jordan universities students

“…Since the beginning of the pandemic, an increase in the usage of several hand hygiene products, such as soaps, alcoholbased hand sanitizers (ABHS), and disinfectant wipes, was noted (Montero-Vilchez et al, 2022). Zhang et al (2021) reported that Chinese university students washed their hands an average of 5.76 times per day during the pandemic.…”

Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review

“…For prevention, rinsing of hands with warm water, the use of moisturizers or hand creams can replenish the moisture and lipids on the skin surface, restoring the skin barrier ( 79 ). While ABHS can also dissolve natural lipids in the epidermis, studies have found that ABHS are less damaging to the epidermal barrier compared to soap ( 96 ). Therefore, individuals who are not allergic to alcohol are advised to choose ABHS instead of soap.…”