Skin care and hygiene among healthcare professionals during and after the SARS-CoV-2 pandemic

Abstract

The severe acute respiratory syndrome coronavirus 2 pandemic has necessitated enhanced protection against viral transmission among healthcare professionals, particularly relating to handwashing and personal protective equipment. Some of these requirements may persist for years to come. They bring associated concerns around skin hygiene and general care, with damage to the face and hands now a well-documented consequence among healthcare professionals. This review assesses optimal skin care during the severe acute respiratory syndrome coronavirus 2 pandemic and in the “new normal” that will follow, identifies current knowledge gaps, and provides practical advice for the clinical setting. Regular, systematic hand cleaning with soap and water or an alcohol-based hand rub (containing 60%–90% ethanol or isopropyl alcohol) remains essential, although the optimal quantity and duration is unclear. Gloves are a useful additional barrier; further studies are needed on preferred materials. Moisturization is typically helpful and has proven benefits in mitigating damage from frequent handwashing. It may be best practiced using an alcohol-based hand rub with added moisturizer and could be particularly important among individuals with pre-existing hand dermatoses, such as psoriasis and eczema. Face moisturization immediately prior to donning a mask, and the use of dressings under the mask to reduce friction, can be helpful dermatologically, but more work is required to prove that these actions do not affect seal integrity. Nonetheless, such measures could play a role in institutional plans for mitigating the dermatologic impact of transmission control measures as we exit the pandemic.

Prevention of skin damages related to personal protective equipment among healthcare workers: Summary of best‐evidence practiced strategies

“…General information of the included literature was showed in Table 1. The 10 papers contain two guidelines (Alves et al, 2020; Masood et al, 2020), one best practice information sheet (Coyer et al, 2020), five practice recommendations (Cuddigan et al, 2020; Dowdle et al, 2021; Li et al, 2020; Padula et al, 2021; Rivers et al, 2021) and one evidence summary (Le et al, 2020), as well as one expert consensus (Yan et al, 2020). These studies were all released at the same time as the COVID‐19 pandemic.…”

“…The first aspect was cleaning the skin appropriately in the summary of best‐evidence practiced strategies for PPE‐related skin damage. It is of vital importance to clean skin before and after wearing PPE, which almost all literature mentions (Dowdle et al, 2021; Masood et al, 2020; Padula et al, 2021; Rivers et al, 2021; Yan et al, 2020) (Alves et al, 2020; Le et al, 2020). Alpha bacterial diversity test results revealed a statistically significant drop in the alpha diversity index in skin samples taken from the face, hand, and three other locations after wearing PPE compared to the index in skin samples taken prior to wearing PPE (Lin et al, 2022).…”

“…Humectants draw moisture from the deeper skin layers to protect the stratum corneum from damage (Dowdle et al, 2021). A cooling, antipruritic effect might be produced through skin-surface evaporation from water-based moisturisers (Rivers et al, 2021). Occlusive emollients further stop water loss (Dowdle et al, 2021).…”

“…They are performing isolation applications to protect patients on the frontline (Gefen & Ousey, 2020). During isolation, it has raised urgent questions about corresponding techniques for avoiding virtual transmission, for example, the use of personal protective equipment (PPE) (Rivers et al, 2021). The adoption of prolonged preventive measures, including medical masks, facial shields, goggles, gloves and plastic, which constantly induce skin exposure to a humid, closed and stuffy environment, has created huge dermatological challenges for HCWs (Gallagher & Sunley, 2012).…”