Manage Skin Irritation Due to Handwashing and PPE

COVID-19 raises questions about how to manage skin irritation from handwashing and personal protective equipment (masks, etc).

For Health Professionals:

Help patients and colleagues limit dryness, itching, and redness…on the hands, face, and behind the ears.

Advise sticking with fragrance- and dye-free soaps, sanitizers, and moisturizers. Point out that “unscented” products are NOT “fragrance-free”…they often have irritating additives to MASK scents.

Recommend washing with mild soap (Cetaphil, etc) and lukewarm water. Educate to pat the skin dry, not rub.

Clear up the misconception that alcohol-based hand sanitizer is more irritating than handwashing.

Sanitizer may sting…but it doesn’t strip away natural oils as much as soap and water. Suggest using sanitizer if hands are dry and itchy…and not visibly dirty.

Encourage patients to apply moisturizer regularly, especially after washing while skin is damp. This doesn’t negate cleansing effects.

But ensure hands are DRY after using sanitizer before applying moisturizer…to avoid trapping alcohol in the skin.

Point out ointments and creams are more moisturizing than lotions. Suggest using a cream (CeraVe, etc) regularly during the day…and an ointment (Vaseline, etc) overnight, covered with cotton gloves or socks.

There’s no “best” product. Expect trial and error.

Remind that moisturizer should be absorbed and skin should be dry before donning gloves or masks.

Consider protective strategies for masks. For example, suggest a barrier prep (Desitin, etc) to limit moisture damage or friction…or a wound dressing (DuoDerm, etc) on areas of pressure (ears, nose, etc).

But be aware, these may contaminate masks or disrupt N95 seals.

If irritation worsens, investigate possible culprits…such as lanolin in moisturizers, latex in gloves, or formaldehyde in masks.

If patients ask, explain it’s okay to try coconut or olive oil for dry skin. But advise stopping if acne or irritation occur.

Suggest using a topical steroid (hydrocortisone 1%, etc) for flares…and for about 3 days after symptoms clear.