The current 2019 Novel Coronavirus (SARS CoV- 2) pandemic has seen an increased focus on hand hygiene compliance as one of the primary methods of helping to prevent the spread and transmission of the virus1. For healthcare workers on the frontline, this increased frequency in hand washing brings with it potential detrimental effects to skin health.

Although keeping the hands clean is of the utmost priority, keeping them healthy is crucial alongside this in order to help reduce the risk of work-related skin issues such as dryness, redness, cracking and ultimately dermatitis.

Healthcare is one the most common professions affected by occupational skin disorders2, but for healthcare workers, the hands are vital tools of the job. If they become damaged from poor skin health, it is not only unpleasant but could affect an individual’s ability to carry out work effectively, and run the risk of less effective hand washing.

Dry, chapped or irritated skin can be factors in low hand hygiene compliance – a recent study reported that healthcare workers with hand dermatitis avoided the use of hand disinfectants, because of a stinging sensation on damaged skin3. A healthy skin condition is an important element in ensuring good hand hygiene practice4; this is why caring for the skin is so vital.

1. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public    2. https://onlinelibrary.wiley.com/doi/full/10.1111/cod.13214   
3. https://onlinelibrary.wiley.com/doi/full/10.1111/cod.13214
4. https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.13719

The Science

Healthy skin contains natural lipids, moisture and bonded cells on its surface to create a protective layer (the stratum corneum) against physical contaminants and infection from pathogens.

This layer needs to be kept healthy, in order to protect against the penetration of contaminants.

Using moisturising creams helps to nourish and condition the skin, and their regular use helps to encourage the skin’s own production of barrier lipids and cell renewal.

When can poor skin condition occur? What are the risks?

One of the main factors that can affect skin condition is frequent and prolonged contact with water or cleaning materials. This can occur through either poor or improper hand washing technique, or general surface cleaning.

The risks that accompany poor skin condition are many and varied. As the skin’s layers are broken down, deeper layers of the skin are exposed which can result in redness and cracked skin, which in turn can lead to impaired grip and pain, as well as decreased dexterity.

This can also lead to time off work. The Nursing Times recently reported that 1000 healthcare workers in the UK contract diagnosable work-related dermatitis
each year5.

5. https://www.nursingtimes.net/news/policies-and-guidance/nurses-warned-about-dermatitis-risk-from-over-use-of-gloves-26-04-2018/

The Solution

Whilst the solution may seem like a simple one – use of a moisturising cream - not all creams are created equal. Our internal research shows it is common for many nurses and healthcare professionals to use their own personal tubes of moisturising cream.

However, these creams have been designed for the general public as personal care products, rather than to meet the needs of the professional working within a medical, healthcare setting. Clinical practice demands more targeted skin caring benefits, particularly due to the impact of high frequency hand washing on skin health, for which many consumer creams are not designed to deal with. As such, it is recommended that healthcare workers use professional creams formulated specifically for healthcare settings.

Avoiding Skin Sensitisation

Given the high frequency of hand hygiene events in healthcare settings, the skin will be at an increased risk of sensitisation. As such, using fragrance-free moisturising creams can help reduce this risk.

Moisturising creams designed for healthcare settings have been specially formulated and are free from any fragrances to reduce the risk of eliciting skin sensitisation as much as possible. This is crucial, as the healthcare occupation has been identified as high risk in terms of skin sensitisation6, and so the use of a professional product helps reduce this risk.

CHG and Sanitiser Safe

Further to this, high quality professional workplace hand moisturisers have been formulated to ensure that they are compatible with Chlorhexidine Gluconate (CHG - an antimicrobial ingredient commonly used in surgical scrubs and healthcare antiseptic soaps) and are safe to use with alcohol-based hand sanitisers. The SC Johnson Professional range includes creams that have been tested and shown to not interfere with or detract from the efficacy of such hygiene products.

Often poor skin condition is normalised among healthcare professionals and seen as simply part of the job – yet irritated skin is considered to be one of the main reasons for failure to comply with hand hygiene guidelines. Damaged skin should not be seen as an occupational hazard to be endured, and as demonstrated above, it can actually be harmful.

Moisturising, restoring creams specifically designed for a professional, healthcare environment should be used often and regularly – before work, at break times and after work are key times.

For more information or to download key resources on skin health, head here.

6. https://www.hse.gov.uk/pubns/guidance/g403.pdf