Has Covid-19 Led To A Hand Eczema Crisis?

A guest post by Dr Ruth Cammish

The past year has been tough on our hands with frequent handwashing and harsh hand sanitiser.  It’s not only affected health and social care workers or people with known eczema; few of us have escaped unscathed.  Since the recent return to school, cases of children struggling with their hands are also on the rise. So, I ask, what can we do to protect our hands and wave goodbye to sore, cracked and dry skin? 

Firstly, why are we struggling with our hands?

Mostly, this is due to the effects of handwashing itself. Soap and hand wash contain detergents which break down grime, viruses, and bacteria. They do a great job at protecting us, but these products also strip the natural oils on our skin leading to dryness.

The skin barrier is like a wall with skin cell ‘bricks’ and fatty acids supporting them like cement. In eczema there are less of these fatty acids, so they skin easily loses water and becomes dry. These gaps make the skin more permeable, meaning irritants like soap, dust and fragrance can cause further inflammation.  It becomes a vicious cycle. Even those of us who have never suffered with eczema are noticing our hands are now extra sensitive and easily aggravated by products that never caused a reaction before. This is called contact irritant dermatitis or hand eczema. The skin can become itchy, sore, red, and even develop small blisters or painful cracks.  Protecting the skin barrier is key.

The medical term for a moisturiser is an emollient.  Simply, this is a skin softener and there are many forms. Some draw water from the surroundings to prevent drying, some soften the top skin layer, and some occlude the skin to stop water loss. Most emollients do one or two of these jobs and it can be trial and error until you find one which works for your skin.

There are balms, lotions, creams, and greasier ointments. The best emollient for you is one you like enough to use regularly! Remember when the skin is irritated it may not like more fragranced products.

Balmond’s Skin Salvation was developed by a mother who wanted something kind yet effective for her daughter’s very sensitive skin. It works as a semi-occlusive balm with beeswax to lock in moisture and soothe irritation whilst letting the skin ‘breathe’. It contains hemp oil which is packed with fatty acids to help repair the skin barrier. Balm-like textures are deeply moisturising, but Skin Salvation isn’t greasy and easily melts into the skin.  It’s no wonder it’s the ‘hero’ product in their extensive range.  

Emollient tips

  • When your skin is dry it needs all the help it can get, so have your emollient everywhere – your bag, in the bathroom by the sink and by your bed. It’s helpful to have that visual reminder to apply it often.
  • The most effective way to apply an emollient is on damp skin. Your skin is like a sponge, so if it’s damp, it holds on to more moisture.
  • In between the fingers and the back of the hands are often the first areas to show dryness. If these areas feel tight or look dry, it’s a sign your skin is dehydrated.
  • Treat your sore hands to a mini massage when you apply your emollient. You deserve a minute or two for yourself. Move in circles and give your hands a good stretch too.

(If your skin is not improving with these measures, please see your GP.)

Health care workers on average apply hand sanitiser 9 times an hour and wash their hands at least twice. This year has seen most of us washing our hands like never before; no wonder our delicate skin is struggling.  How do we balance the need to hand wash to prevent spread of covid-19 with protecting our hands?

Hand washing tips

  • The Government guidance is to use soap and water for 20 seconds. We know that soap can be drying but it’s an effective way to remove virus particles.  You can use your emollient as a soap substitute as a second wash to remove drying and irritating soap particles.  Avoid heavily fragranced soaps.
  • Pat your skin dry rather than rubbing and then apply your emollient liberally on slightly damp hands.
  • Very hot water worsens water loss from the skin, so try warm instead.
  • Water can get trapped under rings and cause irritation so either remove them before hand washing or make sure the skin is fully dry underneath.

When the skin barrier is damaged and dry, it is more likely to become further irritated.  During the day think how many different substances your hands are in contact with.  Even chopping food especially acidic or spicy foods like citrus or chilli, can irritate. Other common irritants are cleaning products, dust, fragranced shampoo, and pollen.

Irritant tips

  • Look for patterns by noticing when your hands feel itchy, this can help point you towards a possible irritant.
  • When cleaning wear cotton gloves to protect your hands. Wash these in a non-fragranced, dye-free laundry detergent. These gloves can double up as a hand treatment too. Apply a generous amount of a soothing balm or thick emollient at night, put on some gloves and leave overnight.  Your hands will feel super smooth by morning.
  • Wearing waterproof gloves when washing up protects your skin from the washing up liquid and the hot water.
  • Do you notice your hands are tighter or redder after a shower? Shampoo is usually fragranced so wear gloves then too or try a new hair product.
  • Weather can affect the skin barrier too. In winter when the air is dryer and temperatures drop, the skin needs more help. Spring and summer bring pollen and sun cream, two common irritants. Creating a supple and protected skin barrier is even more important when the weather changes.

If your child is experiencing sore hands, the above advice applies too. It can be helpful to have a conversation with their school so they are aware that your little one needs access to a moisturiser regularly and especially after they wash their hands.

Remember that small changes add up so finding a great emollient and avoiding irritation is a great start.  Be gentle and develop a consistent routine every day to repair your hands, you’re absolutely worth it.  

 
   
     by Dr Ruth Cammish
     @drruthskinjourney

 

 

Recommended products:

Balmonds Skin Salvation
with hemp and beeswax

Balmonds Intensive Hand Cream
with shea butter and sea buckthorn oil

eczema Expert Advice hand eczema

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