Skin reactions related to hand hygiene
Hand-washing certainly has benefits to reduce the transmission of infections and should be encouraged.
However, many people who wash their hands multiple times a day, such as with health care workers, develop rashes on their hands.
We also hear from health care experts (including our own doctors) that frequent hand-washing can help reduce the spread of germs, especially during the cold and flu season.
People who get rashes from repetitive hand-washing may experience symptoms of redness, flaking, blister formation, cracking, and chronic skin thickening. Pain and itching may also happen. These skin changes generally happen on the back of the hands as well as the spaces between the fingers. The skin on the palms is much thicker and therefore more resistant to irritants and allergic rashes.
For people who wash their hands multiple times a day, hand rashes are generally caused by an irritant effect. In fact, in a study examining 1,300 people with hand rashes, 35% were caused by skin irritation. Nearly 20% had atopic dermatitis while only 19% had allergic contact dermatitis. While many people blame hand rashes on alcohol-based hand cleansers, these agents rarely reason contact dermatitis.
The prevention of hand rashes contains reducing the irritant effects of repetitive hand-washing. While this may seem difficult, or even impossible, for people who require washing their hands frequently, the solution is to raise the use of alcohol-based hand cleansers as an alternative. Hand-washing with soap and water needs to occur when the hands are visibly dirty, and should not be used simply to disinfect the hands.
Treatment of hand-washing rashes contains aggressive moisturizing, such as at the end of a work shift and before bed. Ointment-based moisturizers, such as Aquaphor, work the best in my opinion, and other similar brands can be found over-the-counter, often specifically labeled as being for dry hands. Topical corticosteroid creams and ointments may also be used, especially if contact dermatitis, atopic dermatitis, or dyshidrotic dermatitis is the diagnosis.