Hand washing is nothing new to doctors.
One of the first things drilled into us when starting our medical rotations is that excellent hand hygiene is critical to stopping the “chain of transmission” or spread of germs from person to person via the hands.
But with government and health officials touting the importance of proper hand hygiene throughout the Covid-19 crisis, that message has filtered down to the general public and it’s unlikely anyone will forget the importance of washing and sanitizing once this pandemic is over — and it will be.
As a dermatologist, I’m sensitive to the impact frequent hand washing and sanitizing can have on the skin. Here are my recommendations for practicing excellent hand hygiene and preventing dry, chapped — even cracked — hands. It’s something you should continue to do whether there is a pandemic or not!
HAND SANITIZERS ARE LESS IRRITATING TO THE SKIN THAN SOAPS/CLEANSERS AND WATER
One of the authorities on hand hygiene is the Centres for Disease Control and Prevention (CDC). They have detailed instructions informing the public on how to wash their hands for at least 20 seconds (or two rounds of “happy birthday”) to effectively remove infectious germs. They also recommend alcohol-based hand sanitizers with a minimum 60 percent alcohol content to remove infectious germs, however, they advise they are not as effective as soap and water at removing all types of germs.
In a recent interview for the Guardian, Dr. Sally Bloomfield, Professor Emeritus from the London School of Hygiene and Infectious Disease, whom I had the pleasure of interviewing for my book, Beyond Soap, pointed out that coronavirus is an envelope virus which contains a lipid or fat membrane. Alcohol attacks and dissolves this membrane thereby eliminating the threat of the virus.
It is widely accepted by public health officials, health care workers (and particularly Occupational Dermatologists, like me) that hand sanitizers, which kill the microbes on the skin without removing debris, irritate the skin less than soap.
It has always been our advice to patients and workers to use hand sanitizers in everyday use – like after touching a door handle or light switch — when your hands are not obviously soiled.
USE CLEANSING BARS TO WASH YOUR HANDS.
Cleansing bars also known as beauty bars should be used to wash your hands when possible. They are not soap. They contain synthetic detergents that are less drying to the skin and most importantly are pH balanced (acidic at 5-6).
True soap bars, like Ivory, or the natual bars you can get at health food stores (no matter how much goats milk or essential oils they contain) are high pH or alkaline (usually 9-10) and are excessively damaging to the skin’s protective barrier.
These high pH soap bars remove our skins natural oils which leave the skin more open and vulnerable to infectious agents. Most “natural” true soap bars also contain unnecessary essential oils and citrus ingredients that will irritate the hands over time.
Below are the cleansing bars I recommend:
Dove for sensitive skin bar
Aveeno moisturizing bar
Cetaphil cleansing bar
Vanicream cleansing bar
AVOID FRAGRANT LIQUID HAND SOAPS
Rather than highlighting the cleansing and moisturizing benefits of their products, most liquid hand soap brands have dedicated their marketing dollars to selling consumers on a pleasant scent (lemon or winter fresh, anyone?).
In fact, a look at one of the most common hand soap brands boasts seven different fragrances, formaldehyde-releasing preservatives and dyes, just so your cucumber-scent hand soap can look green!
Please avoid scented liquid hand soaps including natural varieties with ingredients like lavender, rose, bergamot or pumice particle which are unnecessary — not to mention very pricey. Repeated use of these products will increase the dryness of your hands leading to small fissures (open sores) on your skin which could increase your risk of infection.
Washing your hands is a not a beauty or perfuming ritual, it’s about your health.
HOW TO WASH YOUR HANDS
Washing your hands is ideally a six-step process:
1. Run your hands under warm water
2. Apply your cleansing bar
3. Lather for at least 20 seconds, paying attention to the palms and back of each hand, between the fingers, thumbs and under the nails.
4. Rinse well
5. Pat completely dry
6. Apply a moisturizer
APPLY A HAND REPARATIVE CREAM EVERY TIME YOU SANITISE OR WASH YOUR HANDS.
Applying a reparative cream post-wash is key to preventing dry, chapped skin and fissures on the hands. It has been the key to keeping health care workers hands healthy, who on an average day sanitize or wash their hands over 50 times per shift.
Like my advice regarding liquid hand soaps, moisturizes should not be selected based on scent. Fragrance is an irritant that can potentially dry out your skin even more.
Below is a list of hand-specific repairing moisturizers to use after washing or sanitizing to help prevent dryness and fissures.
WEAR NON-LATEX RUBBER GLOVES FOR ALL WATER WORK
Your hands take enough of a beating from hand washing, sanitizing and personal grooming, so, it is important to avoid unnecessary exposure to water for any other reason.
For this reason, I recommend wearing a non-latex re-usable rubber glove (I like Mr. Clean Bliss latex free gloves) for all water work, including doing the dishes and washing the car.