Healthy hands despite intensive hygiene

Redness, blisters, itching: Frequent hand washing, as is now indicated as a hygiene measure to protect against the coronavirus, can strain the skin on the hands. What to do?

Dermatologist Dr. Hans-Ulrich Voigt

© Dermatologie am Dom

Dr. Hans-Ulrich Voigt, dermatologist from Munich, explains what protects the hands and helps with complaints.

1. Not everyone can tolerate frequent and intensive hand washing. Some people get rough skin, others even develop hand eczema. Which people are particularly sensitive?

Allergy sufferers are particularly affected, including atopic dermatitis patients and all those who have very dry skin. In these people, the natural protection of the skin is impaired: the protective acid mantle is weakened and the skin cannot fulfill its important barrier function. This is especially true when it is severely irritated, such as by washing your hands very often.

2. What is so harmful about it?

Soap has a fat-dissolving property. But the soap foam can not only destroy the fatty shell of the corona virus, it also dissolves skin oils. This will dry out the hands. The skin flakes off, redness, blisters and small cracks form, which can itch and ooze. It is through these gates that bacteria, fungi and viruses can easily get into the skin. This leads to inflammation. Dermatologists then speak of eczema.

Our short video explains why thorough hand washing is so important and how to do it correctly.

Irritant contact eczema - not that rare

The so-called irritative contact eczema goes back to the constant handling of irritating or moist substances, usually cleaning agents, solvents or disinfectants. Light forms included are up to eleven percent of the time

Population affected by the skin disease. Often these are people who work in the healthcare sector, in the food industry, in the automotive industry, as hairdressers or as cleaning staff.

The disease begins when the skin is dry and slightly red. After a while, itchy blisters may appear and the skin will tear. Cracks form, which are often very painful and do not heal well. If sores become infected with bacteria or viruses, it can lead to chronic inflammation. Doctors speak of chronic hand eczema if the disease lasts at least three months or occurs at least twice in a period of twelve months.

© W & B / Dr. Ulrike Möhle

3. Can this be avoided despite the hygiene measures that are now required?

It is important to give your skin back what you take away from it. That’s mostly fat. Therefore, the hands should also be creamed after each wash. However, because one or the other may find it uncomfortable to leave stains and marks all over the place with greasy fingers during the day, I recommend using a moisturizer. In the evening, a greasy hand care should then be applied. If you want, you can wear thin cotton gloves over them at night. These are available from pharmacies or medical supplies.

4. Does it help to choose a particularly mild soap?

As protection against the corona virus, it makes little sense to switch to particularly gentle preparations. In order to protect the skin, however, you should make sure to always dry your hands well.

Soon healthy hands again

  • Do not scratch or rub
  • Follow therapy as prescribed by the doctor
  • Do not wear rings or bracelets
  • Use a moisturizing cream or ointment after each wash
  • In addition to washing your hands, avoid contact with aggressive substances such as cleaning agents, detergents or polish as far as possible
  • If handling of skin-irritating substances is unavoidable, put on gloves. Wear cotton gloves under rubber or latex gloves
  • Even after the eczema has healed, continue to care! The resilience of the skin is still weakened for a few months

5. Some people use a disinfectant after washing their hands. Is that important?

Hand disinfectants contain alcohol. This also dries out the skin. Those who wash their hands well - lather them intensively for at least 30 seconds - do not need additional disinfection. Such means are useful for in between and on the go, when there is no opportunity to wash your hands.

6. Some people now wear gloves in public, for example when shopping. What do you have to take into account?

To keep your hands clean, thin disposable gloves are best. However, they should only be worn for a short period of time. Moisture forms under the rubber cover. As a result, the skin initially swells and then dries out. Anyone who uses rubber gloves should always apply cream to their hands after wearing them. To protect yourself from the coronavirus, the same rule applies when wearing gloves: do not touch your face!

7. Many people currently prefer not to attend a practice. Which home remedies help if the skin is damaged?

The best help is to generously pamper the skin with oil. Oil baths are well suited for this. Put two tablespoons of oil on a bowl of lukewarm water, for example olive oil from the kitchen. Soak your hands in it for ten minutes, then dab them gently and apply a hand cream. The first inflammation should subside after a few applications. In mild cases of hand eczema, ointments with 0.05% cortisone, which are available in pharmacies without a doctor's prescription, also help.

8. Those affected often suffer from severe itching. How can I avoid scratching?

Blisters and cracks should, if possible, not be additionally irritated by rubbing and scratching with your fingernails. If you have a hard time not doing this, you should put lotion on your hands and put on cotton gloves until the itching subsides.

9. When do you advise making an appointment with the doctor?

If there are open spots that are oozing or bleeding, those affected should consult their dermatologist or family doctor. Pathogens use these entry portals to penetrate the organism. There is a risk of serious complications. At the moment: call the practice! The doctor can advise you by phone or video consultation and send you the prescription. He will usually prescribe a cortisone supplement to help the skin heal. This can be a cream to be applied to the individual areas. In more severe cases, there are also means for internal use in tablet form. However, cortisone should only be used for a short time in order to give the skin the chance to restore its barrier. Then care measures are important.

10. Can the nails also be damaged?

Frequent hand washing can also damage the layers of the fingernails. Here too, moisturizing hand creams and oil baths help.