Increased Hand Washing Requires Special Attention to Skin

One of the best defenses against the spread of coronavirus, which causes COVID-19, is hand washing. But frequent rubbing and scrubbing can take its toll, depleting skin of its natural moisture and oils.

So what should you do if your hands are becoming raw, dry and irritated with constant hand washing?

First, it’s ideal to use a soap that is hypoallergenic, free of irritants and perfumes, said Dawn Davis, a Mayo Clinic dermatologist. It’s also good to note that soap in bar form tends to have fewer chemicals than the liquid form and more moisture content.

Next, wash your hands in comfortably warm—not scalding hot—water. Dr. Davis offers the familiar recommendation to sing a favorite song so you wash your hands for at least 20 seconds.

Hand sanitizers are thought to be nearly as effective as soap and water, but the latter are preferred, especially after using the restroom and before and after eating. Be sure to scrub between your fingers, including your thumbs, under your rings, the back of your hands and around your wrists. The same is true when rinsing.

“People forget about that and then soap residue stays between the digits or lies on the backs of the wrists and, over time, will get an irritant dermatitis from the soap residue that’s there,” Dr. Davis said.

After scrubbing to clean your hands, be gentle with your skin when you dry them. In fact, Dr. Davis said you should pat dry instead of rubbing your hands. And avoid paper towels if you can.

“I would suggest using linen, such as a cotton towel, over a paper towel,” she said. “But using either a paper or cotton towel is preferable to letting hands air dry. Air drying only lets the skin dry out more due to diffusion and evaporation of moisture off the skin, and then if you shake your hands dry, you might contaminate surfaces if you happen to have any germs left on your skin. Your skin is sort of like a kitchen sponge, and over time, with repetitive washing, it will simply dry out and look like a dry kitchen sponge.

After you wash and pat dry, some moisture comes back into the skin and you can trap it by putting on a moisturizer. There are multiple ways to do that, including lotions, creams or ointments.

“Lotions tend to be the weakest of the three with regard to moisturizing because they have more water content and, so, lotion goes into the skin quite well,” Dr. Davis said. “It tends to be thinner, but it will evaporate faster.”

Creams have less water content than lotion. They tend to be thicker and take longer to absorb into the skin. They evaporate more slowly over time.

Ointments sit on top of the skin. “So you can think of them like a greenhouse roof or like a lid,” Dr. Davis said. “They prevent or slow the evaporation that naturally happens off the skin.”

The recommendation? Apply a hypo-allergenic lotion or cream to your skin, and rub it in gently, making sure to get between each finger and include your wrists.

“If you don’t feel that your hands are moist enough, wait 30 seconds to a minute, then reapply,” she said. “You definitely get benefit from a second application. If you think your skin needs more help, you could apply a cream or a lotion first. Then use an ointment on your second application to seal it in like a roof, allowing sort of that greenhouse effect.”

Patients with sensitive skin may have dermatitis flares. There are also those who didn’t know they had sensitive skin until they started the extra hand washing. “So, there’s sort of a three-step process in my mind of how to go above and beyond the general moisturizing,” she said:

• Apply a single or double layer of lotion or cream on your hands, ideally before bed.
• Cover those layers with an ointment, like petroleum jelly.
• Put a cotton sock over your hands and wrists for the night.

If you’ve tried layered moisturizing with the cotton sock, and that isn’t helping, Dr. Davis suggests you kick it up a notch with her skin burrito:

• Before bed, wash your hands and pat them dry.
• Put on two layers of your thickest, most effective hypoallergenic lotion or cream.
• Put a teaspoon of white vinegar into a glass or small bowl of warm water, and soak two clean washcloths.
• Wring them out and wrap them around your hands.
• Cover your hands with socks.

“The warm water and vinegar soak adds more moisture to that greenhouse effect,” Dr. Davis said. “The vinegar helps adjust the pH, which keeps the skin clean. The heat, or the warmth, allows the pores to open up and allows the extra lotion to soak deeper into the skin.”