With the arrival of Covid 19, hand hygiene guidance was introduced as one of the measures to reduce the spread of the coronavirus. Hand hygiene involves cleaning the hands with soap and water or hand sanitiser.
Unfortunately, the increase in hand hygiene measures can lead to skin irritation, due to frequent skin contact with chemicals, preservatives, fragrances, or detergents contained in soaps and sanitisers.
These ingredients can upset or damage the skin barrier. Repeated exposure to these products can ultimately lead to a condition known as irritant contact dermatitis – a form of eczema, which can cause the skin to become red, itchy, sore, and cracked.
To reduce the risk of developing hand dermatitis, it is important to take care of the hands. Understandably not all these steps are possible at school, so take advantage of the time your child spends at home to give the hands some extra attention.
Top tips for good hand care
Use gentle soap
The HSE guidance is to use soap or hand sanitiser to destroy the coronavirus. Ordinary soaps can be irritating to the skin, so ideally use a product that is gentle and fragrance free. If you are in a situation where ordinary soap is the only option, you may counteract some of the irritating effects of the soap containing detergents by doing a double hand wash. First wash hands with ordinary soap, then use a soap alternative such as Silcocks base to wash away any detergent that may be left on the hands.
There are very few soaps that are gentle on the skin and destroy the virus. Talk to your pharmacist for advice. Dermatology clinics frequently suggest Elave sensitive hand wash. It is a gentle product that effectively breaks down the lipid layer that surrounds the coronavirus and destroys the virus.
Wash with lukewarm water
When washing hands, wet the hands before applying soap. Keep the temperature of the water lukewarm, as hot water is more drying and irritating to the skin. After washing, make sure to pat the hands dry. Do not rub! This is a good time to apply moisturiser.
Choose a non-cosmetic moisturiser (emollient)
Moisturiser is very important to repair and protect the skin barrier that has been damaged by increased hand hygiene. Choose a non-cosmetic moisturiser (often referred to as an emollient). These contain less preservatives and fragrances than cosmetic moisturisers. Emollients are an essential part of treating hand dermatitis. They lock moisture inside the skin, making it soft and supple, whilst restoring the skin barrier.
Emollients provide a protective film on the hands. They should be applied after handwashing, repeatedly through-out the day, and whenever the skin feels dry. Ideally emollients should be applied to hands at least 3 or 4 times per day to help repair the skin. There are many options for all budgets and a couple are available on the medical card. Your pharmacist can help you choose a suitable one.
Ideally choose a tube of emollient rather than a tub, as they are more hygienic. If your budget allows, a pump dispenser is easy to use and is also very hygenic. Some emollients come in 500g tubs which are better value for money and are available on the medical card. If using a tub, do not stick fingers in the tub. Take the emollient out with a clean utensil e.g., a spoon. You do not want to contaminate your cream with dirty fingers!
Keep the emollient in places you spend the most time
It is helpful to keep the emollient/moisturiser in the places you spend the most time – beside the sink to be applied after hand washing, beside the couch to be applied while watching TV, and beside the bed to apply at night before sleep.
Try to make applying emollients fun for children!
Try to make the time spent applying emollients fun for children, not a chore. Consider making a game out of the application. For example, put dots of cream on the hands and get your child to join the dots together by gently rubbing them and watch them disappear. If you put emollient on your own hands as well, you could have a competition to see who can make the dots disappear the fastest. Perhaps create a reward chart so that your child gets a star every time they put their cream on, or each time they make the dots disappear the quickest!
Another good way to moisturise the skin is by doing an emulsifying soak:
- Put 1 dessertspoon of emulsifying ointment into a jug and add boiling water to dissolve the ointment. Whisk with a fork until creamy. Pour the mixture into a basin of warm water and mix thoroughly. Check the temperature of the water before soaking the hands. You may want to set the basin up on a tableand turn on the TV to distract your child or turn on some music and get them to swish their hands in the emulsifying hand bath to the beat of the music. Make it feel like fun.
- Encourage your child to soak their hands in the basin for 5-7 minutes.
- Pat dry and whilst the skin is warm and slightly damp put another layer of emollient on. This will trap moisture in the skin.
Moisturising overnight & on weekends
Overnight moisturising treatments are beneficial, particularly if the hands are sore. Apply a generous layer of a greasy emollient just before bed. This may help to repair some of the dryness and cracks overnight and relieve any soreness.
Hand care can be time consuming when the hands are dry and cracked. Try to make time in the evening and the weekends to put the creams on. If permitted by the school put a small tube in the schoolbag. Frequent application helps to heal and repair the hands.
Consider applying a barrier cream to the hands to provide a protective barrier. These are sometimes referred to as liquid gloves. An example of this is Epi-Shield. If applied in the morning to the child’s hands, it will provide an additional protective barrier, and will last for 4 hours before needing to be reapplied. This product gives some protection against the irritants in the soaps and sanitisers. Your pharmacist may recommend other alternatives.
Hand sanitisers are another product recommended to clean the hands. Try to choose a gentle hand sanitiser that contains ingredients to destroy the coronavirus, but also contains ingredients like glycerol/ glycerine or aloe vera to counteract the drying effects of the sanitiser. Talk to your pharmacist regarding gentle products that may be available. Dermatology clinics frequently suggest Ovelle hand sanitiser gel or La Roche Posay purifying hand gel as skin friendly options.
Talk to your GP
If the skin is painful, sore, and cracked you may need to see a GP to get a prescribed treatment to settle the inflammation. The Irish Skin Foundation Helpline can guide you on the use of any treatment prescribed.
For more information watch our video on emollient therapy
If you need guidance or support about managing a skin disorder, contact the ISF Helpline for free assistance and information.