Our hands are the most used part of our body and many a times also the most abused. The current scenario of the pandemic is making it even more difficult . The increased frequency of hand washing, repeated use of sanitizers and prolonged duration of working with soap and water for most of us has made our hands susceptible to damage which in turn may crop up as problems like fissures or dermatitis. This would adversely hamper the quality of living for those affected. Let us try to understand the cause, presentations and the various ways to resolve / prevent it .
Causes:
1) Soaps: The pH of the skin is normally acidic, whereas soap bar or liquid soap are alkaline in nature. On washing our hands with soap, the pH of the skin increases but normalises back due to the buffering capacity of the skin. However on repeated hand washing the pH alters drastically and makes the skin susceptible for irritation and allergies.
2) Water: even in the absence of soaps/detergents, water can dry our skin by removing the protective fatty layer present on it.
3) Sanitizers: most commercially available ones contain alcohol which can also remove the fats on the skin.
4) Others: friction (during the course of washing and cleaning in our homes ,due to the physical nature of the work there would be pressure and strain on the skin), food ( vegetables etc. can cause irritation in certain individuals).
Presentation:
Individuals can have varying clinical presentations of hand dermatitis depending on the nature of insult. People with atopic dermatitis (dry and sensitive skin) tend to show a much severe reaction compared to the rest of the population. Other risk factors include housewives, healthcare professionals etc.
Symptoms like itching, burning sensation/stinging after contact with the offending agents and skin changes like redness, scaling, fissuring, thickening of the skin, oozing etc. is often seen.
Prevention:
It is vital to identify the early signs and correct the hand care practices, as most often these irritant/allergic reactions of the hands tend to be resistant and recurrent once they set in .
1) Judicious hand washing: It is important not to overdo this practise as it is seen that washing hands more than 20 times a day or contact with water for more than 2 hours/day can put one at risk for hand dermatitis. So within the home environment be mindful of this practice. Also using a gentle soap (acidic pH, mildly fragrant with minimal or no dyes, SLS free) would be the best bet. Avoiding antibacterial soaps/cleansers is beneficial too.
2) Moisturiser: Immediately after patting the skin dry, moisturising the hands further prevents dryness of skin. Use any of the following for the same. a) Oils: cold pressed, cooking grade oils like coconut oil, groundnut oil etc. are best suited when working in the kitchen or even otherwise. Use it as frequently as possible .b) creams/lotions: commercially available ones or the ones made at home using Shea butter/coco butter etc. work well to hydrate the skin. Again avoid preparations which are very fragrant or contain chemicals like parabens etc. c) Petroleum jelly: is an occlusive agent and acts as a barrier cream. For very severe cases, use of this jelly overnight along with a pair of cotton gloves can restore the damage.
Gloves: Use of gloves is especially recommended for individuals with sensitive skin or if the duration of water/soap exposure is more than 2 hours/day. It is beneficial to use 2 gloves simultaneously, a) an inner cotton glove that would absorb the sweat during the process and b) an outer waterproof glove (rubber, latex, plastic ) which would act as a protective agent against the water and soap.
In conclusion, proper hand care practices when followed judiciously go a long way in maintaining the health of the skin which in turn improves the overall functioning of our hands.
Consultant Dermatologist
Eyedentity