COVID-19 hand hygiene measures for health care workers

As the COVID-19 pandemic is still developing, it is becoming more and more evident that currently recommended hand hygiene measures to limit the spread of the virus should be respected whenever and wherever possible. Different health authorities worldwide recommend frequent hand washing with soap or similar detergents and water, the use of alcohol-based hand sanitizers (ABHS) and wearing of protective gloves and face masks. Even though these hygiene measures are recognised as being effective, intensive hand cleansing and disinfection, as well as the use of protective gloves, have been reported to cause adverse reactions on hands more and more frequently. Therefore, taking care of the hands is of the greatest importance for all health care workers (HCW).

We performed a literature search in Pubmed and on health authority websites for the most recent reports on hand skin damage following the frequent use of water and detergents or ABHS or from wearing protective gloves before and after the onset of the COVID-19 pandemic, hand skin damage related to COVID-19 pathophysiology, as well as recommendations regarding prevention and care.

To date, more than 10 countries worldwide have published guidelines and recommendations for the prevention and treatment of hand skin lesions caused by frequent hand hygiene. Overall, HCW should avoid harsh washing with overly hot water, and prioritise the use of hypoallergenic foam cleansers or syndets with a pH of 5.5, which do not contain fragrances or antibacterial agents. After washing, hands should be gently dried. The use of gloves should preferably be limited to specific tasks, and after taken off, hands should be washed and dried gently. Specific dermocosmetics are internationally recommended to restore or prevent alteration of the skin barrier due to frequent hand washing, the use of ABHS, and wearing of protective gloves. Fragrance-free, water-rich emollients or moisturizers with a pH of 5.5 should be used preferentially as often as possible