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Compromised Skin Conditions

The flip-side of intense hand hygiene guidelines – Dry skin and hand eczema

National Infection Hygiene guidelines recommend hand washing with detergents and/or use of disinfectants to prevent transmission of microorganisms. *13 However, frequent hand washing may lead to impairment of skin barrier functions and development of hand eczema (HE) due to the irritant effects of water and detergents. *1316 Also, a recent published study explores and documents the irritant effect of alcohol based hand rubs (ABHR) on wet skin. *17 Further, when ABHR are applied on HE or damaged skin, the alcohol penetrates the disrupted skin barrier and causes a sensation of burning and stinging, which is anticipated to influence compliance with hand disinfection in a negative direction. *18,19

The prevalence of HE in the general population is around 10% and even higher among health care workers (HCWs) with a 1-year prevalence of 21% in Denmark and Sweden.  *20,21 The most common subtype of HE is irritant contact dermatitis on the hands. This subtype is primarily due to wet work. *22,23

Eczematous hands are often inflamed, itchy, and at high risk of acquiring pathogenic biofilm infections. In fact, almost 70% of all HE patients are colonized with Staphylococcus aureus. *25

HCWs with HE cannot comply with hand hygiene practices sufficiently. This increases the transmission of pathogens to patients and the prevalence of healthcare-associated infections (HAIs). *24