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Compromised Skin Conditions

The downside of intense hand hygiene guidelines – dry skin and hand eczema

National infection hygiene guidelines recommend hand washing with detergents and/or the use of sanitisers to prevent the transmission of microorganisms. *13  However, frequent hand washing may lead to the impairment of skin barrier functions and the development of hand eczema (HE) due to the irritant effects of water and detergents. *1316 A recently published study explored and documented the irritant effect of alcohol-based handrubs (ABHR) on wet skin. *17 When ABHRs are applied to HE or damaged skin, the alcohol penetrates the disrupted skin barrier and causes a burning or stinging sensation, which is expected to negatively influence compliance with hand disinfection routines. *18,19

The prevalence of HE in the general population is around 10% and even higher among healthcare workers (HCWs), with a prevalence of 21% in Denmark and Sweden over the course of 1 year.  *20,21 The most common subtype of HE is irritant contact dermatitis of 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, nearly 70% of all HE patients are colonised with Staphylococcus aureus. *25

Healthcare workers with HE cannot adequately comply with hand hygiene routines. This increases the risk of transmission of pathogens to patients and the prevalence of healthcare associated infections (HAIs). *24