Frequent Hand Washing Increases Contact Dermatitis in Health Care Workers

Are health care workers at an increased risk of developing contact dermatitis due to frequent hand washing? According to Wikipedia.org, contact dermatitis is a term for a skin reaction resulting from exposure to allergens (allergic contact dermatitis) or irritants (irritant contact dermatitis). It is a common skin condition causing redness, itching, and a burning sensation due to exposure of a substance on the skin. And according to a study from the University Hospital Case Medical Center in Cleveland, Ohio frequent hand washing by health care workers may actually be counterproductive, causing contact dermatitis.

The study was based on 111 health care workers in which 58% developed contact dermatitis with hand soap, but when using an alcohol based solution there was no association with contact dermatitis. All the health care workers were asked to fill out a questionnaire about personal medical and family histories including any previous history of allergies. They were also asked to the frequency of hand washing and or use of hand sanitizers. And among these health care workers those who washed their hands more than 8-10 times per day were more likely to develop contact dermatitis than those who washed less frequently.

There are millions of health care workers in the United States where repeated hand washing is taught and is a crucial component to good hygiene. However with the prevalence of developing contact dermatitis other issues may also arise. With contact dermatitis the top layer of the skin cracks due to the frequency of wetting and drying and this then can develop into itching with a burning sensation which may potentially make an opportunity to let bacteria in. In doing so the health care worker may develop worsening symptoms due to inflammation and may even develop an infection. Prevention and education is the only key element in avoiding this skin condition.

In order to prevent contact dermatitis health care workers should use alcohol based hand cleansers instead of hand soap when appropriate, and cotton gloves should be worn under the gloves to prevent perspiration and to avoid a moist environment. And if there is no alternative other than frequent hand washing then a hand cream or emollient should be utilized immediately after washing before the skin is completely dry. The goal in using these tips is to prevent the skin from drying and chafing and to prevent worsening of symptoms.

If contact dermatitis is suspected then the health care worker should immediately notify the person in charge so it may be documented as an occupational or work related exposure and then the health care worker should be evaluated by a health care provider for the proper treatment and recommendations.

Resources:

http://www.medscape.com/viewarticle/569856_print
http://www.sciencecentric.com/news/08020319.htm