PPE and hand washing causing ‘spike’ in dermatitis among healthcare workers

Nearly six out of 10 healthcare workers (59%) seen in occupational skin disease clinics set up during the Covid-19 pandemic were found to be affected by irritant contact dermatitis caused by the wearing on personal protective equipment (PPE) and constant hand disinfection, research has suggested.

A study presented to the virtual annual general meeting of the British Association of Dermatologists (BAD)  concluded increased use of PPE and frequent hand cleansing had led to a spike of skin irritation amongst healthcare workers around the world, particularly those on the frontline of the pandemic.

Members of the British Society of Cutaneous Allergy (BSCA) conducted an audit of 200 hospital-based healthcare workers attending clinics for those with occupational skin disease in the UK and Ireland to describe the features of occupational skin disease during the Covid-19 pandemic.

On average, the healthcare workers washed their hands with soap 22.8 times per day and used alcohol hand gel 22.7 times per day. A total of 18% required time off work as a result of occupational skin problems, representing a significant burden on the health service during an extremely difficult time, the society argued.

The duration for which PPE was worn, frequency of handwashing and use of alcohol hand gel were all found to have an impact on the time off work required. Longer PPE duration during a shift and more frequent handwashing tended to increase the amount of time off, while using alcohol gel did not, it found.

Almost all the skin problems affected the face and hands. The second most common diagnosis seen in the audit was acne, caused by the occlusive effects of prolonged mask wear, and seen in 15% of healthcare workers. Pressure injuries related to mask wear were seen in 5% of subjects.

Dr Isha Narang, lead researcher of the study and registrar at University Hospitals of Derby and Burton NHS Foundation, said: “Wearing PPE for long periods can cause pressure and irritant effects on the skin and frequent handwashing with soap is drying; sometimes the effects can be bad enough to require time off work. As PPE and handwashing are essential methods of reducing the spread of Covid-19, it is important to provide healthcare workers with advice and support in managing their skin.”

Holly Barber, a spokesperson for the BAD, added: “PPE and frequent handwashing are essential for healthcare workers during the Covid-19 pandemic, however, the resulting skin irritation can cause enormous problems at work. Many members of the public will also have been affected by frequent handwashing, but this audit does give an indication of the spectrum of the issue for healthcare workers.”

The BSCA has published an update on occupational skin disease with the BAD.