What to Do if Your Hands Get Irritated from All the Hand Washing

The top layer of your skin is known as the ‘epidermal barrier’ and it is formed of skin cells called keratinoctyes that are stuck together by a mixture of ceramides, free fatty acids and cholesterol known as the ‘lipid matrix.’ You can think of the epidermal barrier as a brick wall that does not allow irritants from the outside world to penetrate the skin (and therefore in theory enter the body) but it also stops water from leaving the second layer of the skin called the dermis. Water in the dermis is crucial to maintaining the structure and function of the skin.

Epidermal barrier impairment or dysfunction - when the brick wall starts to fall apart - is now considered to be the key underlying problem for a number of skin conditions.If the epidermal barrier does not work as well as it should, irritants can enter the skin and lots of water leaves the dermis. The combination of these two things leads to skin inflammation, irritation and dry and itchy skin.
We call this eczema or dermatitis.

One of the major extrinsic (external) causes of epidermal barrier dysfunction is lots of handwashing with soap and water and the use of alcohol gel hand sanitiser. So the current advice to wash your hands for at least 20 seconds multiple times a day is a serious problem for people who already suffer from hand eczema or other skin conditions affecting the hand (like psoriasis) or for those prone to this type of problem.Everyone can develop hand dermatitis from washing their hands frequently, especially during the colder months. Having dry, cracked, broken skin on your hands is uncomfortable and unsightly and also makes it difficult to clean your hands thoroughly.

So how can you follow the advice with regards to hand washing while protecting your hands at the same time? The first thing to do is to use a skin-friendly hand cleanser. As a dermatological surgeon, I wash my hands constantly so in order to protect my hands I wash them with Dermol Lotion or Cream which is a handwash made with benzalkonium chloride an an antimicrobial and an emollient to leave a protective barrier on the skin surface. Because it is not a soap it has to have an antimicrobial in it to be an effective anti-viral handwash and it is powerful enough to be used to scrub before surgery. It does not foam or lather but it still does a great job of cleaning your hands without completely drying them out. Dermol lotion and cream are readily available online and at pharmacies without a prescription. I try to actively avoid using alcohol gel because it does make my hands extremely dry.

If you can’t get an emollient handwash like Dermol Lotion then your next best step is to regularly moisturise your hands after washing them. This can be challenging though because when you apply moisturiser your hands become greasy and it can be hard to go about your regular activities like using your phone or typing on a computer. If using a moisturiser regularly on your hands during the day isn’t going to work for you, then try using a thick greasy moisturier under cotton gloves at night. Any moisturiser will do the trick - even something as basic as vaseline - because all you are trying to do is stop water loss from the dermis by creating a protective film across the top of the skin.

With a few simple steps - like switching out your soap for a more ‘skin-friendly’ alternative and using a greasy moisturiser at night - you can comply with the 20 second frequent handwash guideline while looking after your skin. If you have a pre-existing skin condition affecting your hands and you are worried about how washing your hands frequently will affect your skin condition, speak to your