Excessive Hand Washing Linked to Hand Dermatitis

A study, conducted in collaboration with the National Institute of Occupational Safety and Health (NIOSH) and the American Academy of Dermatology, focused on 100 health care workers in Cleveland who washed their hands at least eight times daily. Participants completed questionnaires identifying the frequency of hand washing, family history of dermatitis, and medical condition history. Researchers used patch tests to determine how easily detergents irritated the participants’ skin and to predict which patients were at risk for hand dermatitis.

Susan T. Nedorost, dermatologist and associate professor of dermatology at University Hospitals Case Medical Center in Cleveland, revealed the link between frequent hand washing and hand dermatitis among health care workers at the 66th Annual Meeting of the American Academy of Dermatology in San Antonio.

“Our findings confirm that health care workers who wash their hands repeatedly are at an increased risk of developing hand dermatitis, which can take months to heal,” Nedorost said. “This knowledge can help workers at risk for the condition to practice good hand care and follow preventative tips to decrease their risk factors on the job.”

A total of 63 percent of the study participants contracted hand dermatitis, including 22 percent who washed their hands more than 10 times daily. Thirteen percent of health care workers who washed their hands less than 10 times per day developed hand dermatitis. Using alcohol-based cleansers or gloves did not appear to influence the development of the disease.

Since maintaining good hand hygiene at work must remain a priority for health care employees, Nedorost offered some tips to prevent hand dermatitis:

• Wear cotton gloves under rubber or vinyl gloves when performing wet work to prevent perspiration from dampening the skin. Change cotton gloves frequently during prolonged wet work periods.
• Substitute alcohol-based cleansers for hand washing when possible. Most workers tolerate these cleansers better, but may experience temporary stinging when the solution comes into contact with skin cracks.
• Apply a cream or ointment-based emollient immediately after water exposure, and before the skin is completely dry, to help prevent rapid drying and cracking.
• Do not use topical steroids as a long-term substitute for emollients. Evidence suggests chronic topical steroid use can increase bruising and tearing, thin the skin and reduce the skin’s ability to tolerate irritants.

“Patients should consult a dermatologist for the proper treatment of hand dermatitis, particularly those who suspect their work environment may be the culprit,” Nedorost said.