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Hand washing and eczema

***Important advice about hand washing during the Coronavirus pandemic from Dermatologist Professor Sara Brown***

 “I wanted to highlight that washing hands with emollients or soap subs is not effective against Covid-19 so even eczema patients should use soap and then afterwards apply emollient.

 “Covid-19 virus has a lipid outer coat (a layer made of fats) so it’s killed by soap or detergent because that disrupts the fat – like washing up liquid lifts grease off plates – so you need soap or detergent when hand washing.

 “Alcohol in sufficient concentration also disrupts the viral coat, but it stings on any breaks in the skin & when hands are visibly dirty you need soap/detergent.

 “You should also be prepared to step up steroid use on hands.

“Please emphasise this is for hand-washing for the hygiene recommendations … you should continue to bathe in soap substitute to avoid a flare of eczema all over!”

– Dr Sara Brown, Professor of Molecular and Genetic Dermatology, Wellcome Trust Senior Research Fellow, University of Dundee

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Sensitive skin often doesn’t take kindly to regular hand washing and sanitizing. Both hand soap and alcohol, the active ingredient in sanitizers, strip the natural oils from the skin’s surface along with the dirt.

It doesn’t take long for sensitive skin to become dry, sore and prone to cracking. We share our top tips and strategies for keeping little (and not so little) hands intact and hygienic.

Our tops tips for keeping eczema-prone hands clean and healthy

  • Look at the soap you are using and check that it is low pH and free from common irritants (more on this below).
  • Take soap with you so you can wash your hands when you’re away from home. We find that hard soaps are easier to transport and less prone to spillages then liquid soap. Do make sure you keep the outside of the container clean – wash the box or bottle at the same time as you wash your hands.
  • Make sure all traces of soap are rinsed away before drying hands thoroughly.
  • Avoid over drying with hot hand air-dryers.
  • Pat skin dry with a clean towel.
  • Consider investing in a micro-fibre towel as they tend to be kinder on the skin than regular towels.
  • Find a sanitizer with added moisturizer for the times you can’t get to a sink to wash your hands (more below).
  • Leave emollient or hand cream by the sink so you are reminded to moisturise every time hands are washed.
  • Dry hands may need a more greasy emollient, with a higher lipid content, than you need for the rest of the body. Your GP may be able to prescribe an ointment especially for use on the hands. We love the Body Shop Hemp Hand Protector.
  • Invest in travel-sized hand cream to use when you are away from home. As with soap containers, make sure you keep the outside of the tube clean.
  • Moisturize your hands over-night by smothering them in emollient and covering them in a pair of cotton socks to keep the cream in place. If your little one won’t keep socks over their hands consider using ScratchSleeves instead.

Which soaps are best for eczema prone hands?

Hand washing and eczema

Leave emollient or hand cream by the sink so you are reminded to moisturise every time hands are washed.

As with all things eczema related, finding a soap that works for you and your family is a case of trial and error.

Soaps and hand cleansers come in a variety of forms – understanding the differences between these different types can really help when you’re standing in front of the bewildering array of options on the supermarket shelves.

Hard soaps:

Traditional soap bars are typically based on plant or animal fats have a reputation for being hard on the skin. Many popular brands of hard soap have a high pH level, which can be very drying.

However, there are many hard soaps with much lower pH levels and much reduced or even negligible drying effects. Vanicream and Avene bars both have a pH only just above that of the skin and are designed specifically for sensitive skin.

But beware of marketing hype, Johnson’s Baby Soap – which you would think would be gentle on the skin – has a pH of 11.9. You can find a list of popular soap brands with their pH values here.

Look out for transparent glycerin soap bars. These typically have lower pH levels and contain lots of moisturizing glycerin which helps restore the skin’s natural oils. This was my soap of choice when I was growing up but it’s much harder to get hold of these days. Alternatively, check our our blog on how to make your own eczema friendly soap.

Liquid soap:

Liquid soaps typically have lower pH levels than soap bars, so are usually seen as being kinder on the skin than hard soaps.

However, they often contain irritating ingredients including sodium laureth sulphate (SLS), parabens and methylchloroisothiazolinone (MCI), all of which are common triggers for eczema flare-ups.

A study comparing 50 popular hard soaps with 50 liquid soaps and body washes found that liquid soaps contained much higher proportions of irritating preservatives and foaming agents than hard soap(1).

That said, liquid soaps designed especially for sensitive and dry skin, usually exclude these damaging ingredients and can also contain moisturizers which counter the drying nature of the detergent element. We love the Child’s Farm and Faith in Nature ranges.

Foaming hand wash:

Foaming hand wash is the biggest culprit for eczema flare-ups on our family’s hands. The foaming agents are usually SLS, which is a common eczema trigger.

The foaming hand wash also contains alcohol, which is great for killing germs but also strips away the skin’s natural acid mantle, dehydrating cells and leave the skin more vulnerable to attack from irritants, allergens, bacteria, and viruses.

A study published in 2003 found that doctors who were using alcohol-based cleansers to get germs off their hands had low levels “barrier lipids” (healthy fats in the skin) in their hands which caused the skin to lose moisture and hydration(2).

Evidence showed that foaming liquid hand wash was the major offender and that replacing it with alcohol-free alternatives reduced hand problems among hospital staff.

Hand sanitizers:

Hand sanitizers can be particularly hard on the skin. Soap and water kill and flush germs from the skin. Hand sanitisers work by sitting on skin and killing germs on contact. But they only work if they contain enough alcohol to kill the germs—at least 60 per cent.

Once you apply the alcohol, it begins to evaporate, it’s this evaporation kills the germs. If you rub off the sanitizer before it fully evaporates, you’re actually reducing its effectiveness.

As with the foaming handwashes, the alcohol in sanitisers can disrupt the natural barrier function, reducing skin’s ability to protect itself, and leading to increased dehydration. Again, as with foaming handwashes, many sanitizers also contain irritating SLS.

There are hand sanitizers available designed to minimise the drying effect. These sanitizers have added moisturising ingredients such as glycerin and Aloe vera which will counter the drying effect of the alcohol.

We are using the mini Carex Mr Men Fun Edition at the moment, with minimal side effects. However, given that sanitisers aren’t as effective as soap and water, it makes sense to only use them if washing with soap and water isn’t practical. Also, check out our blog on how to make handwashing a fun activity for kids.

So in conclusion:

  • Use hard soaps wherever possible, with glycerine ideally
  • Dry hands extra carefully
  • Moisturise, moisturise, moisturise!!!

Our references:

(1) Comparison of Contact Allergens in Bar Soaps and Liquid Body Washes. JA Siegel, JS Mounessa, RP Dellavalle, CA. Dermatitis: January/February 2018 – Volume 29 – Issue 1 – p 51-53

(2) Hand hygiene and skin health. E Kownatzki Journal of Hospital Infections. 2003 Dec;55(4):239-45.

 

Here at ScratchSleeves, we don’t just share our experiences of bringing up an eczema child (and favourite allergy-friendly recipes), we also manufacture and sell our unique stay-on scratch mitts and PJs for itchy babies, toddlers and children. We now stock sizes from 0-16 years in a range of colours. Visit our main website for more information.

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