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  • Salil Shukla

SKIN REACTIONS RELATED TO HAND HYGIENE

Proper hand-washing is one of the best ways to prevent spreading viruses, like the new coronavirus (COVID-19) and the flu. But when you have a skin condition like eczema (atopic dermatitis or dyshidrotic eczema), washing your hands often can lead to dry and cracked skin, itchiness, pain and possibly infection. Also if you don’t even have any kind of previous history of any skin allergy, the continuous use of sanitizers and detergents is increasing allergic reactions in skin.



It’s possible to be allergic to the ingredients in hand sanitizer. And using too much sanitizer, or the wrong kind, can ruin your skin. Reports from people have been received who have developed rashes and other symptoms after contact with hand sanitizers, which are now widely used - and legally enforced - at stores and workplaces. In fact some may develop severe respiratory distress or hay fever like symptoms due to allergic reactions to ingredients of sanitizers.

Allergic reactions may be caused by compounds that can be present as inactive ingredients in alcohol-based hand sanitizers. Other allergens in the hand sanitizer include the antiseptic agent chlorhexidine, the fragrance used to make the sanitizer smell nice, and the dye used to color it. Any one of them might be causing a reaction.

There are two major types of skin reactions associated with hand hygiene.

The first and most common type includes symptoms that can vary from quite mild to debilitating, including dryness, irritation, itching, and even cracking and bleeding. This array of symptoms is referred to as irritant contact dermatitis.

The second type of skin reaction, allergic contact dermatitis, is rare and represents an allergy to some ingredient in a hand hygiene product. Symptoms of allergic contact dermatitis can also range from mild and localized to severe and generalized. In its most serious form, allergic contact dermatitis may be associated with respiratory distress and other symptoms of anaphylaxis. Therefore it is sometimes difficult to differentiate between the two conditions.

Symptoms


People who get rashes from repetitive hand-washing may experience symptoms of redness, flaking, blister formation, cracking, and chronic skin thickening. Pain and itching may also occur.

These skin changes usually occur on the back of the hands as well as the spaces between the fingers. The skin on the palms is much thicker and therefore more resistant to irritants and allergic rashes.

These hand rashes may occur throughout the year, but are worse during the dry, cold winter months, possibly as a result of warm or hot water being used, which contributes to the irritant effect on the skin.

Another form of eczema that may worsen with hand washing is dyshidrotic eczema (or pompholyx) which occurs on the palms and fingers and can be related to allergies or stress. Dyshidrotic eczema often has the classic finding of small bumps and blisters along the sides of the fingers, as well as the palms, which resembles tapioca pudding.

Lifestyle and home remedies

To help reduce itching and soothe inflamed skin, try these self-care approaches:

  • Avoid the irritant or allergen. The key to this is identifying what's causing your rash and staying away from it. Your doctor may give you a list of products that typically contain the substance that affects you. Also ask for a list of products that are free of the substance that affects you.

  • Apply an anti-itch cream or lotion to the affected area. A nonprescription cream containing at least 1 percent hydrocortisone can temporarily relieve your itch. try calamine lotion.

  • Take an oral anti-itch drug. A nonprescription oral corticosteroid or antihistamine may be helpful if your itching is severe.

  • Apply cool, wet compresses. Moisten soft washcloths and hold them against the rash to soothe your skin for 15 to 30 minutes. Repeat several times a day.

  • Avoid scratching. Trim your nails. If you can't keep from scratching an itchy area, cover it with a dressing.

  • Soak in a comfortably cool bath. Sprinkle the water with baking soda or an oatmeal-based bath product.

  • Protect your hands. Rinse and dry hands well and gently after washing. Use moisturizers throughout the day. And choose gloves based on what you're protecting your hands from. For example, plastic gloves lined with cotton are good if your hands are often wet.

How to make your own hand sanitizer

Mixing the alcohol with other ingredients such as aloe vera and essential oils makes the solution more soothing, but remember that you’re diluting the mixture, so be careful to follow the recipe and keep the proportion of ingredients the same. The recipe below ensures that you end up with at least the required 60% alcohol content.

Ingredients:

  • Rubbing alcohol with 91% or higher concentration in alcohol

  • Aloe vera gel (you can purchase it or make it yourself)

  • Essential oil (optional)

Take 2/3 cup of the rubbing alcohol and combine it with 1/3 cup of the aloe vera gel. Add a few drops of the essential oil if desired.

There are other natural options for cleaning hands on the go — and many of them you can make yourself, using ingredients you already have in your kitchen. But remember that these are not recommended by the CDC as they do not have the required 60% alcohol content.

Plain vinegar The sanitizer: 5% solution of white vinegar. This is the concentration in most bottles from the grocery store. Vinegar is an antibacterial agent that kills 99% of bacteria. It's also nontoxic, nonpolluting, and edible.

How to use: Keep in a small spray bottle in your bag. Spray on hands so the entire surface of hands is wet. Rub all over, then wipe or shake dry.

Hydrogen peroxide The sanitizer: 3% solution hydrogen peroxide.

How it works: When hydrogen peroxide comes in contact with bacteria, it oxidizes, causing the bacteria to decompose.

How to use: Keep a small, dark-colored spray bottle in your bag (exposing it to light will cause it to oxidize). Spray on hands and allow to foam. Wipe or shake dry.

Tea tree oil The sanitizer: 10 drops of tea tree essential oil and 1 teaspoon castile soap in 6 ounces water.

How it works: Tea tree oil is antibacterial, antiviral, anti-fungal, and anti-inflammatory. The castile soap functions as a surfactant to dissolve the oil.

How to use: Keep in a spray bottle and spray on hands, then shake dry.

Gel essential oil sanitizer The sanitizer: 5 ounces aloe vera gel; 1 ounce witch hazel; 8 to 10 drops of any antimicrobial essential oil.

How it works: The essential oils do the cleaning, and the higher concentration of aloe vera gel gives this sanitizer the same gel consistency as commercial sanitizers.

How to use: Put in a squeeze bottle. Squeeze a few drops onto hands and rub all over hands until dry.

MYTHS & FACTS RELATED TO HAND SANITIZERS

Myth- hand sanitizers can cause antibiotic resistance.

The truth is that antibiotics are ingested, and they operate completely differently than alcohol-based hand sanitizers. The alcohol quickly kills a broad spectrum of germs, and it is not left behind on your skin to let the germs become resistant.

According to the Centers for Disease Control and Prevention, the primary cause of antibiotic resistance is the repeated and improper use of antibiotics.

Myth- hand sanitizer is the no 1 solution to keep germs at bay

The truth is soap & water is the best solution. Rubbing your hands with soap for 30 sec is the best solution. Its just little bottle of sanitizer is easy to carry, use it only when you have no access to soap & water.

Myth- as long as I use sanitizer, I’m safe

Truth is sanitizers give people a false sense of security of being 100% disease free. Though its use is beneficial, it is not 100% protective. While buying a sanitizer, check if it contains triclosan, a powerful anti-bacterial agent used in pesticides. It is readily absorbed by the skin and can act on thyroid functioning, causing damage over the long term to liver and muscles. ). Also remember that sanitizers are inflammable and can burn near fire. You need to store them in air-tight bottles in cool and dry places.

Myth- dab of sanitizer obliterates Corona virus

Truth is using just a tiny drops of sanitizer is useless, one needs to squirt a copious amount, enough to fill palms. Aim should be to coat the hand to form a protective film.

Myth- washing facial masks with sanitizer is safe

Truth is washing facial mask or clothes with sanitizers could cause the vapors to get trapped in the fabric and fumes can cause nausea & vomiting.

DIET & REGIMEN – HELP IN DERMATITIS

A gluten-free diet is specifically recommended for recovery. The following dietary foods can be included to accelerate the recovery.

  • Banana: It is rich in potassium and contains histamine-lowering nutrients, magnesium, and vitamin C that help in healing.

  • Potato: It’s rich in fiber, potassium, and vitamin C and has alkalizing properties.

  • Green onions: It contains histamine-lowering, anti-inflammatory agents, and it’s a rich source of vitamin K, which is important for healthy skin.

  • Buckwheat: It is gluten-free millet and helps to lower the histamine levels, and it has a strong anti-inflammatory effect.

  • Drink plenty of water: Above all, drink plenty of water i.e. about 10-12 glasses/day should be the lower limit that should be reached to maintain your skin hydrated. Often, it has been found through the patient’s medical history that drinking less amount of water in itself is a cause for developing dry skin. This habit if continued will trigger dermatitis in prone individuals.

It is noted that stress and inadequate sleep might be a triggering factor. It is recommended that sleeping for at least 7 to 8 hours helps maintain the histamine levels which help in reducing inflammation and itching. Practice meditation and breathing exercises (Pranayam) which will help in alleviating stress.

Homeopathic remedies known to help treat dermatitis:

Sulphur- have a strong tendency to be scruffy. Even if they have just had a bath, they still manage to look unclean and may develop red, dry, flaking skin, which can itch and burn and is worse from washing

Graphites-crusty, moist, yellow and sticky lesions; especially forming in the folds of joints such as the elbows, knees or groin. The skin can become very dry, cracked, red, itchy and painful.


Petroleum- skin is extremely dry and tends to crack, especially on the fingertips and palms. itching is worse at night and from getting warm in bed. The skin is easily infected, and may get tough and leathery from chronic irritation.

Arsenicum album- The skin is dry, itches, and burns intensely. Scratching can make the itching worse, and applying heat will bring relief.

Mezereum- Intensely itching eruptions start as blisters, then ooze and form thick crusts, and scratching can lead to thickened skin. Cold applications often help the itch.

Rhus toxicodendron- has blister like eruptions that look red and swollen, itch intensely, and are soothed by hot applications may respond to this remedy.

Antimonium crudum- thick, cracked skin and are also prone to indigestion.

Calendula- irritated skin has a tendency to get infected. Topical use of the unpotentized herb in lotion, gel, or tincture form is soothing to irritated skin, and can often ease inflammation and prevent infection without artificially suppressing it.


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