Lavado de manos en Covid19

Hand Hygiene During COVID-19

Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• Hand hygiene products fall into the categories of soap (a fatty acid salt with cleansing properties and a pH between 9 and10), synthetic detergents, antiseptic cleansers, and alcohol-based hand sanitizers. Detergents are the harshest on skin barrier function, eroding the lipid barrier of the stratum corneum and leading to increased transepidermal water loss and penetration of irritants and allergens. Alcohol-based hand sanitizers have fewer lipid-dissolving effects. The temperature of water used for cleansing does not affect microbe removal, so use cold or lukewarm water to prevent skin irritation. Use moisturizer devoid of common allergens and fragrance after washing. Avoid donning gloves when hands are still wet, as this potentially traps irritating ingredients on the skin.

• Hand hygiene is essential for reducing SARS-CoV-2 transmission, but its increase may also lead to elevated incidence of irritant and allergic contact dermatitis. Alcohol-based hand sanitizers with moisturizers have the least sensitizing and irritancy potential compared with soaps and synthetic detergents.

– Margaret Hammond, MD

Dr. Rundle and colleagues have provided a succinct, precise, and eminently clear summary/insight in a timely manner that addresses an important matter on what we know about hand hygiene, as related to COVID-19, but probably also to the rest of all of our professional careers. The interventions are clearly stated, as are the potential complications and best practices. We suspect that this will be duplicated and posted in many a medical facility.

COVID, as clearly suggested in this publication, offers us an opportunity to not only deal with COVID, but with many other dermatologic infections that, in spite of excellent therapeutics, remain incompletely understood. Hence, insights into the COVID-related issues might bear fruit in preventing, and perhaps improving, therapeutics in other skin infections.

COVID provides us the motivation and opportunity for additional research, because of great international clinical interest as well as funding. Questions include: What determines whether a virus will become a resident organism, and what is its natural life on any part of the skin—hands as well as face?

Are there wash times and circumstances that might increase adherence, rather than decrease it, as is the case in which water can increase percutaneous penetration of many chemicals.

What are the natural substances within the skin, as noted in research dating back over half a century, such as peptides that control decrease or increase of survival of viruses on skin? Where does glove occlusion fit into this scenario, and should there be recommendations as to the number of hours that a glove is used, and a rest period? What are the factors that increase or inhibit transfer from the hands to the face, and from hard surfaces to the hands and face?

Taken together, we hope that Rundle and colleagues will be widely read, and that they will be a part of the stimulus to better understand the complexities of skin biology.

Abstract

The recent coronavirus 2019 (COVID-19) pandemic has resulted in increased hand hygiene and hand cleansing awareness. To prevent virus transmission, the Center for Disease Control (CDC) recommends frequent hand washing with soap and water. Hand hygiene products are available in a variety of forms and while each of these formulations may be effective against COVID-19, they may also alter skin barrier integrity and function. As health care workers and the general population focus on stringent hand hygiene, the American Contact Dermatitis Society (ACDS) anticipates an increase in both irritant contact and allergic contact hand dermatitis. Alcohol-based hand sanitizers with moisturizers have the least sensitizing and irritancy potential when compared to soaps and synthetic detergents. This article provides an overview of the most frequently used hand hygiene products and their associations with contact dermatitis as well as recommendations from the ACDS on how to treat and prevent further dermatitis.

Journal of the American Academy of Dermatology

Hand Hygiene During COVID-19: Recommendations From the American Contact Dermatitis Society

J Am Acad Dermatol 2020 Jul 21;[EPub Ahead of Print], CW Rundle, CL Presley, M Militello, C Barber, DL Powell, SE Jacob, AR Atwater, KL Watsky, J Yu, CA Dunnick

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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