Effect of hand hygiene regimens on skin condition in health care workers

Abstract

Frequent, repetitive exposure to hand cleansers can negatively impact the skin, particularly the protective stratum corneum (SC). We investigated the effects of synergistic test products (TP) and current products (CP) among health care workers (HCWs) during spring and winter. TP and CP were significantly different in quantitative measures of skin condition. TP resulted in improved condition versus CP at times during both trials. Compared with non-HCW control subjects, HCW hand skin was appreciably compromised. The skin was damaged at the start of a work cycle, suggesting that the SC damage did not recover during time off. In general, the skin was in poorer condition (higher grades) for CP at the end of a cycle than the start during both trials. The dryness scores were often lower for TP at the end of the cycle, suggesting an improvement in skin condition. During some winter cycles, the skin remained unchanged for TP and worsened for CP. For others, the skin improved with TP and was unchanged with CP. Dryness tended to decrease (improve) and erythema increased for TP. Overall, the use of TP consistently resulted in higher skin hydration compared with CP, indicating that product composition can significantly influence HCW skin condition. Regimens that minimize skin damage can improve condition while achieving skin disinfection. The findings emphasize the importance of providing hand hygiene products to minimize irritant dermatitis and maintain an effective skin barrier. Use of such products is expected to substantially impact and increase hand hygiene compliance.